What is Fraxel Laser Resurfacing?

Fractional laser therapies are best to treat skin pigmentation problems, sun spots and sun damage, it will modestly tighten pores as well. Our office uses the Matrix Fractional CO2 Laser (as opposed to Fraxel) and we've found it to be exceptional for skin improvement.

Fraxel had been the pioneer in fractionated laser resurfacing technology, first with re:store utilizing Erbium technology. However, the original Fraxel was found to be more helpful for pigmentation but with rather modest results for acne scarring even after 5 treatments. The new standard of care is Fractional CO2 Laser, e.g. Fraxel Repair, ActiveFx, Mixto if one can afford 6-7 days of downtime where the depth and the energy released are more optimal for acne scarring, rejuvenation, and skin cancer prevention.

The Fraxel laser uses "fractionated" laser technology to deliver laser energy to the skin. Imagine that you want to treat acne scars. Traditional Erbium and CO2 laser resurfacing work to correct acne scars by removing the whole upper layer of skin (epidermis) and part of the lower layer (the dermis). When the skin heals, it heals without the memory of these scars and thus they are improved.

With Fraxel, imagine that instead of removing 100% of the surface area of the skin (like CO2 and Erbium do, we are removing only a portion of it. The portion of skin tissue removed looks similar to the pattern you see when you hold the bristles of a brush up toward your face. All of the tips of the bristles themselves represent where the laser penetrates the skin.

The other difference is that fractional lasers tend to penetrate more deeply than Erbium lasers and can penetrate as deeply as full CO2 resurfacing. Fractional lasers are typically used for wrinkles, acne scars and sun damage.

Fraxel is one of the best for "fractional resurfacing". To understand what fractional resurfacing means, imagine an eraser that wipes away the skin- this would be the old CO2 and erbium lasers. The newer fractional ones remove "fractions" of skin leaving behind islands of normal skin that can repair the adjacent areas.

Fractional is great for improving the texture and fine lines of the skin. In addition, it is great for some types of scars such as certain acne and burn scars.

One area of increasing interest is the use of these lasers for stretch marks. Although these are still tough to treat, Fraxel has been used to help their appearance.

This is one of the most popular lasers in the practice because there is minimal downtime.

Fraxel is the name of one brand of fractional laser. Fractionated lasers treat a fraction of the total skin surface at each treatment session as opposed to total skin resurfacing, allowing for much less downtime and fewer potential side effects. There are different types of fractionated lasers, but in general they are best for fine lines and wrinkles, freckles and sun spots, uneven pigmentation, scarring such as acne scarring, and sometimes can improve the appearance of stratch marks. Fraxel treats texture and pigment and can be used safely anywhere on the body.

Fraxel is a fractionated form of Erbium laser which means it doesn't completely remove the entire top layer of skin also known as the epithelium. It is best for mild sun damage, uneven pigmentation and brown spots, and very mild wrinkles (usually the crepey appearing wrinkles under the eyes). It is slightly more aggressive than a strong TCA peel (like an Obagi Blue Peel) and often requires more than one session for best results.

It can be done with topical anesthesia only in a spa or office setting and the down time is usually 3 days or less. Typically patients note mild swelling and redness followed by bronzing (temporary darkening of the pigment) followed by light peeling of skin.

It is an easy and fast recovery which is the main advantage and it is effective for mild sun damage and wrinkles if done 2-4 times. Usually you separate the treatments by 6 weeks.

Positives:

1. Mild Laser with small amount of down time, very little pain and fast recovery

2. Only topical anesthesia needed in an office or spa setting

3. Can be used on all skin types including the face, neck, and chest and hands

4. Stronger than a chemical peel but not as strong as a CO2 laser

5. Great for mild sun damage and mild wrinkles

5. Good option if you don't want sedation or operating room setting

Negatives:

1. Requires several sessions for best results

2. Treats only very mild wrinkles and mild sun damage

3. Sometimes costs can add up since several treatments are required.

4. Some patients still notice some pain with topical anesthesia during procedure.

Fraxel laser resurfacing is one of many techniques that can be used to resurface the skin in a fractional mode. Today’s lasers are much less invasive than the lasers used many years ago. However, there are multiple versions of fractional lasers—even the Fraxel laser itself comes in 2 versions: one is the Fraxel Restore laser, which is a non-invasive laser that improves sun damaged skin over a series of treatments and has essentially no downtime.

The second Fraxel laser is the Fraxel Repair laser which can improve sun-damaged skin in one to two sessions, but the downtime would be approximately 4-5 days after each laser treatment.

To your health,
Dr. David Goldberg

Fraxel re:pair is the latest fractionated CO2 laser that is creating the greatest buzz in the past 10 years in nonsurgical facial rejuvenation. After much due diligence, I am proud to announce that we are one of the first practices nationwide to offer the Fraxel re:pair laser, the most advanced skin rejuvenation treatment available on the market today.

With the treatment patients receive smoother, tighter skin, reduced wrinkles and fine lines, improved tone, color, and texture, and softening of deep frown lines, all in a single treatment--with minimal discomfort and just a few days of social downtime.

I recommend Fraxel re:pair for patients who have deeper lines, loose sagging skin, acne scars, or surgical scars. The neck and jowls are the first areas that show signs of aging in 30 and 40 year olds. It treats skin laxity very well. This treatment is a "pre-emptive strike" against wrinkles and aging, delaying the need for a surgical facelift.

The clinical researchers have stated, "It doesn't replace a facelift, but may get you to the point where you will never need one." Patients in their 50's and 60's also greatly benefit from the rejuvenating effects of the treatment.

As a result of 2 1/2 years of clinical testing on more than 500 patients, the treatment has received FDA approval. The treatment is very safe, effective, and quick(taking as little as 20 minutes to treat the entire face, 30 minutes for the face and neck). There have been no reports of hypopigmentation (lighter areas of skin seen with other lasers). With this tool, in my hands, I can now confidently offer my patients a nonsurgical compliment that will keep them looking younger and their "natural" best.

You can learn more about the treatment by calling our office. I will be happy to personally to speak to you and answer any questions that you may have. I can also direct you to other resources for more information about Fraxel re:pair treatment.