Everything You Need To Know About Fraxel Laser Treatments

You’ve likely heard of Fraxel®, but do you know its benefits? Top dermatologists break down the ins and outs of the skin resurfacing procedure.
Written by Amber Katz
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Everything You Need To Know About Fraxel Laser TreatmentsPark Street/Unsplash

Looking into lasers? Now’s the time — especially if you’re lucky enough to work from home. There are probably no social gatherings, weddings, or birthday parties on your calendar for the foreseeable future. One laser with a lot of name recognition? Fraxel®, which addresses skin concerns ranging from hyperpigmentation and acne scars to dullness to fine lines by essentially peeing them all away to reveal a fresh layer of healthy, glowing skin.

Why is this laser skin resurfacing treatment so popular at the moment? “Now, people want the bigger bang for their buck. They have more time for downtime being home and money to spend from not going on vacations or dining out,” says Paul Jarrod Frank, MD, a New York City-based board certified dermatologist and author of The Pro-Aging Playbook. “Patients are doing more aggressive treatments like Fraxel® versus Clear + Brilliant®, FaceTite versus Ultherapy®, or tumescent liposuction versus non-invasive fat removal.”

Here, top cosmetic dermatologists break down the technology, what it treats, the recovery process, how long the results last, and more.

How Fraxel Works

Fraxel® is a fractional laser treatment, which means it only targets a fraction of the skin at a time. “It is the Ferrari of laser resurfacing,” Dr. Frank says. Why? The device is both versatile and customizable, with the ability to go through every layer of skin. “The advantage of Fraxel® over other laser skin procedures and treatments is that you are not breaking the skin, the healing is rather open,” he notes.

The Fraxel® portfolio has different treatment options depending on a patient’s skin concerns. Regardless of which device you choose, it works by creating tiny columns of microthermal treatment zones that stimulate cellular regeneration and collagen production to accelerate the body’s natural healing processes. As such, Fraxel® treats fine lines and wrinkles, such as crow’s feet and brow lines, in addition to surface scarring, explains Dendy Engelman, MD, a board certified dermatologist in NYC. It also addresses pigmentation issues like age spots, sun damage, actinic keratosis (a common precancerous skin condition), and the appearance of large pores.

Types of Fraxel

Fraxel® Dual is a non-ablative (read: non-wounding) fractional laser that features two wavelengths (1550 and 1927) to address an array of skin concerns on the face and body. The 1927 wavelength addresses skin tone (think: pigmentation concerns), while the 1550 wavelength treats skin texture (read: fine lines and wrinkles and scarring). For those interested in a more dramatic result, Fraxel® Repair is an ablative (i.e. wounding) fractional treatment featuring a carbon dioxide (CO2) laser wavelength. It can treat deeper scars and wrinkles, in addition to skin laxity.

Ideal Candidates for Fraxel

Those looking for anti-aging, scar correction, stretch mark improvement, or preventative care are all good candidates for this treatment, Dr. Engelman shares. Fraxel® Dual is generally considered safe for most skin tones, including ones on the darker end of the Fitzpatrick scale.

While it’s an effective treatment for hyperpigmentation, those with melasma should tread carefully. “Fraxel®, like most lasers, can make melasma worse, as melasma is often worsened by heat in addition to sun, and lasers are hot,” explains Amy Wechsler, MD, a board certified dermatologist in NYC. An experienced practitioner may, however, be able to assist. “Fraxel® can certainly be helpful in those who have melasma, but it should be performed by a licensed and trained physician who knows the intricacies, risks, and specific and appropriate treatment parameters,” Dr. Engelman notes.

What to Expect from a Fraxel Treatment

About a week prior to a Fraxel® treatment, your provider will likely recommend you stop using retinol, retinoids, and other sensitizing skincare products. Skin should also be relatively clear (i.e. no serious breakouts, open wounds, or infections). On treatment day, the area will be topically numbed for about 45 minutes and the procedure itself will take 15 to 30 minutes. Even with the anesthetic, patients report feeling everything from mild tingling to a bee sting-like effect. A good rule of thumb? Expect to experience a prickling sensation.

Fraxel Recovery & Results

It should come as no surprise that recovery time depends on the type of Fraxel® treatment you get. “Recovery time typically includes one week of potential redness (erythema) and swelling (edema), and patients have to be very strict about photoprotection during healing,” says Emma Taylor, MD, a board certified dermatologist and chief medical officer at Symbiome. In fact, your post-op skincare regimen is key to maximizing results. “Patients should avoid all types of sensitizing agents, like serums, retinols, glycolic, and other exfoliating agents for one week, and stay out of the sun at least two weeks following treatment since the skin will be sensitive,” Dr. Frank says.

The first two days post-procedure are usually likened to recovering from a sunburn, and skin texture usually starts to roughen up and flake between days three and five. Some parts of the body respond differently than others, so this may take more or less time. It should also be noted that Fraxel® Repair often has a longer recovery process due to its ablative nature.

Depending on your skin concerns and aesthetic goals, a series of treatments may be suggested. For people with severe sun damage, Dr. Frank usually performs a series of two to four monthly treatments. “For people who want general resurfacing, I recommend a once-a-year treatment,” he says. “People with a history of skin cancer usually get it done twice a year.”

How long results last will vary by patient and skin tone, but Dr. Wechsler says they can be enjoyed for a year or more. Dr. Engleman often recommends annual Fraxel® treatments to maintain the quality of the skin. “We lose one percent of our collagen a year by the time we reach 30, so a treatment like this once a year will help to build up our collagen as opposed to it diminishing,” she explains.

The Takeaway

Fraxel® is an effective treatment option that can address a wide variety of skin concerns for an array of skin tones, but finding the right provider is key. “It’s important to see a board certified dermatologist who is an expert not only at addressing the relevant skin conditions but also someone who understands the potential side effects to maximize benefit and minimize risk to the patient,” Dr. Taylor explains.

Aggressive treatments on the wrong patient or skin type can lead to long-lasting pigment or scarring issues. “Certain patients with underlying health conditions and certain skin types should be treated with caution or not at all, so a proper consultation to determine a treatment plan is always recommended,” Dr. Engleman concludes.

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AMBER KATZis a contributing writer for AEDIT.

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