Fraxel; At A Glance
- Best Results1- 3 treatments
- Treatment Recovery3-6 days
- Procedure Time30-40 min
- Skin SpecialistDermal Therapist, Nurse, Dermatologist
- Duration of Results60++ months
- AnaestheticNumbing, gas, sedation
- Back to Work3-6 days
Fraxel Fractional Laser
Fraxel laser can be used to treat skin pigmentation, wrinkles, acne scars & sun damage. Treatments are tailored according to your skin concern & downtime. We employ a unique method of Fraxel laser resurfacing called ‘High Density’. This means the vast majority of patients require only one treatment. This laser can be combined with other laser wavelengths to give even better results, a term we call hybrid laser resurfacing. Used in combination we have the ability to tighten & lift at the same time.
FactsFacts on Fraxel laser
- Fraxel is a type of fractional laser
- This laser treats ‘fractions’ of skin, this means increased safety with all skin types and quicker healing times
- Fraxel can be used to treat skin aging, improving skin texture & tone
- It also addresses acne scars, pigmentation, & age spots,
- Recovery can be tailored from 3 to 6 days
- Fraxel resurfacing is bespoke, tailored to your skin condition, downtime & skin type
- Contrary to reports, the majority of patients will require one high density treatment
- Application of other laser wavelengths can provide collagen contraction & in most cases lifting
What conditions can Fraxel treat?
There are 3 types of Fraxel lasers that I use, the 1927, CO2 & the 1550. Depending on what you would like to improve or treat, a custom prescription of the power, density and mix of lasers will be provided by either by me or our laser nurses.
Skin rejuvenation– Fraxel 1927 is one of the best lasers for skin rejuvenation in patients aged 20-55. This laser can improve wrinkles, pigmentation, sun damage, sunspots & enlarged pores. It will give an excellent improvement in skin quality with just one treatment. We use this laser in a unique way, delivering high density fractional beams.
Age spots- Again Fraxel 1927 is my favored laser. I combine this with other lasers including erbium & CO2 wavelengths. Flat age spots can be treated with both IPL and Fraxel. Again, the majority of patients require one treatment.
Sun damage- High density 1927 is my treatment of choice. This laser out performs PDT and creams such as Efudix and Picato. Healing time is only 5 days with this treatment. Expect up to 90% improvement of solar keratosis & sun damage.
Chest and neck rejuvenation – This is where combination Fraxel 1550 & 1927 works best. 1550 Fraxel stimulates collagen and provides tightening of the skin on the neck, whilst 1927 treats superficial pigment. Another wavelength that I use is CO2, often with 1927 Fraxel. 3-5 treatments are recommend, as the neck skin is thinner than the face.
Melasma- low power high density Fraxel has been shown to be help reduce pigment by up to 50%. 3-5 treatments are needed. Fraxel is not my first choice for melasma, as nano & pico lasers are more effective (& more cost effective). I do employ this laser for resistant cases of melasma.
Acne scarring– mild rolling and atrophic acne scars do best with Fraxel laser. In this setting I like to use the 1550 wavelength of this laser. The results are underwhelming, even with high energy levels. I tend not to employ this laser for scar revision as there are many other devices that deliver better results. If your research has shown that Fraxel is the right choice for you, by all means book a session with my clinical team. 3-5 Fraxel treatments are recommended.
Asian and ethnic skin rejuvenation –This laser is gentle enough not to cause unwanted side effects, but strong enough to provide consistent results. Darker skin patients will require 2-3 sessions for best results. Pico lasers have replaced Fraxel laser in the context of ethnic skin rejuvenation.
How does Fraxel laser resurfacing work?
Fraxel laser works by treating a ‘fraction’ or portion of skin, allowing healthy tissue to regenerate. The untreated fraction of skin allows for faster healing times.
Fraxel is a form of fractional laser resurfacing. There are numerous fractional devices that I use, including Fraxel 1927, Fraxel 1550, Fraxel CO2,Erbium Sciton, CO2 CORE fractional laser, Mixto laser, Juliet erbium laser, eCO2, Ultrapulse lasers, Genius RF, Infini RF, Tixel, ematrix RF, ePrime fractional needling, and fractional skin needling with Dermapen. All these devices work in a very similar way- they only treat a fraction of the skin’s surface. This means faster healing times, lower side effect profile, but consistent results, provided treatments are performed correctly.
Fraxel laser delivers columns of laser light. We control variables such as the density, power and wavelength. This gives us the ability to perform bespoke treatments.
Is Fraxel the best treatment for acne scars?
Fraxel can be a great ‘overall treatment’ or generic prescription for acne scars, however as a Specialist I always ‘map out’ scars. Each type of acne scar will have a particular solution that is best for that type of scar.
Fraxel is a treatment option for mild rolling, atrophic and mixed acne scars. Scars such as depressed and tethered- anchored scars do well with subscision and do not respond to Fraxel. Deep ice pick scars do best with TCA chemical peels. Shallow box cars scars are best treated with one single session of erbium plus CO2 Fractional lasers compared to multiple Fraxel laser treatments.
It is not that Fraxel does not work for acne scars, the fact remains that there are many better treatments for scars. Do not use one device to treat many skin conditions. For example, short pulse duration CO2 lasers, will give much better results compared to Fraxel Dual or even Fraxel RE:Pair.
Can Fraxel remove wrinkles?
Yes. Fraxel is one of the best wrinkle removing lasers at Cutis. Laser resurfacing can remove shallow to moderate wrinkles. For deeper wrinkles & lifting, we combine low density CO2 laser with Fraxel. This combination stimulates more collagen & provides contraction. This result in lifting. This form of laser resurfacing is called ‘Hybrid Laser Resurfacing’, meaning we combine different wavelengths.
For marked sun damage with deep wrinkles, my combination of Erbium and CO2 works best. This is called fully ablative laser resurfacing and is reserved for marked sun damage, wrinkles, pigmentation, skin ageing & severe acne scars.
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Is Fraxel the best treatment for skin pigmentation?
The best treatment depends on your diagnosis and skin type. If you have sun-spots, Fraxel is one of the best lasers for this type of pigment. If you have melasma, Fraxel is not ideal (other lasers are more effective, both clinically and cost wise).
Fraxel can treat pigment in Asian – Ethnic skin, however pico lasers are far more cost & clinically effective.
How long does treatment take?
On average each treatment takes 30 minutes. Remember the numbing cream is left on for 60 minutes before Fraxel. Give yourself 1.5 hours for the entire process. Fraxel laser resurfacing is quick & well tolerated.
We use a special form of numbing gel that is 3 times as powerful as most other clinics. We also have laughing gas to help you through the process, should you be anxious.
Is the treatment painful?
Fraxel laser is well tolerated. On a pain scale of 0-10 (10 being the most painful), most patients rate Fraxel between a 2-3. We use a specially formulated numbing cream that is 3X stronger than EMLA. This ensures patient comfort levels.
If you are super nervous, this procedure can be done under partial sedation.
What can I expect after Fraxel treatment?
Your recovery will depend on the power & density of Fraxel. We will give you an accurate idea of the recovery process based upon the planned laser settings.
For medium depth laser resurfacing expect the following-
Day 1: immediately after laser your skin is slightly red, you can wear a special make up called Lycogel to hide this.
Day 2-4: your skin will gently peel. Make up cannot hide this.
Day 5: your skin is pink and healing. You can wear make up at this stage.
Day 6: your skin is back to normal.
Recovery is not painful, but you may experience a slight itch from day 2-4 as you peel.
For very high density setting, or added CO2 add another 36 hours to the recovery process.
Can Fraxel treat other areas of my body such as my neck, chest and arms?
Yes. Fraxel is ideal for sun damage on your check, chest and arms.
In these areas it can be combined with IPL or BBL – a procedure we invented called pulse Fraxel.
We recommend a series of 2-3 Pulse Fraxel treatments for the very best results in these areas.
I prefer Fraxel for areas such as the arms, hands, chest & neck. The reason is that fractional lasers give a much better blend, without areas of demarcations.
How many sessions of Fraxel will I need?
The number of sessions will depend on 3 factors.
- Your skin colour is the most important- darker skin patients will need more treatments than fair skin patients. (Darker skin clients include Asian skin, Hispanic, and Middle Eastern)
- The condition we are treating- acne scarring will need more sessions (3-5) compared to treating solar keratosis or sun damage – freckles. These conditions will only need one treatment.
- Your down time. We can ensure that your skin heals up in the specified or requested time. The more power that is used, the longer the down time, the less treatments you need. Conversely, if low power Fraxel is used, the more treatments are needed (eg. Asian or melasma patients).
Asian & ethnic skin presents a unique challenge to Specialist – skin rejuvenation must be gentle, or post laser darkening will ensure. For darker skin types, my choice would be Pico lasers.
How does Fraxel compare to HALO Laser Resurfacing?
I prefer Fraxel 1927 over the HALO wavelength. The reason is that we can achieve much better results with this wavelength. If downtime is an issue, we can reduce the coverage to ensure that your skin heals up in 2 to 3 days.
HALO uses an erbium ablative wavelength. I occasionally employ erbium, however low density short-pulsed CO2 lasers deliver better collagen remodeling with the same downtime.
What is Fraxel Hybrid Laser Resurfacing?
This treatment is called Dual Laser Resurfacing meaning we use two laser wavelengths in the one session. The most common wavelength we employ is the CO2 or 10600 nm. By adding CO2, we can get-
- Better remodeling of collagen
- Better skin tightening
- Better reduction of fine lines & wrinkles
- Better pore size reduction
- Better pigment reduction
Applied sensibly, your additional downtime will only be an extra 24 to 36 hours. My nurses will discuss if Hybrid Laser Resurfacing is right for you.
What are the side effects that can happen from Fraxel laser?
Side effects are rare from Fraxel. In fact this laser is one of the least complex procedures we perform.
Side effects are very uncommon however include-
- Infection (less than 2% of cases)
- Prolonged redness (more common in rosacea patients and people who flush and blush)
- Darkening of skin (much more common in Asian patients or melasma patients- hence low energy sessions are prescribed or pico lasers are used)
- Demarcation lines and borders- this is because skin is treated and ‘new’ in areas such as the neck and chest. This is easily fixed and identified prior to treatment. The solution is multiple treatments to ‘feather in’ treated and untreated areas. We will discuss the number of sessions needed if you are aiming for extra-facial rejuvenation. In these areas Pulse Fraxel is a better option for blending.
Why is Fraxel one of my favored lasers?
- This laser is gentle to the skin but delivers consistent & predictable results
- This can be safely used on all skin colors
- We can control the density of ‘fractions’ of the surface area treated
- We can blend in areas, and also treat stubborn areas with more passes
- We can combine this laser with all different wavelengths to achieve my desired outcome- this means combining this with CO2, IPL, Q Switch and even another Fraxel laser 1550.
Safety, patient comfort, flexibility and results- this makes Fraxel one of the most widely used lasers in our practice.
How much does Fraxel laser cost?
- Standard Face Fraxel cost $1290 per treatment
- High density Fraxel cost $1390
- Hybrid Fraxel CO2 cost $1990 upwards
- Fraxel –face, neck, chest
The majority of patients will only require ONE session of Fraxel laser resurfacing. The reason is that we use this laser in the advanced high-density mode, thereby providing greater coverage & bulk heating of the skin. This results in far better wrinkle reduction & in most cases lifting.
Addition of CO2 (Hybrid Laser Resurfacing) can provide even better outcomes.
Is Fraxel laser covered by Medicare or Private Health Insurance?
No Fraxel is not covered under Medicare or any private insurance. As a guide Medicare will provide a subsidy for the follow lasers and conditions –
- Scar revision conducted by a Specialist- this includes procedures such as subscision and surgical revision
- Treatment of scars (acne, traumatic, and surgical scars) using fully ablative laser such as erbium or CO2
- Treatment of red skin conditions including rosacea (conditions apply), red birth marks, including port wine stains and spider naevi, red spots that can be seen at 3 meters or more
- Sun-spots can be covered by Medicare, however if you have a white or Gold Card from DVA you are entitled to PDT treatment
Davin’s Viewpoint on Fraxel laser
Fraxel International Advisory Board
Inventor of High Density Fraxel
Fraxel has a heap of marketing behind it. Granted, it is a very good laser especially in the Fraxel Dual 1927 wavelength. Did you know that Fraxel itself comes in 3 wavelengths, namely the 1927 (best), the 1550 (not great but OK) and the Fraxel CO2 Re:Pair (far better & more cost effective CO2 lasers out there).
Fraxel outperforms IPL and even fractional RF treatments because this laser improves texture & wrinkles- even with one treatment! Sun damage can be markedly improved, and even deep wrinkles can be effaced. With the high density setting, the vast majority of patients require only one session.
Recovery can be tailored from 3 to 6 days. The higher the laser density the longer the recovery, the better the results. Most patients have this done on a Friday afternoon, and they are back to work on a Tuesday. The big plus with this laser is that treatments are well tolerated.
Over the past few years, we have been adding different wavelengths to this laser, namely carbon dioxide fractional laser. This term is called ‘Hybrid Laser Resurfacing’. This fusion of lasers is now mainstream, practiced in the majority of dermatology practices in Australia & overseas.
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