Fraxel laser

Fraxel is the newest achievement of laser technology used in dermatology for intensive skin regeneration. Fraxel treatment rejuvenates damaged skin, soothes wrinkles, eliminates scars, stretch-marks, enlarged pores and multiple other skin conditions, like, e.g. uneven pigmentation or discolouration.

How does it work?

FRAXEL is a laser emitting light with the wavelength of 1550 nm, whose energy is absorbed by the water contained in the cells of the epidermis and dermis. The laser light generates a stream of pulses of microscopic diameter, evenly scattered on the skin, due to the scanning head. FRAXEL does not irradiate the skin surface uniformly, but it "perforates" the skin with thousands of microscopic points of light. In this way, fractional (hence the name of the laser technology), microthermal treatment zones (MTZ) are created. The laser pulses penetrate the skin with respective distance, so as not to burn it, but effectively stimulate the dermis to regenerate. It is possible thanks to the fact, that each irradiated spot is surrounded by healthy tissue, which allows the skin to heal very quickly.

The pulse density is precise and regulated on the whole treatment area. Fraxel® laser induces a change in the tissue structure, deep under the epidermis (up to 2mm), enabling unique conditions for full and lasting regeneration of collagen and elastin. During the session, the laser beam penetrates through the epidermis with no damage to the skin surface. It works like a dressing, so that the skin needs only little time to regenerate.

Generally, FRAXEL enables the exchange of a number of skin cells damaged either by the ageing process or skin diseases into totally new, healthy cells.

The procedure:

The parameters for the treatment (energy, number of MTZ, the size of the treated area) depend on the skin condition and a specific treatment area.

During the procedure, the doctor creates thousands of microscopic channels in the skin with the use of a special laser head. Number of "passes" through the skin may wary from 6 to 10. Throughout the treatment, only 20 to 25% of the whole treatment area is ablated. In this way, about 75-80% of the tissue remains intact, which supports collagen restructuring and enables faster healing.

The procedure is quite painful. The experienced sensation can be compared to injecting hundreds of hot micro needles into the skin. Therefore, local anaesthesia is required (EMLA cream). Additionally, to reduce the discomfort, patients may use external cooling devices during the treatment (coolers).

Immediately after the procedure, patients experience redness and swelling on the treated skin. The skin may be irritated, stinging, itching and feel tight and dry. This effect may last for about 2-3 days. Then, flaking of the skin occurs - as a result of the new skin replacing dead skin tissue. Additionally, during the healing time, the skin may have a bronze appearance that can last up to 2 weeks. The full effect of the treatment is visible after about 4-5 weeks. For best results, it is recommended to have a series of 3-5 sessions every 3-6 weeks. Remodelling of collagen, resulting in further softening and firming of the skin, will continue for the next 6-12 months following the treatment.

Skin-care recommendations after the procedure:

• skin care with mild hydrating and regenerating cream (e.g. Cetaphil PS, Physiogel, Cicalfate Avene, Hydrabio Bioderma etc.),
• sun protection - using cream with SPF>30 for about 4 weeks after the treatment,
• make-up: possible already on the next day after the procedure,
• social downtime: 1-3 days, however, usually, return to work is possible on the next day;

Undesirable effects:

So far, no cases of permanent side-effects (scars, infections) of FRAXEL laser therapy have been reported. In the cases of more intensive treatments, there might occur temporary, small blisters and/or temporary discolouration (especially in patients with darker complexion).

Indications:

• acne scars:
  - atrophic, sunken (depressed)
  - thinned out, cigarette paper-like scars
  - little, raised, follicular, resembling milia
• skin rejuvenation on the face, neck, upper chest and hands,
• removal of fine lines around eyes,
• improvement of the face oval,
• improvement of skin density and elasticity,
• closing enlarged pores,
• regeneration of sun-damaged skin, including actinic keratosis,
• stretch marks,
• flaccidity of the skin on the upper arms, abdomen, after pregnancy,
• removal of discolouration (melasma, other dyschromias),
• modelling of atrophic surgical, post-traumatic and burn scars;

Contraindications:

• oral isotretinoin therapy (Izotek, Curacne, Aknenormin) or oral steroid therapy,
• skin cancer,
• pregnancy and breastfeeding,
• active bacterial and viral infections of the skin,
• chronic inflammatory dermatoses (e.g. psoriasis, atopic dermatitis),
• fresh suntan (a week before treatment),
• a period of 4 weeks since the treatment of filling wrinkles with hyaluronic acid,
• hypertrophic scars and keloids cannot be treated with Fraxel laser!

Sensitive skin with dilated capillaries or allergy-prone skin is also suitable for Fraxel treatment!

Body areas most often treated with Fraxel laser:

• face (photorejuvenation, acne scars, discolouration) - also treatments of the chosen facial zones are possible, e.g. only the cheeks, forehead, the area around lips,
• neck (wrinkles, photorejuvenation),
• upper chest (photorejuvenation, loss of skin firmness),
• dorsal part of the hands (photorejuvenation),
• area around eyes (wrinkles),
• back (acne scars, discolouration),
• abdomen (stretch marks, skin flabbiness after pregnancy);

Safety:

Fraxel® technology is FDA ( Food and Drug Administration - an agency of the United States Department of Health and Human Service) cleared. The procedure is safe, so far, no cases of scarring or infection have been reported.

Effectiveness:

The changes of the epidermis and collagen fibres obtained in Fraxel® laser therapy are lasting; nonetheless, the sun exposure, passage of time and gravitation inevitably play their role. The Fraxel® laser may "turn back the time" but it cannot make the passing time to stop.

Fractional lasers:

The name FRAXEL® is reserved for the fractional laser produced by American company Solta Medical (formerly Reliant). First trials with the device started in 2001. In 2004 it was FDA cleared for rejuvenation of the skin around eyes and removal of discolouration, in 2005 for photorejuvenation and the treatment of melasma (mask of pregnancy), and, in 2006, for removal of the acne scars. Obtaining FDA certification means, that the safety and effectiveness of the laser were proved by numerous tests and studies (published in scientific press), are known and predictable. The main difference in the mechanism of action between Fraxel and other lasers lies in the fact that the Fraxel irradiates skin in a smooth manner, which allows for uniform, even and precise coverage of the treated skin with micro channels. Other fractional lasers are based mainly on a stamping technique, where it is difficult to obtain an ideally even and consistent effect.

Photos of patients after treatment with Fraxel® laser:

Acne scars

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