Many options exist to treat aging skin with laser technology. Basically, there are two types of laser treatment, ablative and non-ablative. Non-ablative laser resurfacing traditionally does not remove the outer skin layer. This type of resurfacing treats the deeper layers of the skin and has less downtime and post laser care.

Ablative resurfacing produces a controlled micro burn of the outer skin layers and creates a moist healing environment. This type of resurfacing requires a longer recovery and also meticulous post laser skin care for 1-2 weeks. This type of resurfacing also produces the most dramatic results of all skin resurfacing procedures.

Fraxel is the band name of a laser that employs fractional resurfacing. There are also other brands of laser that also provide fractional skin resurfacing. Fractional resurfacing is different from conventional laser skin resurfacing in several ways. The biggest difference is the way the skin is actually lasered. With conventional laser resurfacing, the laser makes a burn on the skin in the form of a ½ inch square. With conventional laser, the entire tissue inside that square is treated with the laser. This would be analogous to painting a wall with a paint roller where the entire wall is covered with paint. With fractional resurfacing, the laser leaves small spaces between the treated areas within the ½ inch square. This would be like painting polka dots on a wall close together. The wall is covered with closely spaced dots, but some areas remain unpainted.

When the fractional laser treats the skin, the laser makes micro burns but leaves normal untreated skin between the small burns. By doing this, the entire face is not burned. Since there is less of a laser burn, the face is not as burnt to the same extend as conventional laser skin resurfacing. This means that the treated areas will heal faster with less pain and recovery. Since only some of skin is damaged, the post operative care is much less. Fractional laser skin resurfacing treatments typically heal in 3-5 days as opposed to 1-2 weeks with aggressive laser treatments.

ActiveFX In fractional resurfacing only a fraction of the skin is burnt by the laser as opposed to the entire surface. This "polka dot" technique damages less skin and provides less pain and faster healing.

This image shows the spaced pattern of the fractional laser technique. Notice that the entire skin surface is not lasered, only the spotted areas.

Sound too good to be true? Well, it kind of is. The gold standard for treating facial line and wrinkles, sun damage, age spots and pore size reduction is aggressive CO2 laser resurfacing. No other technologies (including fractional) resurfacing can match these results; plain and simple. The down side of the aggressive CO2 laser resurfacing is that it requires almost two weeks to heal. Although there is longer healing, the results have not been equaled with any other lasers. If a patient truly wants optimally impressive results then 12 days is not an unreasonable time to reverse decades of wrinkling and sun damage.

The Power of Fractional Laser Skin Resurfacing

The true advantage of fractional laser skin resurfacing is the ability to obtain mild to moderate improvement with minimal down time. Some patients will settle for a lesser result if it avoids extended time away from work or play. Fractional laser resurfacing is also excellent for younger patients that do not have sever wrinkles or sun damage, but need a “freshening up” of their skin. Most patients notice an immediate improvement of skin texture and a smoother feel. In addition, superficial sun damage and sun spots are usually improved. The finest skin wrinkles may be improved, but deeper lines and wrinkles are usually not improved. Fractional treatments can be repeated for increased results.

Fractional laser treatment WILL NOT EQUAL THE RESULTS OF AGGRESSIVE CO2 LASER and the patient must beware of inflated marketing efforts by the media and laser companies. On February 1, the Today show compared Fraxel treatment to a facelift. This is sadly untrue and will produce many disappointed patients if they believe that Fraxel treatment will provide 1/100 of a facelift result. In a nutshell, this is a newer, friendlier laser treatment with advantages for selected patients. It is not a miracle and will not replace other laser techniques and especially not facelift. It is an additional tool in the bag of tricks for the cosmetic surgeon. One advantage is the ability to treat the neck, hands and other areas of the body that are too sensitive for aggressive laser treatment. Finally, fractional resurfacing can also be carefully used on skin of color which is an additional advantage.

Active FX is a fractional laser treatment from Lumenis, one of the most respected and innovative laser companies in the world. Active FX laser treatment utilizes fractional technology and is an attractive option for patients wanting skin damage improvement with minimal downtime. Dr. Niamtu is a certified trainer for Lumenis and Active FX and teaches this technology to doctors from multiple cosmetic specialties.

Dr. Niamtu offers the full gamut of laser skin treatments and owns numerous lasers to provide a vast array of contemporary treatment options. Each patient is different and presents specific challenges for any laser treatment. We invite you to make an appointment with Dr. Niamtu to see if fractional laser treatment is right for you and to explore other laser resurfacing. Dr. Niamtu will customize a treatment using the proper lasers to suit your skin type, level of damage and recovery time.

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Drs. Niamtu, Alexander, Keeney, Harris, Metzger, Dymon & Associates
11319 Polo Place, Midlothian, Virginia 23113