Fraxel Laser

Fraxel™ vs. Fractional CO₂ vs. Traditional CO₂

Fractional CO₂ laser vs. Fraxel™ laser¨:

Three resurfacing lasers:

• Fraxel™ (a fractional diode laser)

• Fractional CO₂ laser

• Traditional CO₂laser

Either laser can be used to treat acne scars, wrinkles, sun damage, or texture. But Fractional CO2 is our first choice for sun damage, wrinkles, and texture while the Fraxel laser is our first choice for acne scars. These choices are purely based on which laser is more effective for each condition. Of course, there are other considerations. For example, some patients simply cannot have downtime and prefer to use the Fraxel laser for wrinkles, even if it means less dramatic results or greater number of treatments.

Fractional CO2 creates perforations in the skin, so there IS crusting and you DO look bad for a week. The Fraxel laser heats up columns of skin without “perforating”, so there is little or no crusting and you just look a red and puffy for a few days. But the main difference is worth repeating: we use each laser to treat different problems. Fractional CO2 is our first choice for sun damage, wrinkles, and texture while the Fraxel is our first choice for acne scars.

Fractional resurfacing (Fraxel™ OR fractional CO₂) vs. traditional CO₂
Fractional resurfacing has less potential for side effects. The problem with traditional CO2 laser was never the results (they are dramatic). The problem is the potential for side effects. These potential side effects include scarring, hypopigmentation (whitened skin), and lines of demarcation (you can sometimes see were the treated skin starts and the untreated skin stops, and this looks unnatural). Because of the potential for side effects, we have always stayed away from traditional CO2 laser resurfacing. We tend to be conservative and did not think that the risk-benefit ratio was good with traditional CO2 (too much risk). Fractional resurfacing (either fractional CO2 or the Fraxel laser) has a much lower potential for side effects. In fact, since starting to use this technology in August of 2005, the only side effects we have had are temporary hyperpigmentation and even that has been rare.

Fraxel™ vs. Fractional CO₂ vs. Traditional CO₂ summary:

Fraxel™

•	First choice – for acne scars
•	Second choice – for sun damage/ wrinkles/ texture (for those who cannot have “down time”)
•	4 or 5 treatment sessions
•	$850 to $950 per treatment
•	Downtime – little or none (red and puffy, like a sunburn, for a few days)

Fractional CO₂

•	First choice – for sun damage/ wrinkles/ texture
•	Second choice – for acne scars (for a patient with sun-damage AND acne scars, or a patient who had already been treated with Fraxel for their acne scars and wants to try to get more improvement by switching to a laser with a different wavelength)
•	1 to 3 treatment sessions
•	$1100 to $2000 per treatment
•	Downtime – 5 to 10 days of crusting (depending on treatment settings; see photo)

Traditional CO₂

•	We don’t use it. Never have. (Risk of side effects outweigh benefits in our opinion)
•	1 treatment session
•	Downtime – two weeks

Fraxel: The concept | Fraxel expectations | Fraxel vs Fractional CO₂ SUMMARY | Fractional CO₂ Video

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