Are There Any Risks to Fraxel?

Hi Donna.  There are several different types of Fraxel Laser.  The Fraxel DUAL (1550 nm/1927 nm), Fraxel Restore (1550 nm) and Fraxel Repair (Fractionated CO2 laser).  The Fraxel Repair is considered an ablative laser and the Fraxel DUAL and Restore are nonablative lasers.  The nonablative lasers have minimal risks as noted by the other reviewers.  However, some patients have very sensitive skin and may have more swelling and redness than others.  Since you may not be sure how you will react I would suggest not scheduling major social events 3-4 days after your first treatment.  You may just have mild redness, skin dryness and flaking, or your brown spots may appear darker until it peels off.  If you have skin of color, be careful about hyperpigmentation.  Definitely prep your skin with a sunblock before treatment and I like to also prep their skin with a skin lightener 2 weeks before treatment.  This is not required before treatment, just something I prefer to do.  Also ask your provider if they are experience with skin of color because the settings are different.  Finally, be careful about some clinics/spas that claim they are treating you with a "Fraxel" but are using other lasers.  Good luck!

Some risks of laser resurfacing include blisters, burns, bleeding, slow healing, scarring, hypopigmentation, hyperpigmentation, and reactivation of herpes virus infection.

Many of these risks are significantly reduced or avoided with the Fraxel laser because it is a “fractionated” laser. The Fraxel laser is designed to affect only “fractional” volumes of skin within the treatment area. With each treatment session, only a portion (fraction) of the skin is actually treated with the laser. This provides the benefits of rapid healing without significant negative side effects and less down time.  Fractional resurfacing with the Fraxel laser is accomplished by the formation of numerous microscopic zones of thermal damage in the epidermis and dermis, surrounded by normal (untreated) tissue.

Think of painting a wall with spray paint. Each pass you make with the spray can lays down tiny dots of paint. With each pass more and more paint is applied. Each pass of the Fraxel laser lays down many microscopic columns of tissue injury that appear on the surface as little dots. The density of these dots can be adjusted on the laser and the amount of treatment is also controlled by how many passes are made across the skin. For generalized resurfacing, a 25-30% coverage is commonly used during each treatment session. Four treatment sessions are required.

The Fraxel® laser operates at 1550nm. Many people refer to this as a non-ablative laser. It is an ablative laser, but more specifically, it coagulates tissue (rather than vaporizes it). The difference is that after the treatment the skin surface is dry (not weeping/oozing). The microscopic columns of coagulated tissue are sloughed over 4-5 days as healing occurs. Some redness and swelling occurs but healing is relatively quick and patients are able to return to normal activities in a short time.

The Fraxel laser does not quite produce the results of more aggressive ablative laser resurfacing, but offers the benefits of minimal downtime, decreased redness, less risk for scarring and hypopigmentation, and allows treatment of nearly any area of the face or body, in nearly all skin types. It works great for resurfacing for photoaging (face, neck, and chest) and for the treatment of acne scarring.

Best wishes. Ken Dembny

Dear writer, Fraxel laser treatment is extremely safe. It is not typically associated with blisters or scar formation, and infections are rare, even with the ablative Fraxel Repair. Fraxel Restore, for example, will offer great improvement in the appearance of wrinkles, stretch marks and scars, without a significant risk of side effects. One main concern to have, however, when doing Fraxel, is to avoid sun exposure and sun burns for several weeks before and after the treatment. This is done in order to prevent hyperpigmentation (dark patches) after Fraxel is done. This pigment change is reversible, and goes away with the use of topical bleaching creams. Of note is to know that if a patient suffers from cold sores or labial herpes, treatment with antivirals prior to treatment is important in order to avoid severe herpetic breakouts. Please inform your doctor if you suffer from these. Best wishes from Miami, Dr. Leyda Bowes