Iperform 7 different types of fractional laser resurfacing- CO2, Erbium, 3 types of Fraxel, eMatrix, ePrime, and Picosure Fractional Focus Fractional laser. Unlike traditional skin resurfacing, fractional technology uses columns of energy to remove unwanted pigmentation, sun spots, freckles, age spots as well as improves wrinkles, and acne scars. Deep fractional skin resurfacing can also treat stretch marks and provide non-surgical face lifting. Depending on your skin condition I will elect to use a particular laser for the optimal outcome.
- Fractional resurfacing only treats a portion of skin
- The percentage of skin treated will be controlled by the Specialist
- Advantages of fractional skin resurfacing include a quicker healing time and lesser side effects
- Depending on your condition, I will recommend a certain laser or energy device such as eMatrix
- Laser is a better over all treatment as it treats both superficial and deep layers
- Radiofrequency is best for deeper skin conditions such as wrinkles, skin laxity, stretch marks, and early acne scars
- Freckles, sun spots, pigmentation and uneven skin texture are best addressed with Fraxel laser
- Darker and ethnic skin types are best treated with Picosure Picofacial laser
- I often combine treatments for the best outcomes- in many cases I use 2-3 lasers in the one sitting, a term I call ‘Fusion Laser Resurfacing’
Fractional laser resurfacing
Fractional skin resurfacing means only a portion of your skin is treated in a session. This leads to much faster, but also safer treatments for conditions like acne scarring, pigmentation, sun damage, and wrinkles. Fractional treatments can also improve skin texture and skin tone, as well as decrease pore size.
The energy from fractional skin resurfacing can be derived from several sources-
- Laser- this is the best as controlled heat is achieved, in turn producing more collagen. Best for old scars, wrinkles and pigmentation. More on Fraxel laser
- RF or Radio Frequency- this gives great results for new acne scars, but can also improve skin tone, stretch marks and wrinkles. RF has a quicker recovery time and is cheaper than laser. More on eMatrix Fractional Resurfacing
- Needling – skin needling or skin rollers/pens- these are pretty much outdated over a decade ago, however they can produce mild improvements in skin texture. Needling produces trauma to the skin that is not controlled, leading to longer healing times than RF. If needling devices are used, longer needles such as 3.5 mm are best.
Fractional laser resurfacing treats BOTH the upper and lower layers of the skin, whilst RF fractional skin resurfacing only treats the bottom layer.
In Queensland, most clients will have evidence of uneven skin texture- such as fine wrinkles, uneven pigmentation and sun damage. These conditions are ideally treated with fractional laser such as Fraxel.
RF is still and excellent treatment, however fractional radiofrequency treatment spares the upper layers of the skin (hence the quicker healing times). RF is useful if there is minimal texture changes, and best used for acne scars, non-surgical face lifts, deep wrinkles, and stretch marks. Fractional laser resurfacing using second generation devices such as the YOULASER can deliver two different wavelengths in infinite combinations, meaning bespoke treatments.
I utilize 7 forms of fractional lasers and energy devices, most often in combination. This is what I call my Fusion Laser Resurfacing technique.
Within the Fraxel range, I have 3 types of fractional laser treatments-
Fraxel 1927– this treatment is ideal for conditions that lie on the surface of the skin. This includes sun spots, skin pigmentation, age spots, uneven skin texture, freckles, and melasma.
Fraxel 1550- this treatment is ideal for conditions that lie below the surface of the skin. This includes wrinkles, stretch marks, acne scars, and surgical scars.
Fraxel CO2 10,600– this like the CO2 CORE is used for severe sun damage, deep wrinkles and very deep acne scars. Recovery following this form of laser resurfacing is over 8 days.
CO2 CORE laser– Made by Syneron Candella, this is one of my favoured lasers for severe acne scars. Best for rolling and atrophic acne scars, it can be employed in all skin types.
Pro Fractional Scition laser- great over all laser and my resurfacing laser of choice. Best for sun spots, age spots, shallow box car acne scars.
ePrime- this is skin needling with RF or RadioFrequency. ePrime delivers heat deep in the dermal layers of skin.
eMatrix– another one of my favourites for early acne scars.
Focus Picosure Picofacial- the very latest in our collection of fractional lasers. No downtime laser treatment that works best in darker skin types and also for early acne scars.
The majority of laser resurfacing procedures I perform is often a mix of several lasers in the one treatment. This enables me to customise a bespoke treatment based upon your skin type.
Close examination of your skin will reveal how much sun damage, wrinkles, scars or uneven pigmentation you have. I then can then guide you as to which is the best type of fractional resurfacing device to use, depending on your skin condition.
Some patients may benefit from combination treatments.
RF or radiofrequency fractional resurfacing has the very least downtime. Unlike laser, RF does not break the skin’s entire surface. RF is designed to treat conditions in the deep areas of the skin—such as early acne scars and wrinkles.
Fractional laser does both- rejuvenate the upper layers of skin as well as the lower dermal layers. Downtime following laser is usually twice as long as RF Fractional skin rejuvenation.
As a guide, if you have uneven skin texture, pigmentation, old acne scars, sun damage and wrinkles, lasers work better than RF.
Fractional lasers and Radiofrequency can give great results, depending on what are the treatment goals.
Laser is best for extremely sun damaged skin and marked skin laxity, whilst non-laser RF or Radiofrequency is best for early acne scarring and fine to medium wrinkle removal as well as stretch mark removal.
This is a guide as to the pros and cons of laser vs fractional RF therapy.
|Treatment type||Best for-||Downtime-||Cost-||Pain|
|Fractional Laser-Fraxel, CO2, ProFractional||Severe acne scars, severe wrinkles and sun damage||3-7 days||$ 990||Minimal -23/7 used|
|Fractional RadioFrequency||Mild acne scars, skin rejuvenation, scars||1-3 days||From $400||Minimal -23/7 used|
There are two ways to approach acne scars- fractional laser such as Fraxel is an excellent method of reducing acne scars. Fractional resurfacing using laser is much more effective then RadioFrequency resurfacing techniques because laser breaks collagen bonds but also stimulates heat. This in turn remodels collagen.
The second approach to acne scar revision is a bespoke approach whereby each and every acne scar is mapped and treated according to the scar type. I have termed this the Synergy Program for acne scars. This means employing methods such as TCA CROSS, CO2 lasers and fillers.
For more information on this form of acne scarring procedures, click here www.acnescpecialists.com.au
Dr Davin Lim is an International expert on acne scar revision and deals with extremely difficult acne scar revision.
Complications, if performed by a specialist are very rare, however include-
- Infection. Less than 2% of cases. Valtrex is needed if you have a history of cold sores
- PIH or skin pigmentation changes are very uncommon if you have fair skin types, but maybe seen in over 10% of cases if you are of ethnic skin types. The use of bleaching creams can reduce the incidence of skin colour changes.
- Scarring is rare, and usually follow secondary infection
- Stamping or gridding is seen in less than 2% of cases, however this is reversible with laser resurfacing.
This depends on the type of fractional resurfacing. RF Needling has the least downtime. As a guide-
- 0.5-2 mm Fractional needling with or without RF 1-2 days
- Fraxel laser 1927- 4-7 days
- Fraxel laser 1550 or Pearl laser 5-6 days
- Co2 Fractional laser resurfacing 3-6 days
Skin recovery following a light pass of Fraxel laser
Yes. The best type of stretch marks to treat are red and new ones, however old stretch marks can be treated with fractional skin resurfacing.
- RF or radiofrequency fractional skin treatments can be effective, even for old stretch marks
- Fraxel 1550 can be extremely good for stretch marks, however up to 3 sessions or more are needed.
- CO2 CORE gives the best results, however healing may take up to 9 days. Most patients will need up to 3-4 sessions for best results.
Red stretch marks are treated with vascular laser and respond very well to treatment, whilst white, papery and silvery stretch marks are older ones, and may respond to laser of RF.
Bottom line- red stretch marks are more predictable in the outcome, white stretch marks are less predicable and depend on your immune system to remodel collagen and elastin.
More on treating stretch marks
Fractional skin resurfacing can treat the following skin conditions-
- Acne scarring-see above
- Stretch marks- see above
- Brown pigmentation such as freckles, sun damage, age spots, liver spots
- Sun damage including rough scaly lesions and brown uneven skin colour
- Textural changes including pores, roughness and skin irregularities
- Collagen stimulation – this is especially so with fractional lasers. The result is an improvement in skin tone.
Branding provides consistency and this in turn gives results. Well known lasers such as Fractional Fraxel laser cost 10x more than generic brands, however the results from Fraxel are more consistent, and treatments safer.
Two key factors deliver best results- training of the specialist and quality of the equipment.
Technically skin needling or Dermapen is a very, very superficial form of skin resurfacing, however this technology has been out dated for nearly 10 years. Skin needling uses multiple rows of needs to break the upper layers of skin to reach the bottom. Unlike laser or RF, no heat is generated from needling. Why is heat important? Controlled heating of the deeper layers of skin generates HSP expression- this shows that collagen and scars are remodelled.
Heating of collagen breaks down scars more effectively and stimulates new cells called fibroblasts to lay down new, fresh and young collagen. This results in tighter skin with less wrinkles and a firmer appearance.
Skin needling can still be marginally effective, however laser treatment or fractional skin resurfacing is infinitely better and more comfortable for the patient.
More on skin needling
Radiofrequency treatments using the Max RF are best for skin conditions that lie under the surface of the skin- including very mild wrinkles. RF is also good for very early and mild acne scars. Overall this treatment is too weak to make a significant change in your skin texture.
Fractional lasers, such as Fraxel are best for skin conditions that lie either on the surface- pigmentation, sun damage, uneven skin texture and fine wrinkles. Lasers, can however can also improve skin conditions that lie deep under the surface, including severe acnes scars, and deep wrinkles.
Fractional laser resurfacing
Cost will vary depending on the area, intensity and type of device we elect to use. As a rule lasers are more expensive than eMatrix RadioFrequency.
Most patients find that the top line laser such as Fraxel for sun damage and pigmentation will give better results than other treatments.
- Prices for all fractional lasers (Fraxel, CO2, Profractional) start from $990.
- Picosure Picofacial FOCUS $490
- eMatrix $490
Call Westside Laser Dermatology to make a booking with Dr Davin Lim. During the consultation, a full medical history will be taken, as well as base line photography and skin analysis mapping. Dr Lim will discuss the best treatment options for your skin condition.
In some cases, yes. After consultation we place a special 23/7 Gel on your skin. This local anaesthetic is five times stronger than EMLA. This is left on for 45-60 min prior to laser. If there is an available appointment slot, some cases of fractional resurfacing can be done on the same day.
By Dr Davin Lim
Fractional laser resurfacing has revolutionised the treatment of acne scars, stretch marks, skin pigmentation including age spots, sun spots, freckles, liver spots, and wrinkles. Additionally with laser fractional treatments, wrinkles and poor skin tone can be addressed.
Fractional laser resurfacing started with skin rolling and needling over 15 years ago, however this form of fractional treatments has been outdated a decade ago. Now, with lasers of different wavelengths we can safely and effectively ‘dial in’ a treatment for a particular condition. For example, acne scars use a different wavelength of laser than skin pigmentation. Another form of fractional rejuvenation is RF or RadioFrequency treatment, unlike laser, RF fractional treatments concentrates energy deep in the dermal or lower layers of the skin. If acne scars are new (red/pink/shallow), I prefer the use of RF due to the lower down time. The Picosure FOCUS is also impressive, especially for early skin types and laser rejuvenation in darker skin types.
Choosing the right brand and make of laser and RF is vitally important, as machines in Australia are not regulated. The device is just as important as the operator as consistent results can be delivered. The latest in fractional laser resurfacing is called hybrid fractional laser resurfacing- this means two laser wavelengths are delivered in the same session, often within milliseconds of each other. The YouLaser, made by Quanta in Italy is an example of a hybrid fractional laser resurfacing generation 2 device. This delivers better results with less down time compared to older fractional laser resurfacing platforms.