Dr Rita Rakus

Fraxel™ laser treatment is a revolutionary concept in laser resurfacing of the skin. It was devised as a direct result of physicians (and their patients) wanting the benefits of laser skin resurfacing without the downtime side effects and lengthy recovery period associated with traditional invasive lasers.

Fraxel laser treatment produces thousands of tiny microscopic laser spots which produce deep columns of treatment in your skin (known as microthermal zones), carefully eliminating old epidermal pigmented cells deep within the dermis.

However, for every microthermal zone the laser targets and treats intensively, Fraxel laser treatment leaves the surrounding tissue unaffected and intact. This unique “fractional” (or pixel-by-pixel) process allows the skin to heal much faster than if the entire area were treated at once, utilising the body’s natural healing process to create new, healthy and tighter tissue to replace skin imperfections.

The procedure (including the application of topical anaesthetic for an hour pre-treatment) typically takes between 2 hours. There is no prolonged recuperation, no risk of general anaesthesia and Fraxel sessions are generally well tolerated.

Fraxel laser treatment is currently FDA cleared to treat wrinkles and pigmented lesions including age spots, sun spots, stretch marks and dyschromia.

Because of the unique Fraxel™ laser delivery system it is effective on delicate skin and is approved for use on the neck, chest and hand areas. Your practitioner will discuss which area(s) of your skin are appropriate for treatment and decide your programme of care.

Leading researchers and clinicians have been testing the Fraxel laser for nearly 2 years. It was initially cleared by the FDA in 2003 and is now available to a small group of specially trained doctors. Results are comparable to other treatment modalities that are associated with far more significant side affects. Patients are seeing rapid, significant change in their skin quality without the risks or prolonged healing time of other old lasers.

Depending upon your specific needs most treatment regimes require three to five sessions to achieve the maximum result. Each treatment session targets between 15-20% of the skin’s surface and results are immediate and progressive. Optimal improvement is usually visible in about two to three months.

Treatment sessions are spaced at least two weeks apart, but this is very flexible and sessions can be organised to suit your needs, weeks or months apart, with no detrimental effect to the final result.

A topical local anaesthetic is applied to the area(s) of treatment prior to the session for your comfort. The Fraxel laser treatment area will then be thoroughly cleansed.

The Fraxel laser treatment will take approximately 30 minutes (or more depending upon the extent of area to be treated). Additional time will be required for pre treatment photographs so please allow a total time of several hours at the clinic.

Most patients report a mild sunburn sensation for about an hour after the Fraxel laser treatment. The skin will have a pinkish tone for five to seven days – this is a normal sign that your skin is healing deeply. Swelling is minimal and generally resolves in two to three days.

New epidermal skin develops immediately and this process of skin repair involves:

1. Bronzing – your skin will develop a bronze appearance that lasts anywhere from 3 to 14 days.
2. Dryness – your skin will micro-exfoliate naturally as the reorganised epidermal skin replaces dead tissue.
3. Sunscreen – you will need to apply a sunscreen twice a day for several months after the treatment.

After your very first Fraxel laser treatment session you will begin to feel the difference in our skin as it gradually becomes softer, smoother, tighter and fresher. Fine lines around your eyes, uneven colouring and the bronze spots caused by ageing and sun exposure will gradually fade.

After several treatments, your skin will have a much more youthful and healthy glow with results that you can really see and feel.

You may apply make-up or shave soon after your Fraxel laser treatment. Most patients find that they can return to work within 24 hours following the treatment.

Due to the unique delivery of the Fraxel laser system there are very few risks associated with the treatment. However, the skin can be highly sensitive and care must be taken to minimise any adverse reactions. Please ensure that you complete your medical and skin history forms in full and discuss any skin problems you may have with your practitioner.

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

• Swelling/redness/blanching/burns/blisters/scabbing/hyper or hypo-pigmentation changes/bruising/mild to moderate discomfort/itching/cold sores/infection/keloid formation/punctuate bleeding/skin textural changes/milia/acne eruption/permanent scarring.
• In the unlikely event of an adverse reaction permanent scarring may occur.

Please note that the following have NOT been reported after Fraxel^®, but could occur as a totally unrelated clinical incidence – skin cancers (including melanoma).

To date we have not experienced any significant or long lasting adverse effects nor have we seen any evidence of post-inflammatory hyper or hypopigmentation (lighting or darkening of the skin), but these are always considered risks.

The clinical end point we look for with Fraxel is cell turnover and peeling. After treatment your skin tends to be pinkish red for a few days. This is normal and signifies that the dermal tissue is being repaired and there is good blood circulation. The repair process typically entails a faint “bronzing” tan like appearance that lasts anywhere from 3 to 14 days after treatment followed by a flaking process of exfoliation as the reorganised epidermal skin gradually replaces dead tissue.

Although there is some moderate stinging during the therapy the treatment is well tolerated and a topical anaesthetic cream used to alleviate discomfort. Many patients also take Ibuprofen prior to the procedure to reduce the stinging. Patients can apply make-up or shave after treatment and most return to their routine activities the same day or the next.

Our typical patient is someone in their 30’s or older who has photo damaged skin, lines, wrinkles, skin discolouration, dull or rough texture, age spots etc. Fraxel laser treatment especially appeals to those patients who want the positive results of traditional resurfacing methods without the downtime or risks. It also appeals to those who are looking for a more dramatic result than might be achieved with non ablative techniques.

A: Absolutely. There is no evidence of any cross reactions between these treatment modalities.