Fraxel – a Major breakthrough in the treatment of Acne Scarring and other Skin Conditions. Acne scarring can be extremely disfiguring and until recently has been very difficult to treat. The Fraxel and Fractionated Skin Resurfacing have revolutionized the treatment of most forms of acne scarring for the face, neck chest and back.
The Fraxel is a unique non invasive laser technology, which produces columns of laser beams that penetrate deeply into the skin reaching the base of the acne scars, and producing new collagen formation. This in turn “fills up” the acne scars, making them smoother and shallower. Because the treatment is fractionated, it selectively treats the acne scars, without damaging the surface layer of the skin, so there is no open wound. The Fraxel laser penetrates more deeply than previous lasers used for acne scarring and heals faster. Makeup and usual skin care products can be applied within a few days of treatment.
The improvement in acne scarring will depend on the strength of the Fraxel treatment, the number of Fraxel treatments, and the severity of the acne scarring. Stronger Fraxel treatments will produce greater improvement, but have longer “down time”. In most people it is possible to achieve 60 80% improvement in acne scarring with stronger Fraxel treatments. Previous treatments for acne scarring achieved about 20-40% improvement in acne scars.
The number of Fraxel treatments will depend on the severity of the acne scars, the strength of the Fraxel treatment sessions and your expectations. Most people have 4-5 Fraxel treatments, but it is possible to achieve significant improvement in acne scarring with 2-3 sessions. Some people have more than 5 treatments, and continue to improve their acne scars and skin texture.
The amount and degree of discomfort are related to the strength of the Fraxel treatment. Lower intensity, weaker treatments hurt little, while stronger treatments are potentially more painful. In order to minimize discomfort, a numbing cream is applied for at least 1-2 hours prior to treatment. In addition, it is also helpful to have some local anesthetic injections, so that the areas of acne scarring are numb and no pain is felt. In addition, you can also have pain puffers, and other painkillers if needed.
Before the Fraxel treatment is started, a numbing cream is applied for at least 1-2 hours. After this the treatment usually takes about 1 hour. Most people can drive home after the treatment, unless a pain puffer or injectable pain killers are used.
After the Fraxel treatment, it is usual to be slightly red and swollen for 2-3 days. With stronger treatments, redness may last a few more days. Makeup and skin care can be used the day after treatment. Some people also have peeling of the skin for a few days, and occasional scabbing. It is important to avoid using too much or too greasy moisturizers and sunscreens after the treatment, otherwise acne lesions may appear. A light moisturizer and oil free sunscreen may be used sparingly. People with darker skin, may need to use a depigmenting lotion after the treatment, in order to prevent temporary post treatment increase in skin pigmentation. The Depigmenting lotion will cause some redness and peeling while it is being used. This can be purchased at reception.
After Fraxel treatment, people can use their usual skin care products and makeup. Although sunscreens are recommended, it is important to avoid creamy or greasy sunscreens, otherwise acne lesions may develop. Oil free sunscreens and makeup are best. Vitamin A creams can be used after the Fraxel treatment to further stimulate new collagen and improvement in the acne scars. However Vitamin A creams may cause pinkness and peeling of the skin especially when they are used for the first time. It may be best to use them once every 2 or 3 days initially. It is best to avoid Vitamin E creams and oils as they can cause pimples and blemishes. If a depigmenting lotion is used, some moisturizer is needed, as the lotion causes dryness and some peeling. An oil free lighter moisturizer is recommended for acne prone skin.
The use of lasers in conjunction with Ro Accutane is controversial. Some lasers e.g. Erbium and CO2 are, generally not recommended while on RoAccutane. Other lasers and light sources e.g. Laser Hair removal, Pulsed Light can be used. There is no good medical evidence to suggest that Fraxel cannot be used while on RoAccutane. Our clinic has found that it is safe to use Fraxel and RoAccutane at the same time.
There are few side effects with Fraxel Laser treatment but may include:
1. Prolonged Redness While redness is usual for a few days after Fraxel treatment, some people may experience prolonged redness. It will eventually settle in nearly all cases. Prolonged redness may also occur if Vitamin A creams and depigmenting lotions are used after treatment.
2. ScabbingLight peeling and scabbing may occur after treatment for a few days. It will resolve.
3. Swelling This is normal for a few days after the treatment. You may wish to take some Prednisolone tablets after the treatment to reduce swelling.
4. Increased Skin Pigmentation Temporary increase in skin pigmentation may occur in people with olive or darker skins, or those who expose their skin to sunlight after treatment. In order to prevent this, a depigmenting lotion is used routinely in people with olive or darker skin immediately after Fraxel treatments. An oil free sunscreen is also recommended after Fraxel treatment.
5. Scarring This is rare. If it does occur, it usually appears as a red thickened area. It can be successfully treated with injections of 5FU or cortisone.
6. Decrease in Skin Pigmentation In some cases, there may be a slight decrease in skin pigmentation. It may be due to loss of sun damage.
7. Infection This is rare. However, cold sores may occur after Fraxel treatment, if there is a previous history of cold sores. This can be prevented by using anti-cold sore tablets.
8. Recurrence of Acne If excessive moisturizers or sunscreens are used after Fraxel, acne may occur.