Written by Aleksandra Agranovich
Fraxel Laser Indications for Skin Treatment
The Fraxel Laser, also known as fractional photothermolysis, is a dermatological tool that has been proven safe an effective for the treatment of facial photodamage, acne scaring, hypopigmentation, and dyspigmentation. Fractional photothermolysis works by creating “spatially precise microscopic thermal wounds (using a 1550-nm erbium fiber laser) that targets water-containing tissue to effect the photocoagulation of narrow, sharply defined columns of skin known as microscopic thermal zones” (Tanzi, 2008). Treatment with the Fraxel Laser involves multiple sessions mainly because each session only treats a small portion of the skin. Typically, patients may return for additional sessions within a three to six-month course.
There are two different types of lasers that exist for fractional photothermolysis which include ablative and non-ablative therapy. Ablative lasers involve the use of carbon dioxide or erbium and are well tolerated for facial rejuvenation. However, over time, ablative lasers may cause loss of the cutaneous barrier function and prolonged recovery. Non-ablative systems, on the other hand, are a bit safer than ablative lasers, and have a reduced risk of skin cell damage. This technique involves the use of “1064- and 1320-nm Nd:YAG, intense pulsed light systems combined with epidermal surface cooling and infrared or near-infrared wavelengths” (Tanzi, 2008).
How to Take Care of your Skin After Fraxel Laser Treatment
After receiving a Fraxel Laser therapy session, it is important to stay hydrated and void smoking, alcohol consumption, heavy sweating, swimming, and sun exposure. The treated area needs to remain clean and free of makeup, alcohol-based products, and detergents. Post Fraxel Laser recovery tends to take about one full week and many patients may experience redness, burning, throbbing, and peeling of the skin within the first two days. Overall, the Fraxel Laser is a great technique that may rejuvenate the skin, remove acne scaring, and allow patients to feel confident about their appearance. The Fraxel laser was first introduced in 2003 and has become a very effective treatment for different types of facial conditions. The side effects of this procedure are typically mild and can result in erythema and a slight darkening of the skin. According to various Fraxel studies, severe complications are rare.
Resources
Tanzi EL, Wanitphakdeedecha R, Alster TS. Fraxel laser indications and long-term follow-up. Aesthet Surg J. 2008;28(6):675-680. doi:10.1016/j.asj.2008.09.006
Janik JP, Markus JL, Al-Dujaili Z, Markus RF. Laser resurfacing. Semin Plast Surg. 2007;21(3):139-146. doi:10.1055/s-2007-991182
Bertossi D, Giampaoli G, Lucchese A, et al. The skin rejuvenation associated treatment-Fraxel laser, Microbotox, and low G prime hyaluronic acid: preliminary results. Lasers Med Sci. 2019;34(7):1449-1455. doi:10.1007/s10103-019-02738-z
Fraxel Laser Skin Treatment
Fraxel is a trademarked laser resurfacing therapy that is a popular aesthetic treatment used for photoaging, melasma, surgical and acne scarring. This laser technology was trademarked and patented in 2004 and the technology is based on fractional thermolysis. Fractional thermolysis (FT) lasers produce their resurfacing effects by producing microscopic thermal wounds at specific skin depths below the stratum corneum, which remains intact. Fractional thermolysis creates minimal side effects and has a short recovery time, which is beneficial due to minimal impact on quality of life. This laser treatment requires multiple treatments, usually between four to six, to see and maintain effects. Fraxel has received clearance for use from the Food and Drug Administration (FDA) for the treatment of soft tissue coagulation, treatment of periorbital wrinkles, pigmented lesions, melasma, skin resurfacing, and the treatment of surgical and acne scars (Geronemus R).
The Fraxel treatment, called Fraxel DUAL 1550/ 1927 has two wavelengths that penetrate the dermal layers and create patterns of microscopic damage in the areas of concern without damaging the surrounding areas. When receiving Fraxel laser, the skin is cleaned beforehand, a topical anesthetic is applied up to an hour before, and the laser treatment itself takes up to 25 minutes. After completing treatment, aftercare is crucial to maintain benefits for as long as possible. Applying sunscreen of SPF 30 or greater for at least three months or more is highly recommended and wearing a wide brimmed hat while in the sun to promote rapid healing and prevent scarring and dyspigmentation after receiving Fraxel. Patients can experience some side effects, such as redness, swelling and some skin flaking, which are self- limiting and resolve up to a week after treatment (Fraxel Laser).
The efficacy of Fraxel and other FT lasers has been studied in multiple clinical trials in comparison to other laser treatments. For periorbital lines and wrinkles, a 54 percent improvement was seen after one month of treatment. After three months of treatment, there was a 34 percent improvement in wrinkle appearance and a 47 percent improvement in skin texture. These clinical trials and studies report that Fraxel has better results for mild to moderated wrinkles and lines on the face and may not be effective for deeper lines. This speaks to the mechanism of FT lasers, which are nonablative, meaning that the stratum corneum remains intact and does not peel away after treatment (Gold M, Manstein D).
Fraxel is a popular laser treatment that is beneficial for patients looking for minimally invasive cosmetic augmentations with high clinical efficacy. Moreover, Fraxel has been clinically studied and has received FDA clearance for a variety of uses with high safety and efficacy as well as minimal side effects. It is one of the preferred treatments in patients looking to treat wrinkles without surgery.
Citations:
“Fraxel Laser .” Fraxel, SoltaMedical, www.fraxel.com/#faq. Accessed 18 Apr. 2024.
Geronemus R. G. (2006). Fractional photothermolysis: current and future applications. Lasers in surgery and medicine, 38(3), 169–176. https://doi.org/10.1002/lsm.20310
Gold M. (2010). Update on fractional laser technology. The Journal of clinical and aesthetic dermatology, 3(1), 42–50.
Manstein D, Herron GS, Sink RKH, et al. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med. 2004;34(5):426–438.