Nonablative lasers tightens collagen below the skin. The procedure lasts approximately 15 to 20 minutes. No cutting is required. Ongoing collagen stimulation lasts for several months. Repeat sessions are recommended for a sustained effect. No downtime experienced.

FRAXEL LASER REJUVENATION

What is Fraxel Laser treatment?

Fraxel Laser treatment is a revolutionary concept in laser resurfacing of the skin. It was developed in California in partnership with the Harvard Medical School as a direct result of physicians (and their patients) wanting the benefits of laser skin resurfacing without the downtime and recovery period associated with traditional resurfacing lasers.

The laser produces thousands of tiny but deep microscopic zones of laser columns invisible to the naked eye that target flawed skin and leave surrounding skin untouched, similar to editing the pixels of a digital photograph. This is known as “fractional resurfacing” hence “Fraxel Laser”. The skin’s protective barrier is not broken. Requiring only topical anesthetic, the Fraxel laser resurfacing penetrates deep into the dermis treating about 15-20% of the skin at any one time but leaves the surrounding tissue unaffected and intact. The skin heals much faster than if the entire area were treated at once. Just as important is the remaining untreated skin which acts as a reservoir for healing, allowing the body’s natural healing process to create new healthy, tighter tissue.

Is it safe?

Due to this unique laser delivery system there are very few risks associated with the treatment. However, skin can be highly sensitive so care must be taken to minimize any adverse reactions. Please ensure that you discuss any skin problems you may have with the doctor.

Who will benefit from this treatment and what areas can be treated?

Fine wrinkling, some scars, dark pigmented lesions such as age-spots, sunspots and skin discoloration, including melasma can all be treated. It may also improve some stretch marks, skin texture and large pores. Scars may be improved though not cured.

As this laser spares healthy tissue it can be used safely on delicate skin areas such as the neck, chest and hands. It is one of the first laser able to treat these areas.

This laser is an ideal treatment when used in combination with treatments such as Botox and fillers.

How long does it take?

You will need to be in the clinic for approximately two hours. This allows time for pre and post treatment photos, application of local anesthetic cream to the area, skin preparation and rest, and observation following the procedure. The Fraxel treatment itself will take approximately 30 minutes.

When will I see results?

After your very first Fraxel session you will begin to feel the difference in your skin as it gradually becomes softer, smoother, tighter and fresher. Collagen remodeling occurs in the deeper tissues. Fine lines around your eyes, uneven coloring and the brown spots caused by ageing and sun exposure will gradually fade over time. However, as the effects of the Fraxel are cumulative it is important to complete the course of treatments to achieve your maximum results. After a course of treatments your skin will have a more youthful and healthy glow.

How long will the effects of the Fraxel Laser procedure last?

The first Fraxel treatment was performed approximately 4 years ago and the improvements have lasted for that time. It is probable that different problems will have different lengths of improvement. However, it is safe to have re-treatment if needed.

How many treatments will I need?

Depending on your specific problem and the area to be treated most treatment regimens require three to six treatments approximately one month apart to achieve the maximum result. Each treatment session targets between 15-20% of the skin’s surface and results are progressive at each treatment. Optimal improvement is usually visible in about two to three months or following your completed course of treatments.

How long before I can return to my normal activities?

Most patients find they can return to work within 24-48 hours following the treatment.

Because the Fraxel laser treatment spares parts of the skin it heals very quickly. You can apply makeup or shave 48 hours after treatment, however, avoid any other form of facial treatment or therapy until authorized to do so by your doctor.

Will I need to have any pre-treatment?

Retin-A cream, skin lightening cream and sunscreen will often be advised before Fraxel treatment. Stop Retin-A, Tazorac, and any conditioning solutions for three weeks before treatment and resume after your series of treatment.

Anti-inflammatory drugs and some herbal medicines may thin your blood, increase bruising and bleeding. It is best to stop these four days before your treatment and for four days afterwards to minimize bruising.

Patients with known bleeding and/or coagulation disorders, those who are on anticoagulant therapy or those taking the anti-inflammatory drugs listed below are at greater risk for bruising and bleeding. Advise the Dr/Nurse if you are taking: Aspirin, Advil, Ibuprofen, Mobic, Motrin, Naprosyn, Saint John’s Wort, Ginkgo Biloba, Ginseng, Feverfew, Vitamin E or Echinacea. Excessive alcohol may also increase bruising. Tylenol is permissible.

If you feel you may bruise easily or the area will be red you may wish to buy camouflage makeup beforehand. Your local department store may assist you, and some suggestions are Dermablend, Clinique Continuous Coverage or mineral makeup such as Color Sciences.

Will I need anesthetic cream?

Yes. Please arrive one and a half hours prior to your appointment time so the cream can be applied or we cannot guarantee you will be able to have the cream on for the appropriate time needed or have the length of time needed for your treatment.

What happens during the procedure?

Prior to the treatment, the area to be treated will be cleansed and pretreatment photographs taken. You do not need to remove contact lenses if you wear them. Local anesthetic cream is applied to numb the area. After the cream has taken affect (approximately one hour) it is removed.

The Fraxel treatment will take approximately 30 minutes depending on the extent of the area to be treated. You will be advised to stay at the clinic for observation for approximately 15 minutes after the treatment. Additional time may be required for post treatment photographs so please allow a total time of two hours at the office.

The laser treatment has been described as a prickling on the skin, a hot rod or the roughness of a cat’s tongue. The face and neck are more sensitive than other areas. A cooling machine will blow cold air onto the area to make it more comfortable. There is generally no need for pain relief either during or following the treatment. When the eye area is treated you may see a bright red light. This is not harmful to the eyes like other lasers can be.

What will I notice after the procedure?

Most patients report a mild sunburn sensation for a few hours and then virtually no discomfort thereafter. Ice packs such as frozen peas and/or cold soaks will help to comfort the area if it is too hot. The skin will have a pinkish tone. Swelling is minimal although the area under the eyes may swell and generally resolve in two to three days. You may wish to sleep with your head elevated for the first few nights following your treatment if the eyes are swollen.

A new upper layer of skin develops immediately. This process of skin repair involves:

• Bronzing: Your skin will have a bronze-pink appearance that lasts anywhere from 3-14 days, depending on how your skin reacts to the Fraxel.
• Flaking: Your skin will exfoliate as the reorganized epidermal skin replaces dead tissue. Flaking is similar to that of a minor sunburn. Use of a moisturizer may mask the appearance of flaking and help any itching if required.
• Sunscreen: You MUST use sunscreen twice daily to protect the skin from sun exposure during the healing phase and for several months after treatment. Apply a moisturizing sunscreen with an SPF of 30. For added protection from sunlight, use a wide brimmed hat. We have appropriate sunscreen products available in the office if needed.

What are the risks?

The most frequently associated risks are as follows and normally disappear within a few days or weeks of treatment:

• Swelling: areas such the cheeks and eyes swell more than other areas. Sleep on more pillows than normal for a few nights post treatment.
• Erythema: (redness of skin): Usually lasts 3-10 days. This redness is thought to represent increased blood flow during healing. Exposure to the sun, alcohol consumption and perspiring may prolong the erythema.
• Onset of herpes simplex (cold sores): If you have a history of cold sores please inform the doctor so preventative measures can be taken prior to your treatment.
• Scabbing: This is usually not a problem but will depend on the amount of treatment needed in individual areas (e.g. the mouth may need more passes). A finer brown or bronze scaling may occur.
• Hyperpigmentation: (increased skin color): this is more common in those with dark complexions but may occur with any skin type, it is usually temporary but can be permanent. It should respond to the use of Hydroquinone cream, lotions, peels, Intense Pulse Light treatments and sunscreens post-operatively. Exposure to the sun without sunscreens must be avoided.
• Hypopigmentation: (decreased skin color): It can occasionally be longstanding and or permanent.
• Bruising: Superficial bruising under the skin may occur and will resolve in a few days.
• Itching: may occur if the area is very red initially.
• Scarring: In the unlikely event of an adverse reaction permanent scarring may occur. Any procedure in which the surface of the skin is damaged can heal with scarring. This usually occurs because of some secondary factor, which interferes with healing, such as infection, irritation, scratching, poor wound care or exposure to the sun. This scarring appears after approximately one month and usually disappears in a few months, but some scarring may be permanent. Hypertrophic reactions or keloids in susceptible people may rarely appear. These may improve with injections or laser treatment.
• Acne/Milia: This sometimes occurs in patients who are acne prone during the skin repair process following the treatment and could be the skin’s reaction to the topical cream used during treatment. Dr. Chang can prescribe anti-acne treatments if needed.

What alternatives are there to this procedure?

Conventional laser skin resurfacing, which is still more suitable for severe wrinkles and scars on the face; yet it requires longer healing time.

Superficial chemical peels are another alternative but are less predictive in their effects than fractional resurfacing.

Intense Pulsed Light is mainly used for surface problems such as superficial brown spots and fine spider veins.

Individuals vary in their reaction. This means that some patients may require more or less sessions tailored individually for their final result.