Fraxel laser resurfacing uses the 15-year-old Fraxel Dual laser. This laser is one of our favourites for skin rejuvenation, sun damage & pigmentation. It is underwhelming for acne scarring as other lasers perform much better with less cost.
- Fraxel is a well-known laser brand that delivers fractional laser beams
- This laser is brilliant at treating sun damage, age spots & precancer lesions
- A series of fractional laser treatments can improve acne scars
- We find that other CO2 fractional lasers are better at scar treatments than Fraxel
Fraxel Lasers for Acne Scars at a glance
Our results speak for themselves
Fractional lasers treat a portion of skin. This is expressed as a percentage of the surface area. It typically ranges from 5 to 70%.
Fractional lasers have the following advantages-
- Less pain
- Less recovery/downtime
- Less side effects, including post laser pigmentation
- Easy to use as it is computer protocol driven
The major disadvantage is that Fraxel has limited capacity to deliver custom settings. Apart from that, their 1550nm scar wavelength is underwhelming, & the company charges for a consumable. This is added to the patient’s overall costs.
The most common wavelength is the Fraxel Dual with the 1550nm non-ablative as well as the outdated 10,600 nm CO2 Fraxel RePair.
Fraxel also has a 1927 thulium wavelength that is excellent for sun damage & mild to moderate wrinkles.
It is not great for acne scarring. We have two Fraxel Dual lasers, however we employ other lasers for scar revision as they are more effective & cost less for the patient. The argument is not that it does not work, it is that lasers such as the eCO2, erbium Sciton, MixTo, Ultrapulse work a lot better.
Fraxel also has the RePair, a CO2 fractional laser. We handed that back to the company after 2 years as it is inferior compared to other lasers.
3-5 with Fraxel Dual. Using a properly calibrated CO2 laser, we can half the sessions required.
Treatments are spaced 6-10 weeks apart. If your own Google research has shown that Fraxel 1550 is the treatment of choice, sure, we can fire up the 2 systems.
Recovery depends on the settings. With higher settings, downtime approaches a week. This is very similar to a short pulse duration CO2 laser.
Downtime for RF microneedling is even less, about 2-4 days. The results are better than Fraxel.
Fraxel laser can be used to treat deep acne scars, however there are much better options that are more effective, & more cost effective. These include CO2 lasers as well as radiofrequency microneedling. Be guided by your specialist.
Our dermatologists and nurses perform revision based upon matching treatments to the scar type. These include-
- Deep focal peels: TCA or Phenolic acid. This is known as CROSS or paint.
- Laser resurfacing (full ablation): Erbium or CO2 lasers
- Fractional lasers: MixTo, eCO2, CORE 2, Ultrapulse Deep Fx, Scar Fx, Fraxel
- Subcision: Nokor, blunt cannula, hypodermic, Taylor, dovetails
- RF microneedling using the Genius RF or Lutronic Infini
- Microneedling with Dermapen, SkinPen & derma rollers
- Nano RF treatments; older eMatrix series
- Surgical: Punch elevation, excision, grafting, dermal grafting, fat transfer, micro pigment transfer
- Micrografting for hypopigmented or white scars.
- Pico lasers for dark scars or PIH
- Vascular lasers for red scars or marks.
- Surgical excision for linear & deep ice pick scars.
- Steroid injections for raised scars.
When other devices are not working, or if the patient is adamant that Fraxel is the best choice for their scars (& no one can talk them out of it).
On a serious note, we perform 4 to 6 Fraxel treatments a day, but they are not for acne scarring.
Commercial gain. Fraxel lasers are marketed to do everything- from melasma pigment, wrinkles, pores, hair loss & haemorrhoids. The reality is that they are excellent for some things (pores, wrinkles, sun damage) and really bad at others.
Fraxel is also an easy platform to learn, hence it is good as a beginner laser. The parameters are limited to keep operation simple at the expense of providing better outcomes for scarring.
Undergoing scar revision is an investment of time, effort, and money for patients. Here are some helpful points that may help you along your journey.
- Always control your acne. You will go infinitely faster & better with any scar revision treatment; this includes fractional lasers. If you have inflammation, collagen remodeling is compromised. If in doubt, seek professional advice from our dermatologists and nurses.
- Time. Collagen remodelling does not occur in weeks, but months. You must be committed to the timeline & treatment plan.
- Sun protection is paramount. It does not mean you can’t go out in the sun; it means sun protection is important. SPF 50+ twice a day regardless of exposure. If a 50 ml bottle lasts longer than 3 weeks, you are not using enough sunscreen.
- Darker skin types; you may require more sessions compared to lighter skin. In some cases, we will expectedly darken your skin, but will come up with solutions to lighten it back to normal.
- Costs. If cost is an issue, our nurse led scar clinic can provide you with cost effective treatment options. This way you can budget spend & maximise your gains.
Settings of laser / devices matter. Lasers are just tools to get the job done. Parameters are crucial for best outcomes. Additionally, using the best brands are important.