Fraxel Re:store or Fraxel Re:pair for Rosacea?

I am a 19-year-old white female who has tried everything from topical medication to oral antibiotics, microdermabrasions and chemical peels. Just recently heard about this Fraxel treatment and I'm wondering which version works best for rosacea?

Doctor Answers 4

Rosacea and Fraxel

There is no theoretical reason why Fraxel would help Rosacea. Acne Rosacea, consists of red bumps, pustules, increased capillary blood vessel formation in the surface skin and increased oil gland size which can thicken the nose. Not all of these features are seen in all patients with Rosacea. The bumps and pustules might flare with more aggressive laser resurfacing including Fraxel Re:pair and even the non-ablative Fraxel Re:store. The blood vessels do not tend to disappear with either of these lasers and can reform readily if they do. The V-beam 595 nm. laser is more effective to lessen the blood vessels. Rhinophyma, or the thickened oil glands, can lead to large bumps on the nose and thickening of the entire skin of the nose ( the W.C. Fields nose). Possibly Fraxel Re:pair may help shrink this thickening, and even multiple Fraxel Re:store treatments, but flares of Rosacea papules (bumps) and pustules may be induced during the healing.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Fraxel for Rosacea

Both Fraxel Restore (Erbium glass fractionated laser) and Fraxel Repair (fractionated CO2) laser target water in the skin (water is the target chromophore). Because rosacea is a vascular (red) problem, lasers which target blood/hemoglobin usually work better than those that target water. While both the Fraxel Restore and Repair can improve redness in the skin (rosacea), I would suggest going with a laser which will target blood such as a pulsed dye laser or a broad-band light source (IPL or fotofacial device). The vascular lasers generally give a better result if redness in the skin is your primary problem.

John L. Burns Jr., MD
Dallas Plastic Surgeon
4.7 out of 5 stars 42 reviews

How about neither?

If you have a doctor who is pushing this on you, you need to go elsewhere! None of these lasers are effective for this problem and can actually cause damage. It used to be thought that this type of laser treatment might help rosacea. We now know better, but it sounds like you are hearing some bad information.

On the other hand, IPL is fantastic for that and would be a great adjunctive tool to medications if you wished. Good luck!

Joel Schlessinger, MD
Omaha Dermatologic Surgeon
4.8 out of 5 stars 40 reviews

Neither Fraxel Restore or Fraxel Repair are my favorite

Fraxel Repair likely will flare your rosacea. Restore may help, but I doubt it. Have you tried Theraplex B-lift peels? IPL? Isolaz?

In my experience these give more consistent results, but remember that rosacea is chronic and nothing will cure it. Only control and remission are reasonable goals.

Good luck.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.