Laser Skin Resurfacing? What is Fraxel?

Another great question ,unfortunately, there is alot of hype over Laser Peels, Micro Laser Peels, Erbium Peels and Chemical Peels. I will try to separate the forest from the trees in this blog.

Laser Skin resurfacing is just that.. using a Laser to resurface the skin. The advantage of a Laser versus a Chemical Peel is there is a definite thickness(depth) that is repeatable and controllable with a Laser that can not be achieved  with a Chemical Peel. There are many “grades” of Peels mild, moderate and Strong… but all them share common elements… putting some form of acid on the face performing a controlled “burn” with the goal  of rejuvenating the skin… Limiting factors tend to be pain during the procedure, controlling the depth while trying to do the most good and complications. Complications increase with increased depth of peel.
Laser Skin Resurfacing using a laser to put a controlled amount of energy onto the skin comes in various forms.

The  “Gold Standard” to this day is still the CO2 Laser Resurfacing which has been around 10- 12 years gives outstanding results but has its limitations. This technology extends to the dermis to get maximal collagen stimulation.

  • Must be done under general anesthesia or with heavy sedation
  • 2 weeks of downtime or more, can be months before the patient resumes a normal lifestyle
  • Complicated wound care, bleeding, oozing , crusting
  • increased complications hyper/hypo pigmentation, scarring
  • Limited the the lighter skin types

An Erbium Resurfacing is very similar to the above but much more superficial but also does more damage superficially. Downtime is considerably less, ( 2-5 days) with less complications but less results overall since Erbium can’t penetrate deeply enough into the dermis to cause collagen stimulation. Microlaser peels and Laser peels also fall into this category and are good for superficial treatments some fine lines, sun damage  but don’t go deep enough to case significant collagen stimulation. These technologies can be done with usually a topical anesthetic.

Fraxel Laser

Fraxel is the name of one brand of fractional laser. They were ingenious in their marketing strategy and put Fractional Lasers on the map. Fractionated lasers treat a fraction ( 30-40%) 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. The analogy is like aerating your lawn so the grass grows better. The Fractional laser punches microscopic holes in the skin .. the healthy skin pushing out the damaged skin. The initial Fraxel Laser ( Restore)  was a superficial treatment that needed 4-6 treatments to see results but ended up being too superficial to do any collagen stimulation. Thereby falling into a similar category to the erbium peel and microlaser peel.

Fractionated CO2 Laser Skin Resurfacing

Once they combined Fractional technology to the CO2 Laser they had the best of both worlds. Outstanding results with minimal downtime. I find most people can’t afford to take off two weeks from work but can afford two days. Thursdays and Fridays are popular days for treatments since the patient can lay low the weekend and be back to work on Monday. This is done with a topical anesthetic. I have a special combination of Tetracaine/Lidocaine/Benzocaine compounded for me. The skin after the  procedure looks like a bad sun burn some bronzing and fresh skin underneath in 2-3 days. However, in the case of acne scarring there would be more downtime due the the depth of the scarring but no way near that of a classic CO2 resurfacing.

Fractionated CO2 Resurfacing gets down to the dermis to stimulate collagen production enough at times to cause  contraction of collagen to cause a “lift”. The Fractionated CO2 Laser treats fine lines, wrinkles, and sun damage, uneven pigmentation, fills acne scarring and one of the most important things it does is stimulate collagen. The Fractionated CO2 Resurfacing is largely replacing all other technologies described above with good reason – RESULTS!

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