FREQUENTLY ASKED QUESTIONS

Fraxel laser treatment is the premiere solution for fractional aesthetic skin resurfacing, delivering remarkable results with reduced downtime. Including two non-ablative treatments and one ablative treatment, all three lasers in the Fraxel family of products use the science of fractional photothermolysis—combined with unique Fraxel technology—to deliver the optimal balance of clinical efficacy and patient comfort.

The science of fractional photothermolysis, pioneered by Fraxel engineers in 2001, treats microscopic volumes of skin with each unique pulse, leaving the surrounding area intact for fast healing. These microscopic treatment zones (MTZs)—each just one-tenth the diameter of a hair follicle—penetrate to the precise height and width necessary, while sparing many of the stem cells and melanocytes in the papillary dermis. This fractional treatment results in both rapid reepitheliazation of the epidermis as well as collagen remodeling deep into the dermis. The skin heals much faster than if the entire area were treated at once, because the treatment uses the body’s natural healing process to create new, healthy tissue. For more information, please visit Fraxel technology.

The Fraxel family of products includes three lasers for a variety of indications: Fractional non-ablative

• Fraxel re:fine^™ treatment—A gentle yet effective option for skin rejuvenation and resurfacing. á FDA clearances: pigmented lesions, periorbital fine lines, melasma, skin resurfacing, soft tissue coagulation.

• Fraxel re:store^™treatment—The flagship Fraxel system and the gold standard for non-ablative skin resurfacing and rejuvenation. á FDA clearances: photodamage, mild to moderate periorbital wrinkles, acne scars, surgical scars, melasma, Actinic Keratosis.

Fraxtional ablative CO₂

• Fraxel re:pair^® treatment—A minimally-invasive fractional CO2 procedure for significant skin resurfacing. FDA clearances: rhytides, pigmentation, moderate to severe wrinkles, photodamaged skin.

The Fraxel non-ablative lasers—Fraxel re:fine and Fraxel re:store —coagulate epidermal and dermal tissue, while penetrating the stratum corneum as if it were a window, leaving it completely intact. Depending on the aggressiveness of the treatment, downtime is only 0-4 days.

The ablative Fraxel re:pair laser, on the other hand, treats the skin fractionally, but it removes all layers of the skin in its microscopic treatment zone, including the stratum corneum. Due to the removal of the skin’s protective barrier, there is a risk of infection following the treatment, as with any ablative laser system. However, thanks to the fractional modality, these risks are much lower than traditional bulk ablative lasers. Depending on the aggressiveness of the treatment, downtime may last up to 1 week.

In most states, Fraxel re:fine and Fraxel re:store treatments can be delegated. These non-ablative treatments leave the stratum corneum intact. The fractional ablative Fraxel re:pair treatment, however, usually must be performed by a physician. Please check your state’s regulations for more information on delegable procedures.

Traditional ablative treatments, which use a high temperature to vaporize unwanted tissue, often damage more healthy tissue than necessary, which can cause significant side effects and significant downtime. Typical non-ablative treatments, meanwhile, have very few side effects and low downtime, but they commonly require numerous treatments to produce only modest results.

Fraxel laser treatment delivers the potency of ablative treatments with the safety of non-ablative lasers. So patients get the best of both worlds: dramatic results and reduced downtime.

The non-ablative Fraxel re:fine and Fraxel re:store treatments are safe and effective on Fitzpatrick skin types I—VI. The fractional ablative Fraxel re:pair is safe and effective on types I—III.

Because the fractional technology targets the precise height and width of tissue necessary for the desired result, all Fraxel laser products are effective on and off the face.

Our team will install your Fraxel laser, train you and your staff, help maintain the system, and provide ongoing workshops and training courses to keep you up to date on the latest advancements. For more information, please visit Clinical Excellence: Delivery.

Fraxel re:fine treatment, which uses a fractional non-ablative fiber laser, is the most gentle option in the Fraxel family of products. The laser’s 1410 nm wavelength is optimized for superficial treatments at lower energy levels, while still enabling treatment up to 650 µm deep into the dermis. The treatment improves skin texture, tone, pigmentation and periorbital fine lines—with almost no downtime or discomfort

• Pigmented lesions
• Periorbital fine lines
• Melasma
• Skin resurfacing
• Soft tissue coagulation

With Fraxel re:fine, you can treat all skin types and all areas of the body, as the laser targets water, not melanin.

First, cleanse the skin. Then, about 60 minutes prior to treatment, apply a topical anesthetic to the treatment area. Right before treatment begins, wash off the anesthetic and apply a thin layer of the tracking gel. During treatment, apply cold air for patient comfort.

The Fraxel re:fine procedure takes 20 to 25 minutes for a full face.

Clinical studies suggest that on average, an effective treatment regimen is 4 to 6 sessions spaced about 2 to 4 weeks apart. Depending on your patient’s condition and schedule, you may choose to space treatment sessions further apart. Results are both immediate and progressive, with optimal improvement usually visible in 2 to 3 months. This time frame and treatment structure allow for complete healing and the production of new collagen and elastin to replace damaged tissue.

Most patients describe a "prickling" sensation during treatment. To minimize discomfort, apply topical anesthesia before the procedure and cold air during the procedure. After the treatment, most patients feel like they have a sunburn, which usually diminishes in 1 to 3 hours.

During the first 24 hours after treatment, patients’ skin may feel like it’s sunburned, and it will appear pink or red. Patients can wear make-up to reduce the sunburned appearance. The skin will naturally bronze over the next week or two, and as treatment continues, the sunburned-to-bronzed appearance will repeat. As with a sunburn, the skin will flake and exfoliate normally. Advise patients to use a moisturizer to reduce the appearance of dry flakes.

Edema and erythema are the most common side effects from Fraxel re:fine treatment. Any edema is typically minimal and subsides within a day or two, and any erythema typically fades within a few days. Other temporary side effects may include minor itching, dry skin, peeling or flaking, and a bronzed skin appearance. There is a very limited risk of infection or scarring.

In most states, Fraxel re:fine can be delegated since the treatment leaves the stratum corneum intact. Please check your state’s regulations for more information on delegable procedures.

Fraxel re:store Dual laser treatment is the premier Fraxel system for non-ablative skin resurfacing and rejuvenation, delivering remarkable results with minimal downtime. The laser’s 1550 nm and 1927 nm wavelengths, combined with proprietary advancements in optical technology, enables patients to uncover the skin of their youth with minimal disruption to their daily routine.

• Photodamage
• Mild to moderate periorbital wrinkles
• Acne scars
• Surgical scars
• Melasma
• Actinic Keratosis

First, cleanse the skin. Then, about 60 minutes prior to treatment, apply a topical anesthetic to the treatment area. During treatment, apply cold air for patient comfort using the Cool Roller tip technology.

The Fraxel re:store Dual procedure may take up to 20 to 25 minutes for a full face.

Clinical studies suggest that on average, an effective treatment regimen is 3 to 5 sessions spaced about 2 to 4 weeks apart. Depending on your patient’s condition and schedule, you may choose to space treatment sessions further apart. Results are both immediate and progressive, with optimal improvement usually visible in 1 to 2 months. This time frame and treatment structure allow for complete healing and the production of new collagen and elastin to replace damaged tissue.

Most patients describe an increased sensation of heat during the treatment. To minimize discomfort, apply topical anesthesia before the procedure and cold air during the procedure. After the treatment, most patients feel like they have a sunburn, which usually diminishes in 1 to 3 hours. The 1927 nm wavelength is reported as being more comfortable to patients due to the superficial nature of the wavelength.

During the first 24 hours after treatment, patients’ skin may feel as though it is sunburned, and it will appear pink or red. They can wear make-up to reduce the sunburned appearance. The skin will naturally bronze over the next week or two, and as treatment continues, the sunburned-to-bronzed appearance will repeat. As with a sunburn, skin will flake and exfoliate normally. Advise patients to use a moisturizer to reduce the appearance of dry flakes. Healing process may be dependent on individual skin type.

Edema and erythema are the most common side effects. Any edema is typically minimal and subsides within a day or two, and any erythema typically fades within a few days. Other temporary side effects may include minor itching, dry skin, peeling or flaking, and a bronzed skin appearance. There is a very limited risk of infection or scarring.

In most states, Fraxel re:store Dual System can be delegated. Please check your state’s regulations for more information on delegable procedures.

Fraxel re:pair treatment is the only CO₂ laser on the market that delivers the results of traditional bulk ablative lasers with the faster healing times of true fractional delivery

The Fraxel re:pair laser combines all the benefits of traditional ablative resurfacing lasers without the prolonged downtime and significant risk of side effects. With Fraxel re:pair treatment, the skin heals vertically instead of horizontally as with traditional bulk ablation. In addition, clinical data suggests that Fraxel re:pair treatment, unlike conventional CO₂ lasers, is safe for off-the-face treatments.

Other key differentiators for Fraxel re:pair treatment:

• Extensive research. More clinical results and patient follow-up than any other fractional CO₂ device on the market.

• Speed. Treats up to 4 times faster than any other ablative fractional device on the market.

• Flexibility. Delivers the broadest range of fractional ablative treatment in a single handpiece—superficial to deep (5-70 mJ) and mild to aggressive (5-70% coverage).

• Continuous motion. The Fraxel scanning technique ensures uniform treatment zones for greater efficacy and faster healing.

• Ease of use. It’s the only fractional ablative device with built-in smoke evacuation, eliminating the need for staff support.

• Precision. Superior access to small areas and around the eyes.

As a non-ablative laser, Fraxel re:store treatment coagulates epidermal and dermal tissue, while penetrating the stratum corneum as if it were a window, leaving it completely intact. As a result, there is no clinical downtime. And depending on the aggressiveness of the treatment, social downtime is only 2-4 days. The ablative Fraxel re:pair laser, on the other hand, still treats the skin fractionally, but it microscopically removes all layers of the skin in its treatment zone, including the stratum corneum. Due to the removal of the skin’s protective barrier, there is a very small risk of infection following the treatment, as with any ablative laser system. However, thanks to the fractional modality, these risks are much lower than traditional bulk ablative lasers. Depending on the aggressiveness of the treatment, clinical downtime may last up to 2 days and social downtime may last 1 week.

• Rhytides
• Pigmented lesions
• Moderate to severe wrinkles and furrows in lax skin
• Fine lines
• Textural irregularities
• Vascular dyschromia

Clinical trials are in progress for acne scars and atrophic scars.

Clinical studies suggest that for most people, maximum results are realized in just one Fraxel re:pair treatment. The treatment was specifically engineered to enable you to tailor the treatment to your patient’s particular needs. Depending on the aggressiveness of your treatment, a patient may have a week of social downtime

First, cleanse the skin. Then, 60 to 90 minutes prior to treatment, apply a topical numbing agent to the treatment area. You may also choose to give another medication, such as Ativan, to relax the patient. The procedure takes approximately 30-40 minutes for a full face

Most patients describe an increased sensation of heat during the treatment, and there may be some discomfort or pain. However, unlike the experience in traditional CO₂ treatments, patients will feel quite comfortable immediately after a Fraxel re:pair treatment.

Depending on the aggressiveness of treatment, patients may have some pinpoint bleeding following the procedure, as well as some oozing for up to 48 hours until the wounds close up. The most common side effects are edema, which usually subsides after a week, and erythema, which may last up to a month, depending on the aggressiveness of treatment. Other temporary side effects may include minor itching, dry skin, peeling or flaking, and a bronzed skin appearance. Some of these skin reactions may not occur with all patients.