What are the difference between Derma K laser and Fraxel Repair laser?

Question

Some doctors say the result of Derma K is better. Others say both are less effective than traditional ablative CO2 laser. I'm confused

Harold J. Kaplan, MD · Answer

Hi Lock, all fractional laser technology is similar.  Not the same, but similar.  The Derma K uses both Erbium (2940nm) and CO2 (10600nm) light.  Although the laser light is slightly different for Erbium and CO2 the effect that it has on skin is very similar and both types are used for laser resurfacing of acne scars and wrinkles.  The Fraxel Re:Pair is a CO2 laser.  so it has only one of the wavelengths that the Derma K has.  Does that mean the Derma K is better?  Not necessarily.  It just means that there are two wavelengths instead of one.  What you need to know about practices that have fractional laser technology is that once the practice buys the laser, they need to use it to justify the cost ($150,000) by using it.  This means that you are going to be told that each one is the "best" because that's the one that this particular practice uses.  As a consumer, you are not expected to be able to differentiate, so here are some good questions to ask.  How long is the downtime, what anesthesia will be used and will there be any bleeding during the procedure.  If the downtime is short (3 days or less), if only facial numbing cream is used for anesthesia and if there is no bleeding, it's safe to say you are getting a very superficial peel that will not help that much with wrinkles and acne scars.  Deeper fractional resurfacing treatments and traditional CO2 resurfacing both offer better results but also require more advanced  anesthetic techniques, bleeding during the procedure and a week or more of recovery time.  Another very important issue that most consumers tend to neglect is that the practitioner is the most important piece of the process.  You could be getting treated with the best laser possible, but if it's being used by a novice, it's very likely you will not benefit.  You and I cannot drive a NASCAR like a professional driver and the same is true of lasers.  Those that use them well and make it their focus to be good at the process will deliver better results.  Look for referrals among friends and on the internet and ask for before and after photos of their own patients.Finally, traditional ablative CO2 lasers are excellent resurfacing tools and there are many arguments to support the fact that they are better than fractional lasers.  But here are the drawbacks.  Even though the skin can look very smooth after traditional CO2 resurfacing, it can also look very waxy (shiny) and it can be lighter (hypopigmentation).  These are two side effects that are common with traditional CO2 resurfacing.  Another drawback is cost.  Traditional CO2 resurfacing requires general anesthesia and a surgery room environment.  This usually means the cost is 3 or 4x the cost of fractional resurfacing.  Finally, the recovery for traditional CO2 resurfacing can be weeks or months.  It's a minimum of 2-3 weeks for the initial recovery and prolonged redness of months is quite common.  If you are skin type IV or darker (Hispanic, Asian, African), this type of resurfacing is not recommended because of the risk of skin lightening.To see photos of fractional laser resurfacing with the Sciton Profractional for our Los Angeles and Orange County patients, click on the link below.

Richard Chaffoo, MD, FACS, FICS · Answer

Hi and thanks for your question. There is minimal difference between these two laser modalities. The outcome is more dependent upon who performs this procedure than the subtle differences between them.

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