Is it Fraxel or Fractional?


It is difficult to know which laser to choose from when deciding on a treatment that is really going to remove brown spots, eliminate those deepening lines and wrinkles, and at the same time provide some true skin tightening.  And do all these things with the least amount of downtime possible, perhaps in 4-5 days.  It is true many advertised laser treatments claim to do so, but the results simply do not match their marketing claims.  Here are some useful points to consider when deciding on a treatment that you are counting on (and paying for) to obtain significant improvement in your skin.

The gold standard treatment for skin rejuvenation is the CO2 (“See-OH-Two”) laser beam, and this type of laser beam is readily available in many offices in Orange County.  The CO2 laser beam has been around for decades and no other laser beam type (such as erbium and Thulium, for example) can compare to the results obtained from the CO2 laser beam.  Now, there are many brands out there for CO2 lasers like Pixel, Dot, Matrix, Active Fx, and Fraxel and I am often asked what are the differences and which one is better and why does one cost more than another.

(Key Point:  The term Fraxel is often thought of as a type of laser, but it is actually just a brand name, much like Kleenex is just a brand name of a particular tissue paper; we all commonly use the term generically to refer to all types and brands of tissue paper, which is OK but not correct.  With a laser we want to be a little more precise.)

Most CO2 laser beam treatments performed in Orange County and elsewhere are a type of CO2 laser termed a “fractional” CO2 laser.  Fractional CO2 lasers are an excellent and safe treatment (usually just one treatment ) with only a few days of downtime.  Most fractional lasers in Orange County do an excellent job at removing brown spots, evening skin tones and improving the overall texture of the skin.  However, the fractional laser does not remove redness, red vessels, and most fractional CO2 lasers in use cannot provide deep enough treatments to tighten skin or substantially improve lines and wrinkles, especially the deep wrinkles around the mouth.

To improve deeper, more etched lines and wrinkles and tighten skin the laser has to have the capability of providing a more thorough (more dense) treatment at certain settings.  Most fractional lasers cannot reach this level, hence the cheaper costs for their treatments because the laser costs less, but the true results are much less too.

The Active FX laser with the Deep FX mode easily reaches the necessary levels to eliminate deep lines, wrinkles and tighten skin.  The treatments are the same as the other fractional CO2 lasers but with perhaps a few more days of pinkness after the treatment, which is easily camouflaged with make-up.  The beauty of this laser is that it can also be easily adjusted to perform very superficial treatments to just remove brown spots or switched to a mode than can improve even the deepest and thickest scars left after a burn, acne or accident; it is a truly wonderful and effective CO2 laser.

Timothy R. Miller, M.D.

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