What are the options for managing pain during a Fraxel laser treatment?

Question

I have had an IPL and Fraxel skin treatment. Both were painful but the Fraxel was so painful that the aethestitcian only got 2 out of 4 passes. I am very fair but do have a decent pain tolerance. I did laser hair removal with no pain management whatsoever. For the Fraxel laser, they pretreated with lidocaine for almost an hour. When I inquired about whether there was anything else we could do for pain during the treatment the practice said no. Are there other options?

Kally Papantoniou, MD, FAAD · Answer

Next session you can pre-treat yourself with 2 advil or motrin (if not contraindicated by any pre-existing medical conditions) about an hour prior to the session, and you can ask for the office to reapply a layer of the Lidocaine Ointment. For a topical numbing cream or ointment to work its best it should be applied in a layer that is approx 1/8 to 1/4 inch...you should not be able to see the skin underneath. Now, the Fraxel will not feel like "nothing" even after numbing properly, but you should be able to tolerate the treatment. And there is also very cool air that blows at the same time, and this is also adjustable for comfort level, and most patients really feel that this provides the most relief. Very rarely I have performed nerve blocks, this is done via injection of lidocaine to several areas on the face that can cause an entire area to turn numb.

Jason Emer, MD · Answer

Numbing with topical lidocaine, oral medications like valium and vicodin/percocet, and injectable nerve blocks can all be used to limit pain during a laser procedure. Speak to your physician for best options. Best, Dr. Emer.

Lenore Sikorski, MD · Answer

Thank you for your question. At our office to manage the pain we numb the patients with topical numbing one hour before the procedure. We do one half hour of topical Lidocaine/Tetracaine 23/7% and then a half hour of 30% Lidocaine. We also recommend they take something oral for the pain before the procedure. We offer narcotic pain management as long as the patient has a driver and if not then 800mg of Ibuprofen. It would dependent on where you go for the procedure if they could offer stronger pain management for you. If not, I would suggest taking some Ibuprofen before the procedure.

Steven F. Weiner, MD · Answer

I usually only use topical Lidocaine OINTMENT. I use 23% lidocaine, 7% tetracaine. If still not enough, I give what I have coined a superficial skin block which is multiple small injections on the surface of the skin using a mesotherapy needle. This gets the skin almost completely numb.

What are the options for managing pain during a Fraxel laser treatment?

Answers (4)