Fraxel Laser Treatment Benefits
Fraxel (fractional photothermolysis) laser treatment effectively improves skin texture, reduces wrinkles, treats acne scars, and corrects pigmentation irregularities with minimal downtime, and outcomes are significantly enhanced when combined with platelet-rich plasma (PRP) therapy. 1, 2
Primary Clinical Benefits
Skin Rejuvenation and Photoaging
- Fraxel treatment creates microscopic thermal zones that stimulate collagen remodeling, resulting in more homogeneous skin color and texture with decreased fine wrinkles and melanocytic pigmentation. 3
- The 1550-nm erbium fiber laser targets water-containing tissue to create spatially precise microscopic thermal wounds surrounded by normal skin, which rapidly heals the injured areas. 4
- Patients experience improvement in skin laxity, enlarged pores, and overall pigmentation irregularities with statistically significant results. 5
Scar Treatment
- Fraxel demonstrates particular efficacy for atrophic acne scars, achieving results comparable to traditional ablative laser resurfacing but with significantly less downtime. 4
- The treatment is effective for hypopigmented scars and depressed surgical scars, including those from Mohs micrographic surgery. 6
- A series of 3-6 treatments at 2-4 week intervals is typically required for optimal scar improvement. 4
Pigmentation Disorders
- Fraxel represents a particularly useful modality for difficult-to-treat conditions such as melasma and dyspigmentation. 7
- The treatment reduces unwanted melanocytic pigmentation throughout the face and body, including neck and upper chest areas. 7
Downtime and Safety Profile
Minimal Recovery Period
- Patients experience minimal downtime consisting primarily of erythema and edema for a few days, followed by light skin exfoliation. 3
- This represents a significant advantage over traditional CO2 laser resurfacing, which carries higher risks of complications and prolonged recovery. 7
Safety Considerations in Asian Skin
- In Asian patients (skin types III and IV), post-inflammatory hyperpigmentation occurred in 55.5% at 1 month but decreased to 11.1% at 6 months post-treatment. 5
- Despite this risk, 86% of patients reported overall satisfaction to very satisfaction with treatment outcomes. 5
Enhanced Outcomes with Combination Therapy
PRP Adjunctive Treatment
- The American Academy of Periodontology recommends combining Fraxel laser treatment with PRP to reduce downtime and improve healing, with studies showing shorter duration of erythema, edema, and crusting compared to laser treatment alone. 1, 2
- The combination results in improved wound healing and scar resolution with better patient satisfaction and reduced post-procedural symptoms. 8, 2
- PRP should be applied after laser treatment (either topically, via microneedling, or as an injectable) since ablative laser wavelengths can damage PRP if applied beforehand. 8
- Patients reported 56.2% satisfaction with PRP combination versus 43.8% with saline control, with significantly better clinical improvement scores (2.7 vs saline control). 8
Treatment Areas and Versatility
Body-Wide Applications
- Unlike CO2 lasers that cannot be safely used on the neck due to scarring risks, Fraxel is excellent for reducing neck wrinkling and treating upper chest hyperpigmentation and sun damage throughout the entire body. 7
- The treatment is effective for both facial and non-facial photodamage. 4
Common Pitfalls to Avoid
- Do not expect single-treatment results comparable to ablative CO2 resurfacing—a series of treatments is required for optimal outcomes. 4
- For perioral laxity and deep rhytides, Fraxel may fall short of ablative laser results; set realistic patient expectations for these specific concerns. 4
- In Asian patients or those with darker skin types, counsel about the risk of post-inflammatory hyperpigmentation, though this typically resolves by 6 months. 5
- Always apply PRP after laser treatment, not before, to avoid damaging the growth factors. 8