Fraxel Repair and the Dermis?

From what I've read fraxel repair is the gold standard for white stretch marks. What is the difference in the repair vs restore when it comes to ablative. I'm guessing repair is semi-ablative? And does it actually repair the dermis/epidermis? How does it diminish the stretch mark/color? I know the dermis is 70%ish collagen, what is the other 30% made from? HA? Thank you.

Doctor Answers 3

Fraxel Repair and Stretch Marks

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Fraxel Repair is an ablative fractional CO2 laser. Fraxel Restore is a non-ablative fractional Erbium laser.

Once they turn white, stretch marks are very hard to treat (with anything).

About the lasers: Both are made by Solta (originally made by Reliant). Ablative lasers (CO2) completely destroy the tissue that is treated (the skin literally goes "up in smoke"). However, since Fraxel Repair is "fractionated", it only treats a percentage of the area. This is done by laying down columns of laser light, rather than a "sheet" of laser light.

Fraxel Restore causes coagulation, rather than ablation. So, while it also knocks out tiny columns of skin, the top layer is left intact. If you were to look at a biopsy of skin after treatment with the Fraxel Restore, you would see columns of dead tissue surrounded by areas of live tissue. The live tissue begins to regenerate the dead tissue columns - making new collagen, elastin, and new cells. This regeneration process is what causes visible improvement in texture, lines, and pigment.

Stretch marks are best treated when they are brand new and red. A pulsed dye laser, like the Vbeam Perfecta, would be the treatment of choice. Once they turn white, they are hard to treat. Also, using an ablative laser off of the face can increase the risk of side effects. I recommend that you pick a "test patch" of a couple of inches and try either a series of Fraxel Restore (4 treatments), or a fractional CO2 (such as the Fraxel Repair). If you feel that you got good results, then you can go on to treat larger areas.

The dermis is the 2nd layer of skin. It provides pliability and elasticity. The main cell type in the dermis is called a fibroblast. They make the matrix of the dermis. Collagen accounts for 75% of the dermis. Elastin 5%. The rest is Hyaluronic acid, cells, vessels, nerves and hair follicles.

Fraxel Repair that works!!

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As previous mentioned, Fraxel Repair is a ablative, fractional carbon dioxide laser while Fraxel Restore is a non-ablative fractional erbium laser.  Both lasers create microscopic columns of directed tissue damage, leading to new collagen formation within the dermis.  This new dermal collagen helps repair the skin and make stretch marks less apparent.  Although we have had a success with both types of lasers at our practice, we have also found other lasers such as the Excimer and pulsed dye laser (PDL) to be more effective at treatment stretch marks.  In several studies that we performed, we achieved a 50% - 56% higher improvement in color, elasticity/recoil and in teh skin sepressor using laser.  Of course, any of the aforementioned procedures would require in-person evaluation with pricing dependent on several factors, including size of the area to be treated and treatment modality decided upon by you and your doctor

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Fraxel Repair to target stretch marks

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To answer the question simply, the Fraxel Dual Repair and the Juvia CO2 Fractional machines are two different options to specifically treat a multitude of skin imperfections.

Restore has a dual head and is non-ablative. When it comes to white stretch marks, this type of Fraxel treatment will improve the overall texture, however it won't completely eliminate the stretch marks' appearance nor change it's color. Often multiple treatments may be required to see a noticeable result.

My advice for you would be to locate a clinic that can offer you detailed explanations of the options best suited to your specific needs. These decisions should be based on an understanding of realistic expectations and a history of remarkable results.



Steven Bernstein, MD
Montreal Dermatologic Surgeon

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.