Which would you recommend; Fraxel vs. CO2 laser resurfacing of face?

Full face ablative  CO2 laser is still the best treatment for facial skin rejuvenation.That said, it has downsides- higher risks, longer recovery and most importantly hypopigmentation.Patients should expect their skin will be lighter. In addition, fully ablative CO2 laser is really only for patients with lighter skin- it cannot be done without risks even on patients with olive skin.Fractional lasers are lasers that treat the skin with lasers in a fractionated matter-treated only a portion of the skin at a microscopic level. This lowers the risks, shortens recovery, and expands who can have laser (darker skin types). All that said, results generally are not as dramatic as fully ablative CO2 laser.In general, I like fractional lasers for younger patients who are active, are in the sun, have less time for recovery, and need less dramatic improvement. Fully ablative CO2 laser resurfacing is reserved for those who have deep wrinkles and aging, are lighter skin, regularly wear make-up and are careful about the sun.They are motivated to have a dramatic change in their skin and willing to take the time to recover. For those patients, fully ablative CO2 laser resurfacing can be a great option.

Great question. The quality and color of your skin will help us make that determination. Our office uses multiple lasers for resurfacing of the face and we tailor the treatment to your specific skin type. Best, Dr. Karamanoukian Los Angeles

co2 lasers and erbium can both be fully abltive and fractionated..  a combination of both is sometimes used to get better surface improvement and tightening and also collagen growth at a deeper level. it depends on your condition and amount of healing you are willing to put up with

There are a few types of fraxel lasers.  The first one was a non-ablative resurfacing.   This works well for scars but is not great to tightening the skin.  They also make a fractionated CO2 system as do many other companies.  For CO2 resurfacing, it can be done as totally ablative for the best result.  This can only be done in lighter skin tones, and there is a significant recovery time.  It is the best laser for rejuvenation.  To enable it to be used on more people, it is now fractionated.  This means that microscopic channels of CO2 energy are sent into the skin.  This allows for faster healing and can be used on more skin types.  While not quite as good as full CO2 resurfacing, you can see some excellent results.     

The answer really depends on your skin condition and what you are looking to accomplish.  A fraxel or fractionated CO2 simply means that some tiny areas of the skin are left untreated to help promote healing.  When a physician makes more than one pass with a fractionated CO2 laser, then it essentially approximates a fully ablative CO2 laser (where no tiny islands of untreated skin are left).  Both treatments will give improvement, but the fully ablative is more extensive, which will lead to more dramatic results.  However, you may not need dramatic results -- that's why an in person exam is key.  Other valid resurfacing options are chemical peels and dermabrasion.  Consult with a facial plastic surgeon, plastic surgeon, or dermatologist to discuss your options in person. I wish you well!

Over both, I would recommend erbium. A fractionated laser is next best. However, there is a fractionated C02 laser. An experienced board certified physician is a more important consideration than the laser as the physician needs to be able to select the appropriate patients for the procedure, and needs to have the technique to deliver the best possible results.

Fraxel refers to fractionated CO2 laser resurfacing.  CO2 laser usually refers to fully ablative laser resurfacing without the mesh or swiss cheese holed pattern you get with fractionated.  Over a decade ago before the discovery of fractionated CO2, fully ablative CO2 was very popular and was the original deep laser peel.  While fully ablative CO2 is still effective and safe in an experienced laser surgeon's hands it is not appropriate for skin types other than fair-skinned Fitzpatrick 1 or 2.  The risk of depigmentation is too great in those darker skin types.  In fact fully ablative CO2 is rarely used anymore since fractionated was invented.  In my practice, I don't do fully ablative CO2 anymore because of the delayed healing and increased complication rate, but occasionally will do Erbium/CO2 for more severe wrinkles.  I recommend for best results you see an experienced laser dermatologic or plastic surgeon.