If you know of someone who has gotten Fraxel done in the past, you’re probably aware of the slight pain and significant downtime that comes with the treatment. Fraxel is a fractional laser that can be used for resurfacing and the rejuvenation and elimination of dark spots, and without the use of numbing cream, the treatment has a reputation for being rather uncomfortable.
According to Delray Beach, Florida, board-certified dermatologist Dr. Janet Allenby, Fraxel is the first effective device that introduced us to non-ablative resurfacing. “This type of resurfacing means you can traumatize deeper into the tissue,” she says. “What the laser’s looking for in the tissue is, in this case, water, [and] it causes a steam injury to the tissue, creating a deeper wound to the dermis and creating collagen build.”
Fraxel has two wavelength settings: 1550 nm and 1927 nm. “The 1550 nm is typically used for resurfacing procedures like acne scars, whereas the 1927 nm setting is used for dark spots from sun damage or melasma,” says NYC NYC board-certified dermatologist Dr. Hooman Khorasani. “The laser light penetrates the skin and creates columns of heat, which stimulates new collagen and elastin.”
According to Khorasani, most patients can tolerate the Fraxel laser well with topical numbing cream for one hour prior to the procedure, and depending on the wavelength and setting used, patients can expect up to five days of downtime. “Usually, peeling [and] redness are the worst on day three,” he says. Dr. Khorasani adds that response is best seen with a series of three to four treatments, about six weeks apart. However, multiple treatments of Fraxel aren’t necessary to see improvement in the skin. Patients often see a significant enhancement in skin texture and laxity after just one session.
Unfortunately, not all of us want to use our precious vacation days to hide at home and watch our face flake off for five days straight. In addition, Fraxel is not considered an entry-level laser, and not everyone might be eligible for treatment. Below, you’ll find five other treatments that can offer similar results to Fraxel—major discomfort, downtime, and peeling not included.
Related: The In-Office Treatment I Got at Age 40 Gave Me Skin So Even, I Can Now Skip Foundation
Clear + Brilliant
Often referred to as “baby Fraxel,” the Clear + Brilliant laser contains the same 1927 nm wavelength as Fraxel but is much less powerful because it doesn’t penetrate the skin as deeply. Clear + Brilliant works by making thousands of tiny micro injuries in the top layers of skin, triggering the body’s healing process and building new tissue. Used to treat fine lines and melasma, shrink pores, and improve skin tone and texture, the Clear + Brilliant laser offers more modest results and minimal downtime—only about a day or two of redness (if any at all)—compared to Fraxel. Plus results are shorter-lived, lasting only a few months, and require progressive treatments, whereas a single Fraxel treatment produces results that can last years. “This device can be likened to a facial, with improved skin texture and quality,” says Dr. Khorasani. “Most patients have this laser on a quarterly basis.”
Microneedling
Microneedling pens contain tiny needles encased in a pen-like structure and can be rolled or stamped onto the skin. “They are best for acne scars and other scarring and can be combined with platelet-rich plasma (PRP) to create the Vampire Facial,” says Dr. Khorasani. The treatment takes about 15 minutes and has about one to three days of downtime. In order to see the full benefits, it’s recommended to undergo three to five monthly treatments. New collagen production kicks in around four to six weeks after treatment, so results take a bit of time to become visible.
Radiofrequency (RF) microneedling
This treatment combines microneedling, a more superficial injury, with radiofrequency, which heats the lower layers of tissue and helps tighten the area by stimulating collagen production in the healing process. “This is best for crepey skin and for skin tightening, especially [in] areas around the eyes,” says Dr. Khorasani. After three to four sessions, you will see smoother fine lines and wrinkles as well as firmer, more even skin. However, the results are temporary and typically need follow-up treatments to maintain results.
Dr. Allenby specifically loves using Vivace on her patients. “I think the cool thing about Vivace is that you’re really not having [a lot of] downtime because you’re delivering the heat at different levels in the tissue,” she says. With Vivace, you can target vessels that are more superficial, since providers can choose to penetrate the skin at varying depths between 0.5 mm to 3.5 mm “so you’re not going to bleed and have that red [look] after deep microneedling,” explains Dr. Allenby. “You just look maybe pink at the most, and very rarely will somebody bruise [from the Vivace], because it’s coagulating those vessels when it’s hitting them.”
Related: Why the Plasma Pen Is So Divisive
Picosecond laser
Using controlled pulses of light, this laser specifically targets pigment in the skin, including ink pigments from tattoos. “Picosecond laser can be used as an alternative or adjunct to Fraxel 1927, since both target pigment,” says Dr. Khorasani. “It is commonly used to treat tattoos—often requiring many sessions, depending on [various] factors—and lentigines, or sunspots.” A Picosecond laser—like PicoSure—will help stimulate collagen and elastin production and can also help remove melasma and acne scars.
After the treatment, most patients will experience up to three hours of minor swelling and redness and feel like they’re suffering from a mild sunburn. They may also notice a slight bronzing of the skin, which can last up to 10 days. When getting treated for discoloration and skin rejuvenation with a picosecond laser, you’ll want to get a series of at least three treatments.
VBeam laser
If you suffer from visible blood vessels, broken capillaries, redness, rosacea, and telangiectasias (spider veins), the VBeam laser might be a good option. The VBeam pulsed dye laser uses laser energy to target the hemoglobin within damaged blood vessels and remove redness without damaging the surrounding tissue. “There is some skin texture improvement with this laser, but it’s modest—and [the laser] wouldn’t be used just for that purpose,” says Dr. Khorasani. While the VBeam is primarily used to treat vascular issues, added benefits include improvement in acne and acne scars, dark spots, stretch marks, hyperpigmentation, and fine wrinkles.
You’ll likely need a series of three to five sessions, spaced a month apart, to see the best results (which occur about six weeks post-treatment). The most common side effects include short-term swelling and redness, but downtime is minimal. You might experience slight bruising from VBeam, but it typically goes away within a few days.
