What is Fractional Laser Therapy? What are the Side Effects?

What is Fractional Laser Treatment?
What are the Side Effects?

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Fractional laser treatment is an ablative and non-ablative laser technique used to treat sun-damaged and aging skin.

While ablative laser treatments work mainly on the epidermis (surface skin cells) and non-ablative treatments work only on dermal collagen (the middle layer of the skin), fractional laser treatment works on both the epidermal and dermal layers of the skin.

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What is Fractional Laser Treatment
Used for?

Fractional laser treatment is used for the treatment of:

Facial lines and wrinkles
Sun damage
Skin pigmentation in relation to photoaging
Surgery and acne scarring
Although advocated in the treatment of pigmentation disorders such as melasma, the treatment itself can lead to post-inflammatory pigmentation.

Fractional laser application can be used anywhere on the body, but is particularly beneficial on the neck, chest and hands compared to traditional ablative methods.

It can be used on all skin types and patients, but the techniques vary depending on the patient's age, skin type, sun exposure and body position. It can be combined with surgery and other skin treatments.

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How Does Fractional Laser Treatment Work?

To understand how fractional laser works, a basic understanding of the skin structure is needed. Briefly, the skin consists of 3 layers: epidermis (the top layer), dermis (the middle layer) and subcutis (the lower fat layer).

The epidermis contains pigment-producing cells called melanocytes, which are responsible for skin color. The dermis is composed of collagen and elastin fibers that provide strength, durability, elasticity and flexibility to the skin. As the body ages, the appearance and properties of the skin change.

The epidermis thins, so blemishes become more visible and collagen in the dermis gradually disappears, which contributes to the formation of facial lines, sagging and wrinkles.

How fractional laser treatment works is by targeting both the epidermis and the dermis. It does this by sending a laser beam into the skin that is divided into thousands of small but deep treatment columns.

These are called microthermal treatment zones (MTZs). Within each MTZ, old epidermal pigmented cells are expelled and the penetration of collagen into the dermis causes a reaction that leads to collagen remodeling and the formation of new collagen.

Fractional Laser Application

The glide gel acts as a contact lubricant for the robotic handpiece that glides on the skin surface.
Fractional laser treatment time will depend on the areas treated, but a full face will take approximately 30 minutes.
The pain associated with the procedure depends on the energy delivered to the treatment area. It is essential to use the strong anesthetic cream provided with the Fraxel laser.
A cooling device called a Zimmer machine is used to reduce discomfort during the procedure.

Fractional Laser Treatment Aftermath and Recovery

The slippery gel is washed off after the treatment.
Patients may experience a slight sunburn sensation about an hour after the procedure.
Swelling is usually minimal and resolves within 2-3 days.
The skin will have a pinkish tone for 3-5 days.
Within 24 hours, new epidermal skin forms and the skin has a bronze appearance that can last 3-14 days.
Skin flaking may also occur as the new skin replaces dead skin tissue, which can be treated with a moisturizing cream.
Skin peeling may be evident after ablative treatment, when the skin needs to be gently removed once or twice a day with tap water, petroleum jelly and gauze.
During the healing phase and for several months after treatment, it is recommended to protect the treatment area using a moisturizing sunscreen with an SPF of at least 50+. Protective clothing and wide-brimmed hats should also be used to protect the skin from sun exposure.

Depending on the energy level used and the condition of the skin being treated, four to five treatments with Fraxel are required. These are spaced one month apart.

Fractional laser results are not immediate and progress slowly with optimal improvement visible over a period of three to four months.

This time frame and treatment regimen allows for complete healing and replacement of damaged tissue with new collagen and elastin and vibrant, healthy skin cell growth.

Ablative fractional resurfacing lasers are more aggressive than non-ablative devices, so recovery takes slightly longer.

What are the Side Effects and Complications of Fractional Laser Therapy?

It seems to be well tolerated by most patients. Shaving or mineral makeup application can be done immediately after treatment.

In most cases, patients can return to work immediately after treatment or the next day, depending on their skin condition and treatment.

Some of the side effects and complications that may occur after aggressive or ablative fractional laser treatments, especially on the skin of the neck, include

Excessive desquamation (scaling, peeling) and some crusting
Swelling for up to a week after treatment may be helped by applying an ice pack at 10-minute intervals for the first 24 hours.
Postinflammatory pigmentation is more common in patients with a history of melasma or postinflammatory hyperpigmentation (more common in patients with darker skin types).
Acneform rashes, herpes simplex, bacterial and candida infections
Contact dermatitis

These articles are written for informational purposes. You should consult your doctor to determine whether the procedure has been performed and the appropriate treatment for you.