What is Fraxel Laser Resurfacing?

Depending on the type of fractional Fraxel laser, and depending on the type of condition and severity, acne scars, wrinkles, pores, dark discoloration (freckles, melasma, etc.) crepy skin, poor tone and texture can improve with Fraxel laser. Three main Fraxel lasers include Clear & Brilliant, Fraxel Dual / Restore, and Fraxel Repair. I spend time evaluating and examining my patients in consultation and determine with their individual needs, time commitments and risk profile,  what is the best laser for them, and discuss the recuperation, cost, benefit and risks.

Thank you for your question!
Fraxel, (profractional), and/or Co2 are best for resurfacing.  Erbium is a good alternative. I always combine lasers with microneedling/(RF/)prp for more robust outcomes. 
For skin tightening, I recommend a combination of ultherapy with RF treatments and sculptra for skin tightening. 
I recommend getting a formal evaluation with a cosmetic dermatologist. 
Best, Dr. Emer

Non
ablative Frax laser targets soft tissue to remodel and resurface the
tissue.  We use the Frax 1550 laser by Ellipse.  This Frax is a high
power, non ablative laser which delivers results without significant
downtime.  The 1550 wavelength energy works at the dermal layer of skin by
laying down a “grid” of energy that treats stimulates a healing response of the
tissue.  This serves to improve texture and tone of skin.  Frax laser
treatments can be used for general skin resurfacing, or to specifically target
concerns such as stretch marks, acne scars and surgical scars.

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 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 re:store is the non-ablative Erbium fractionated laser that has been around for the past 3 years. It effectively treats sun damaged skin. Mild to moderate wrinkles, brown pigmented spots, melasma, acne and other scars all respond well to the treatment. It can be used to treat anywhere on the body and on any type of skin.
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.

Fraxel is a brand of lasers and they have a line of lasers that are different. SmartSkin CO2 is not a Fraxel laser. It is an ablative laser. What that means is that it is more invasive but can deliver improved results when it comes to aging to serious scarring. I would suggest you to find a provider with experience who can tell you what type of laser will work the best for you. Good luck!

I love to do Fraxel for my face neck and chest three times a year!
Fraxel is a unique laser because it has the ability to rejuvenate the skin in a non-invasive, effective fashion with minimal downtime. It can be an ideal treatment for sun damaged skin on the face, neck and chest. In addition to brown marks, it can used to improve scars, stretch marks, fine lines and wrinkles and age spots.
By placing tiny columns of energy into the skin, the Fraxel laser promotes the body’s natural healing response and development of new collagen. The Fraxel laser is used fractionally treating a patient’s skin in specific areas, while leaving some skin unaffected nearby, allowing for an easier and less invasive rejuvenation.
The net result is tighter, smoother, and more radiant skin.
Treatment with the Fraxel laser begins by first using a numbing cream to make the procedure comfortable. Generally three treatments are needed for great results.  Because the process requires new collagen to form, maximum results take few weeks to show. After each treatment there is about a 1 week period of “downtime” where a patient may experience light redness and discoloration in the skin while the skin is undergoing this healing and rejuvenation.

To know if you are a candidate for laser resurfacing, you need to be evaluated by your dermatologist.  The Fraxel Dual laser has two wavelengths that can be used separately or together during a treatment.  The 1550nm (erbium) wavelength helps most with textural differences and is my choice for deeper wrinkles, scars and stretch marks.  The 1927nm (thulium) wavelength provides more superficial resurfacing that is ideal for pigment, fine lines and pores.  The Fraxel Dual laser has been invaluable in my practice.  I treat so many patients who had more sun than they should have in their teens and 20s.  When they reach 30 - 50, their skin looks much older than their age.  Often they started protecting their faces before the rest of the body, so the ability to improve the skin texture and color safely on the neck, chest, arms and hands in addition to the face provides a very natural appearance.  My patients also appreciate the limited 3 - 5 day downtime after each procedure.  Procedures can be separated by 4 or more weeks and the number needed will depend on the degree of damage to be improved.  In general scars and stretch marks take more treatment than pigment and wrinkles.  The place I see the fastest improvement are the eyelids which can look tighter after only 1 or 2 treatments.The Fraxel can also be combined with other lasers or devices at the time of treatment.  Speak with your dermatologist.I hope that answer was helpful. Best wishes.