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Fractional Laser Resurfacing

Fraxel® lasers help reverse the signs of aging by improving skin imperfections like fine lines, wrinkles, scarring, keratoses, and age spots. Fraxel lasers help stimulate collagen and resurface the top skin layer.  All Fraxel lasers use fractionated laser light to treat the skin.  This works by creating tiny holes in the skin, leaving small islands of healthy, intact skin in between.  These healthy areas help to speed healing, promote formation of new collagen, and remodel the skin.

There are actually three different types of Fraxel lasers, and it is important to understand how each laser works differently, as this will impact your healing times and treatment plans.

Fraxel Re:Store Dual

This is the most popular Fraxel laser and actually incorporates two lasers into one machine.  These lasers are non-ablative, meaning the top layer of the skin remains intact in the areas around the laser holes.

The Fraxel Erbium laser

The Fraxel Erbium laser (1550 nm) was the original Fraxel Re:Store and remains as one of the two lasers of the current Fraxel Dual.  This laser has a relatively shallow depth of penetration and works well for acne scarring, skin toning, aging and sun damaged skin. If you have a history of cold sores or fever blisters, your doctor may prescribe antiviral treatment starting 3 days or so prior to your appointment.  Treatment can be somewhat painful, and topical numbing cream is typically applied for 30 minutes prior to your treatment to reduce the discomfort.  Desired outcomes are typically reached with 3 to 4 treatments approximately one month apart.  Acne scarring patients may benefit from more treatments. You may experience redness or swelling after the procedure which diminishes quickly over the next several days. It is common for skin to feel rough for a short time after treatment.

The Fraxel Thulium laser

The Fraxel Thulium laser (1927 nm) is the newer laser that was added to the new Fraxel Dual.  This treatment helps with sun damage and hyperpigmentation with one to two treatments. The Fraxel Thulium has a deeper depth of penetration than the Fraxel Erbium, and uses a different light wavelength than the Fraxel Erbium. The best results are typically achieved with 1-2 treatments. Your doctor may prescribe antiviral treatment starting 3 days or so prior to your appointment.  As with the Fraxel Erbium, treatment can be somewhat painful, and topical numbing cream is typically applied for 30 minutes prior to your treatment to reduce the discomfort.  There is minimal downtime after the procedure.  Most patients report a feeling similar to a sunburn after treatment.  During the first week after your treatment, a mild topical steroid cream is often used, and the outermost layer of your skin will tend to turn brown (similar to a suntan in color) and crumble off with washing (using a gentle cleanser). Patients are strongly advised to avoid sun exposure during this time.

Fraxel Re:pair (CO2)

This Fraxel laser works well for deeper wrinkles, acne scars and also tightens the skin. This laser is ablative, meaning that the top layer of skin (epidermis) is removed by treatment, and penetrates deeper into the skin than the Fraxel Thulium or Fraxel Erbium lasers.  Because of this, healing is different and longer than for the Fraxel Thulium or Fraxel Erbium, with most patients experiencing an average of 7 to 10 days of healing downtime, during which your skin will be raw, tender, and sensitive. Your skin may continue to flush more easily than normal for 4-8 weeks after treatment.  Desired outcomes are typically reached in just one session, but final results may require 6 months to 1 year.

Frequently Asked Questions

How do these lasers work?

All fractionated lasers (like the Fraxel lasers) work by creating tiny holes in the skin.  The surrounding islands of intact skin help to regenerate, resurface, and renew your skin.  Each laser has slightly different characteristics, so it is best to refer to the information above.

What is the Fraxel laser best at treating?

This depends on the type of Fraxel laser being used.  Because each laser works slightly differently, it is again better to refer to the information above.

What is the difference between ablative and non-ablative?

A non-ablative laser leaves the uppermost layer of your skin (the epidermis) intact.  An ablative laser (such as the Fraxel CO2 laser) will strip off this layer.  The ablative laser treatments are much more intensive and require longer healing times, but fewer treatments, and may be better options for deeper scars or more serious skin damage.

What will I look like after the procedure and how long are the typical recovery times?

This varies based on the type of laser used in your treatment.  Generally, the more deeply the laser penetrates, the longer your healing time will be. The information above for each laser gives some generally observed healing times, but your provider will discuss your expected recovery with you in detail.

How long do the results last?

Results from laser skin resurfacing vary based on how well you care for your skin after your procedure. Your provider will give instructions on how to care for your skin during the healing phase following your treatment.  Beyond that, it is generally recommended to limit sun exposure and use sunscreen daily to maintain your new skin.

I’ve heard you can’t use lasers on darker skin.  Is that true, and are there any options for darker/ethnic/suntanned skin?

Fraxel laser treatments can cause your skin to lose pigment and look lighter in color.  This is part of why Fraxel lasers are used to even out skin pigmentation!  However, this may be less desirable for people who want to keep their sun tan, and becomes more of a concern for people with darker pigmentation.  Some lasers, such as the Fraxel Erbium or Fraxel Thulium, can be used for darker skin, but deeper lasers such as the Fraxel CO2 are not advised.  Your provider will assess your skin and provide you with the best treatment option, and can discuss the details with you at a consultation.

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