Understanding Fraxel and Fractional Laser Skin Resurfacing-The Revolutionary New Wrinkle and Acne Scar Treatments

If you are interested in skin rejuvenation and laser skin resurfacing you will be hearing a lot about Fraxel and Fractional laser Skin Resurfacing in the future. To better understand the significance of these new advances some technical knowledge of laser skin treatments and past laser skin care technology is important.

The photo above shows the result of a full face CO2 Laser Resurfacing for wrinkle removal done 10 years ago using the Ultrapulse CO2 laser, a revolutionary advance in 1995. While the wrinkle removal results were stunning, CO2 laser resurfacing created a “burn wound” that took months of recovery and after a year often left the skin white or hypo pigmented. Because of the prolonged recovery, the need for general anesthesia, and other side effects most people today do not choose to have this effective wrinkle removing procedure.

Over the past three years the concept of Fractional Skin Rejuvenation or fractional laser skin resurfacing has evolved. With Fractional Skin Rejuvenation the laser beam, an erbium laser beam, is broken up or fractionated into many small micro beams which are separated so that when they strike the skin surface small areas of the skin between the beams are not hit by the laser and left intact. (See Figure Below) The small areas treated by the fractional micro beams, called micro treatment zones, cause sufficient laser injury to promote new collagen production to replace collagen damaged by aging and sun exposure. Damage to collagen in the skin is a cause of skin wrinkles. The new collagen produced by the laser injury “plumps” skin wrinkles. The intact skin between the micro treatment zones allows for much more rapid healing-3-4 days as opposed to 2-3 weeks for the older CO2, and enough pigment cells are left intact that hypo pigmentation does not occur.

The diagram above shows the progression of laser skin rejuvenation technology from the older CO2 on the left to the newest fractional ablative lasers which have just come out. The Fraxel laser and the Lux 1540 are depicted in the 3^rd illustration under Non ablative fractional laser resurfacing.

Fractional Non Ablative Laser Resurfacing

To ablate means to “surgically remove”. The Fraxel and Lux1540 are non ablative lasers which mean that when the laser beam strikes the skin the skin is not removed immediately, rather the laser beam heats the skin to cause inflammation and new collagen production. The benefits of the Fraxel and Lux 1540 non ablative laser skin treatments are dramatically reduced recovery time, but the results in terms of wrinkle removal and skin tightening are less dramatic than with ablative lasers.

However, the new fractional lasers like Fraxel and the Lux 1540 are able to penetrate much deeper than traditional non fractional ablative lasers and we are discovering that deeper penetration of the laser produces a much more dramatic stimulation of new collagen formation which translates into a plumping effect on the skin. This is particularly useful in treating depressed acne scars. Another diagram which helps explain this is the diagrammatic representation of the Lux 1540 below.

In summary, the benefits of fractional non ablative laser skin treatments are:

1. Less down time- only pink skin for 1-2 days and a day or so of bronzing that can be covered with make up
2. Better new collagen production in the deeper skin layers causing skin plumping especially of acne scars
3. Fewer complications like hyper pigmentation (although with Fraxel there is a 15% incidence of hyper pigmentation (darkening of treated areas) especially in dark skinned people, but it is temporary.
4. Improvement in skin texture and possibly enlarged pores
5. Improvement in wrinkles (See Photos below of Lux 1540 Results)

Above-Before and after Lux1540 treatment-Photos courtesy of Palomar and Dr Dwight Scarborough

The Future-Fractional Ablative Laser Resurfacing

Recently several new fractional ablative lasers have been developed which have the benefits of fractional treatments, less down time and complications, as well as the benefits of ablative skin resurfacing, better wrinkle removal and facial rejuvenation. Fractional ablative lasers are depicted in the last or 4^th picture in the first comparative fractional laser diagram above.

The fractional ablative lasers remove the tissue in the micro treatment zone rather than just heating it as is done with Fraxel and the Lux 1540. The benefit of ablation is that more sun damaged, wrinkled skin is removed than with Fraxel or the Lux 1540 and better wrinkle removal and skin surface smoothing and textural improvement is achieved. This however comes at the price of some recovery time, redness and pinkness for 4-6 days. The fractional ablative lasers however require much less recovery time than the traditional non fractional erbium and CO2 ablative lasers which required weeks of recovery. Reliant, the company that makes Fraxel has released a new CO2 fractional laser called the Repair, Lumenis has released a CO2 fractional ablative laser for Bridge Therapy, and Palomar has released the Lux 2940, an Erbium fractional ablative laser.

Impressive wrinkle removal and improvement in skin texture is achieved with the Lux 2940 fractional ablative laser (see Photo Below).

The first non ablative fractional laser on the market was the Fraxel. The Fraxel has been improved and many new improved fractional devices have been released since Fraxel appeared on the market three years ago. The field of laser skin rejuvenation is advancing rapidly and new technological breakthroughs occur frequently. The benefit to you is that better wrinkle removal results are possible with less down time and fewer potential side effects. The applications of fractional laser technology are expanding to other fields like skin tightening and eventually to fat and cellulite removal.

For further information on the skin rejuvenation and facial aging read Save Your Face or contact me. In my practice I use the new Lux 1540 Fractional Non ablative erbium laser for skin rejuvenation.

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Dr Seckel
978-369-4499

Concord, Massachusetts

Boston, Massachusetts