What is Fraxel Dual?

Question

What is the Difference Between Fraxel Restore and Fraxel Restore Dual?

Ron Shelton, MD · Answer

Solta, the company that makes Fraxel, has now made a two-in-one laser. The former Fraxel Re:store, good for fine lines, texture and dyschromia, is joined by a separate wavelenght, a 1927nm. specifically targeted in peeling away brown discoloration. Unlike the Re:store, there is definite down time for several days, looking unsightly before improvement occurs. This has just been offered on the market for physicians so there is minimal clinical information about its effectiveness and safety.

William Groff, DO · Answer

Fraxel Dual is an innovative laser device that combines two different wavelengths to address a broader range of skin concerns. The Erbium laser works deeper into the dermal tissue to stimulate collagen production and cell renewal. The Thulium laser is a superficial laser that works on pigmentation concerns without damaging surrounding skin and tissue. This device can be fully customized to the precise needs and goals of each patient for superior results. I advise you to work with an experienced, board-certified dermatologist with expertise in the Fraxel lasers to ensure an optimal outcome from your treatment.

Hooman Khorasani, MD · Answer

The Fraxel DUAL 1550/1927 is a cutting edge system that uses two lasers which can improve the appearance of your skin. The 1550nm wavelength improves fine lines and scarring, while the 1927nm improves pigmentation. 
The 1550nm penetrates deeper and you would expect more redness and swelling as a result.
As always, an in-person consultation with a board certified dermatologist with cosmetic training is the best way to assess your needs and provide medical advice.

Michael A. Persky, MD · Answer

Hi Sea,

	Fraxel restore is the original Fraxel laser product, a fractionated Erbium laser that works at 1550 nanometer wavelength. It is non-ablative, heats the skin in pixilated columns that results in collagen stimulation over time, resulting in improvement of fine to moderate lines and wrinkles, and improvement in skin pigmentation (as well as tone and texture). The older Fraxel restore required a series of treatments (4-6) separated by about 2 to 3 weeks. The Dual's 1550 has been modified to be faster, more effective, and more comfortable than the prior Fraxel re:store laser. Usually patients will require 3 instead of 4 treatments with this laser as compared to the previous version. It is also effective for the treatment of acne, traumatic, and surgical scars.

	Fraxel Dual laser adds another laser to the restore laser. The new wavelength is 1927 nanometers; it is a Thulium laser (say that a few times in a row). 1927nm is very specific and effective at treating brown pigment including sun damage lentigines (sun spots), aging spots, and studies are being conducted for the treatment of melasma. In a single treatment, remarkable clearance of pigment occurs within 7 to 10 days. The treatment is very tolerable, either with or without numbing cream. The face as well as the entire body can be treated. Unlike IPL treatments, usually 1 to 2 treatments are all that are necessary for fresh rosy skin.

	Patients also like the comfort, quickness, and uniform application of the laser.
	Solta, the company that makes Fraxel, will not be offering stand alone Fraxel restore units. They will only be selling the "Fraxel restore Dual". Another advantage of the Dual is that the two laser treatments can be combined at the same treatment session for those patients who desire a deeper treatment for collagen stimulation along with eradication of brown spots.

	We believe that Fraxel restore Dual will be a very popular treatment, especially here in California. Many of the first patients treated have been actresses, treating their face, chest, and hands. Patients are extremely happy and excited with their fresh new skin. The big question is how long will the results last? That will depend on the individual patient, their sun protection habits (including clothing, hats, physical sun block, etc.), and in melasma patients their hormone levels (which should be normal at the time of treatment).

	Good luck and be well.

	Dr. P

Ran Y. Rubinstein, MD · Answer

Fraxel Re:store can fall short in removing pigmentary problems such in patients with Melasma. The Dual addresses this by adding a second laser with a wavelength of 1927nm. This second laser is used at the same time as the Fraxel Re:store to better address the pigmentary problems.

	A way around this potential problem with Fraxel Re:store is to combine it with Nd:YAG laser or IPL photo facials or vascular lasers such KTP laser. These lasers are used just prior to the Fraxel treatment. By combining these two laser modalities similar effects as with combining the Fraxel Re:store Dual laser can be accomplished. The Fraxel Dual laser is pending FDA approval and its true value has yet to be determined pending more clinical experience.

Heidi A. Waldorf, MD · Answer

Fraxel devices are all fractionated resurfacing lasers.  That means they 'chop up' the pulses to leave a fraction of the skin untreated between the microthermal heating zones that are treated and the skin heals faster.  The difference amongst the devices is the wavelength of light used for the laser. The Fraxel Restore has only an erbium laser.  The Fraxel Dual contains both an erbium and a thulium.  The benefit of the thulium is for the removal of pigment. The erbium is better for deeper wrinkles or acne scars.  The two wavelengths can be used in combination or alone, on and off the face.

Tanya Kormeili, MD · Answer

Fraxel machines include one that helps with pigmentation and one that helps collagen problems such as fine lines, pores, scars etc.
You can always do both or the one you think you need. Keep in mind that if you have melisma or are of ethnic skin, you really need to choose carefully as it can be associated with discoloration.
Good luck!

Karen Beasley, MD · Answer

The Fraxel Restore Dual is a two-in-one laser that combines the original Restore erbium laser with a second thulium laser. The erbium laser is great for treating fine lines and wrinkles, skin texture, and acne scars, while the thulium laser is better suited for reducing brown pigmentation, such as sun damage and brown spots. With Fraxel Restore Dual, more skin concerns can be treated with a single device.

Brenda Dintiman, MD · Answer

I agree with the comments made distinguishing the Fraxel lasers.  I love Fraxel Dual for pigmentation and for freshening sun-damaged skin. Although there is definite redness and swelling on days 1 and 2, then on day day 3 the skin appears brown like your skin has been "overly tanned," then starts to flake off in small flakes day 4, 5 and 6. The results are soft, more even skin even after one treatment but you can definitely do more.  I like the results that I have seen with the 1927nm, Fraxel Dual.  You can still use the 1550 wave length to work on scarring and deeper wrinkles to continue the treatment process.

Meg Cherry, MD · Answer

Both the Fraxel dual and the Fraxel restore offer a deeply penetrating non-ablative fractionated wavelength. The dual also has an additional wavelength, 1927, which is more superficial and treats pigmentbas well as superficial fine lines. It is also FDA approved to treat the precancerous lesions actinic keratoses. The dual can be used just to treat deeper fine lines and wrinkles, just the superficial pigment, or both at the same time. It offers the ability to customize a treatment to the individuals need.