Fraxel Repair vs. Fraxel Restore - Pain?

Fraxel Repair hurts much more than REstore.  Fraxel Repair is a carbon dioxide laser and Restore, now in the dual, has an erbium 1550nm and a Thulium 1927nm. wavelength both of which are less painful than the Repair.  My patients are able to tolerate the Fraxel Restore laser, a series of multiple treatments every few weeks, even with my highest energies, with a numbing cream applied on the face in the office for one hour, or so, prior to the treatment. The Fraxel Restore was made much more comfortable as soon as we combined our Zimmer air cooler which we blew across the skin at the time of the laser.  The Reliant company, now Solta, had learned from physicians and now incorporate the same air chiller in their new Fraxel lasers.  The Fraxel Repair, although fractional, is still ablative, unlike the fraxel Restore which is non-ablative.  Ablative lasers mean that a second degree burn is caused and allowed to heal. Numbing cream, local anesthetic injections, pain killer and sedatives are often prescribed for Fraxel Repair. The healing of Fraxel Repair is also much more involved and prolonged than the Fraxel Restore.  Each laser, is however, designed to treat different skin conditions.
 

The Fraxel Re:Store is much less painful than the Re:Pair. The Re:Store can easily be done in a clinic setting using numbing cream and a skin cooler such as the Zimmer air cooler. The Re:Pair is much more painful and I prefer to do the treatments with IV sedation in our surgery center. This allows me to give an effective treatment while keeping my patients comfortable. However, the is very little discomfort after the laser treatment with either laser. Most patients describe their post treatment as mild, like a sunburn.

Both procedures require topical numbing but the fractional CO2 -Fraxel Re:pair - procedure is much more painful. We use oral pain control and mild sedation with shots to face for local numbing as well. After the Fraxel Re:pair, there is a burning sensation for about an hour which is alleviated with ice packs and cold air from the Zimmer but beyond the first hour there is minimal pain.