What is the function of the Fraxel Dual (non-ablative fractional laser system) in dermatology?

Fraxel Dual: A Non-Ablative Fractional Laser System for Skin Rejuvenation

The Fraxel Dual is a non-ablative fractional laser system that creates microscopic zones of thermal injury in the skin to improve skin texture, reduce wrinkles, treat pigmentation issues, and address scars with minimal downtime.1, 2

Mechanism of Action

• The Fraxel Dual is a hybrid fractional laser system that utilizes two different wavelengths sequentially 3:

  • 1550 nm wavelength: Creates controlled zones of coagulation up to 700 micrometers deep into the dermis
  • 1927 nm wavelength: Provides precise ablation in the epidermis up to 110 micrometers

• The laser creates microthermal zones of injury surrounded by normal intervening skin, allowing for rapid healing while stimulating collagen remodeling 1, 4

• Unlike fully ablative lasers, the Fraxel Dual preserves the function of the epidermis while still achieving significant skin remodeling 2

Clinical Applications

• Treatment of photoaging and photodamage 3:

  • Fine lines and wrinkles, especially periorbital (around eyes)
  • Uneven skin tone and texture
  • Pigmentation issues (freckles, solar lentigines)

• Improvement of various types of scars 4, 3:

  • Acne scars
  • Surgical scars
  • Chickenpox scars

• Treatment of melasma and other pigmentary conditions 4, 2

• Can be used on both facial and non-facial areas including neck, chest, hands, arms, abdomen, legs, and buttocks 3

Treatment Protocol

• Typically requires 2-6 treatment sessions spaced 1-3 weeks apart for optimal results 1

• Treatment can be performed under topical anesthesia (eutectic mixture of lidocaine and prilocaine) or with topical cooling for patient comfort 4

• Parameters vary based on the specific machine, location and type of lesion, and skin color 4

Clinical Outcomes

• Improved skin color and texture with decreased fine wrinkles and melanocytic pigmentation 1, 5

• High patient satisfaction rates (studies show up to 100% satisfaction with treatment and results) 5

• Minimal downtime compared to traditional ablative lasers 1, 2

Post-Treatment Effects and Recovery

• Typical post-treatment effects include 1, 4:

  • Erythema (redness) and edema (swelling) lasting a few days
  • Light skin exfoliation for a few days following treatment
  • Dryness and peeling may occur

• Most patients can resume normal activities quickly with proper post-treatment care 4

Enhanced Results with Combination Therapy

• The American Academy of Periodontology recommends combining Fraxel laser treatment with platelet-rich plasma (PRP) for enhanced results 6

• Studies show that combining fractional laser treatment with PRP results in:

  • Shorter duration of erythema, edema, and crusting 7
  • Improved wound healing and scar resolution 7
  • Better patient satisfaction and reduced post-procedural symptoms 7

Safety Considerations

• Generally safe for all skin types (Fitzpatrick I-IV) when used appropriately 5

• Rare complications may include post-inflammatory hyperpigmentation, which typically resolves within 90 days 5

• Proper sun protection is mandatory following treatment 4

• Treatment should be performed by qualified practitioners with specific training in laser procedures 4