Today I would like to talk about resurfacing treatments, namely fractional laser (Fraxel).
Fraxel is a non-invasive resurfacing treatment which targets both the superficial layer of the skin (the epidermis) as well as the mid-layers of the skin (the dermis) for both ablative and non-ablative effects. But is it really worth the money? How painful is it? What are the risks involved?
Sadly as we age, our epidermis thins and blemishes become more apparent. Paired with loss of collagen in the dermis, this can lead us to look more aged, wrinkly and have poor skin texture and quality. Luckily, fractional laser targets both of these layers and can restore our skin to give it a more youthful appearance. Win win!
However, it can be a costly procedure to consider (in the UK it costs £500 for the full face and around £1,500 in the US) so it’s worth knowing more about it before taking the plunge.
Fractional laser has a whole host of indications from scars to anti-ageing. Due to it’s collagen stimulating properties, it can be used for resurfacing scars following acne, surgery or trauma. This has had some really successful outcomes and can be done in conjunction to IPL lasers if there is any redness in the scar (more on this topic in later posts). It also has anti-ageing properties and can stimulate collagen production in the dermis as well as target and breakdown pigment in the skin by targeting the pigment producing cells (melanocytes) in the epidermis. Additionally, Fraxel has the potential to treat the notoriously difficult area under the eyes to combat wrinkles. However, this depends on the experience of the practitionner as there is a small risk of causing blindness. If you wish to treat the under eye area, chose your practitionner wisely and enquire whether they offer this service and how they go about doing so. Fractional laser tightens but doesn’t lift. This means it can make skin feel more taut and improve the texture and quality, but it won’t give you gravity defying effects such as lifting jowls, so make sure you adjust your expectations accordingly. It can be done anywhere on the body but is most commonly done on the face, neck, decolletage and hands. In short, it’s a multi-beneficial skin restoring, anti-ageing superstar when done and managed correctly, it can give you a glowy boost that no other potions and lotions can.
With any procedure there can be risks involved, however, the risks with Fraxel are minimal. Although it can be used on skin types Fitzpatrick 1-6 and often aims to alleviate skin conditions with hyperpigmentation, it can unfortunately also cause post-inflammatory hyperpigmentation in some cases. This is of particular concern to those with darker skin types and those who suffer from melasma. To minimise this risk, the laser machine takes into accounts various parameters such as age, skin type, sun exposure and area of the body treated and adjusts the settings accordingly to err on the side of caution. However, I would still avoid Fraxel in patients with Melasma as it’s potentially not worth the risk of exacerbating this condition.
If you are considering booking appointment for this procedure, it is worth avoiding using retinol-based creams for a month prior to the procedure as well sun exposure to the affected area. You can wear make up on the day of your appointment as this will be cleaned off beforehand.
Upon arrival to the clinic, your skin concerns are addressed, the procedure is explained, informed consent is obtained and a series of before photos of the areas to be treated are taken. This is followed by a topical numbing cream which is applied for up to an hour prior to the procedure, unless you are extremely brave. Then the face is cleaned and a white pencil is used to sectioned off the face into smaller segments. Your personal parameters such as skin type and sun exposure are entered into the machine and we have lift off! A small rolling pin is rolled across each segment of the face in 3-4 different directions known as “passes”. Sometimes there is a crackling sound, this is the moisture that is left in your skin following the anaesthetic or the cleaning solution evaporating from your skin and is nothing to be concerned about. A full face takes around half an hour and the third or fourth pass of the laser over one area of skin may become more sensitive, particularly on more bony areas such as the jaw. It’s nothing too unbearable though. Once completed, I generally like to apply a soothing aloe Vera lotion as you may feel as though you have sunburn. Then of course I apply sun cream liberally over the treated area and recommend you continue doing so daily, forever and forever.
Usually 3-5 sessions are recommended, with each session lasting half an hour and each session should be done a month apart. The results are cumulative, so don’t expect perfection from the first session, it will come with time. Particularly as it takes a few days for collagen synthesis to be stimulated and occur. Expect to look and feel sunburnt immediately afterwards. For me this lasts around 2-3 hours. It is advised to avoid exercise for up to a week afterwards. This is because your skin may be red and swollen for a couple of days afterwards and you don’t want to aggravate this further. If the Fraxel is done particularly aggressively, you may experience crusting on the skin for 1-2 weeks post-procedure. Try not to pick any scabs as it could cause scarring and send you back to square one. I personally have not experienced a significant amount of crusting but I did notice my skin was relatively dry from around day 3 afterwards and I could feel that my skin was slightly rough to touch, which isn’t surprising considering it is a resurfacing treatment. This is nothing to worry about and generally subsides within a week or two. I would recommend using a gentle cleanser afterwards such as Cetaphil or CeraVe, as well as an antioxidant such as SkinCeuticals CE ferulic acid and also a great moisturiser such as Obagi’s hydrate. Also, very important to wear a good, high factor spf daily to prevent all of the benefits being undone and rendering your treatment ineffective.
If you’re still not sold on Fraxel laser, or don’t have the spare cash at the moment, there are cheaper and less daunting options available. These options include chemical peels such as the Obagi Radiance blue peel. These cost less than laser, have less down time and can work really well for Sun spots. I am personally a fan of both but do not recommend having them in conjunction with each other, especially not in the same sitting as they both target the superficial epidermis and can really aggravate your skin. If you have fractional laser, I would recommend waiting one month before having a chemical peel just to ensure the skin barrier has appropriately healed.
I hope you found this blog post educational and informative for those of you wishing to know more about Fraxel, to those of you who haven’t heard about it before.
If you do decide to go ahead with a course of treatment, it might be a great idea to do your own before and after photos to document your own progress as it’s a relatively long term treatment so can be difficult to remember where you started. Stay tuned for more posts about laser treatments.