Faxel Laser

Fraxel Laser – A Trio of High-Tech Skin Rejuvenation Treatments

Reviewed by Yael Halaas, MD

Sun damage, dark spots, old acne scars, large pores, wrinkles — are these signs of aging staring back at you when you examine your face in the mirror? Whether your skin damage is mild, moderate or severe, the Fraxel laser may help.

Fraxel is a laser skin rejuvenation treatment that resurfaces your outer skin, erasing imperfections. It also encourages the production of collagen, a protein found in connective tissue. Collagen is instrumental in maintaining firm, youthful, healthy-looking skin, but its production drops off as we age. The result is clearly visible lines, folds and wrinkles.

Courtesy of AAFPRS

Fraxel laser skin rejuvenation is a non-invasive technique that affects only about 20 percent of the facial skin exposed to it. It works by creating tiny wounds in the dermis, the dense inner layer of skin where collagen is produced; the top layer of skin (epidermis) remains undamaged. As the dermis heals itself, old skin cells are sloughed off and collagen regeneration occurs, resulting in improved skin tone, appearance and elasticity.

The Fraxel laser is approved by the U.S. Food and Drug Administration for a number of rejuvenating treatments for the face, neck, chest and hands. Fraxel is not the only laser that uses "fractionated" technology to resurface and rejuvenate your skin. There are several others. The main difference among them is in the wavelength of light that they emit during treatment.

Three Levels of Treatment

There are three varieties of Fraxel laser treatment. They vary in aggressiveness, downtime, number of procedures needed, after-treatment wound care, and results.

Fraxel re:fine is the gentlest version and is used for prevention and maintenance. This superficial fractional, non-ablative cosmetic procedure staves off the signs of aging by treating minor skin damage, including fine lines around the eyes, age spots, pigment irregularities (hyper- and hypopigmentation) and uneven skin tone. Fraxel re:fine may require four to six treatment sessions; discomfort is mild, downtime is minimal.

Fraxel re:store treats mild to severe damage to the skin. This fractional, non-ablative treatment targets wrinkles around the eyes, acne and surgical scars, age spots, melasma (dark pigmentation of the skin, also known as the mask of pregnancy) and Actinic Keratoses (dry, scaly, rough-textured patches on the skin caused by exposure to ultraviolet rays.) Three to five Fraxel re:store treatment sessions are usually needed, during which you may experience mild to moderate discomfort. Social downtime is two to four days.

Fraxel re:pair is touted by its manufacturer, Solta Medical, as a "preemptive strike against a facelift" that provides dramatic results that tighten the skin and correct the severest skin damage. This includes deep frown lines and wrinkles, irregular texture and sun-induced redness. Fraxel re:pair is a single treatment procedure involving a fractional ablative CO2 laser. It causes moderate to significant discomfort and requires downtime of a week or more, as well as two to three days of wound care.

Fraxel laser treatments are sometimes used in tandem with Thermage, which focuses radiofrequency energy on the deeper dermis and subcutaneous layers to tighten and contour the skin and stimulate new collagen growth.

Are You a Candidate for Fraxel Laser?

If you are considering Fraxel laser for skin rejuvenation, consult with a board-certified plastic surgeon or facial plastic surgeon who is well-versed in the procedure. He or she can answer all your questions, ascertain your aesthetic goals and help you determine if you are a good candidate for Fraxel laser or, perhaps, some other skin rejuvenation treatment.

If you are ready to start your search for a surgeon, All About Facial Rejuvenation can help. Our directory exclusively lists surgeons who have undergone extensive training and are experienced in the full range of facial plastic surgery procedures.

Fraxel lasers can be used on a wide variety of skin types, but the range varies depending on the Fraxel level chosen. Fraxel re:fine works on all skin types, from very white or freckled to black. Fraxel re:store is recommended for skin ranging from very white to brown, while Fraxel re:pair is limited to very white to olive skin. The right choice for your skin type and condition should be determined in consultation with your physician.

Alternatively, another non-invasive facial rejuvenation procedure is Pelleve, which uses radiofrequency energy to firm and tighten skin, eliminating mild to moderate wrinkles in the process.

Preparing for Fraxel Laser Treatment

Fraxel laser treatment is performed in your doctor's office. The treatment area is cleaned thoroughly and a topical anesthetic ointment is applied. Once the anesthetic has taken effect (usually within 60 to 90 minutes), the treatment can begin.

During the procedure, expect to feel a slight pressure against your face with each pulse of the laser. Some people liken it to snapping a rubber band against their skin. The length of the procedure depends on the size of area being treated, but 30 minutes to an hour is typical.

After the treatment is over and the anesthetic is removed, you will have some redness and swelling, similar to what you feel from a sunburn; the degree will vary depending on which Fraxel treatment you received. These side effects are part of the natural healing process as new skin is built from the inside out.

It's normal for the skin to take on a bronze hue over the first couple of weeks after a Fraxel laser treatment. The skin will repeat the sunburn-to-bronze cycle after subsequent treatments and continue to exfoliate normally.

Your physician will instruct you on how to care for your skin as it rejuvenates. This usually includes the use of a moisturizer with an SPF of at least 30; direct sun exposure should be avoided for at least three months. The full results of your Fraxel laser treatment will evolve over several months.

Fraxel Laser Risks

The most common side effects of Fraxel laser treatment are edema (swelling) and skin redness; both should subside within a couple of days. Other temporary side effects may include minor itching, dry skin, peeling or flaking, and a bronzed skin appearance. The risk of infection or scarring is very limited.

The best way to minimize your Fraxel laser risk is to choose an experienced physician. Ask how often he or she uses the Fraxel laser and request to see before and after pictures of others who have undergone the procedure.

Fraxel Laser Cost

Fraxel laser treatment cost is in the $400 to $1,000 range per session. Since it is a cosmetic procedure, medical insurance will not cover it. If the out-of-pocket cost is prohibitive, financing may be available through your physician.