In response to an ever-increasing number of medical skin conditions, the choice of technologies to treat them has also increased. Over the last twenty years, as new light-delivery systems have come onto the market, the use of light as a treatment option has become more common.

Fast Facts

  • Lasers are the latest step in the evolution of light used for medical purposes.
  • The word  “ablative” means, “removing a top layer of skin.”
  • Discomfort during and after the procedure ranges from mild to moderate, depending upon the patient’s tolerance for pain.
  • Fractional resurfacing is performed on an outpatient basis. You will go home straight after the treatment.

Ultraviolet light, for example, is often used to treat the skin disease psoriasis, a condition that causes redness, itching and irritation. Light boxes, which mimic natural sunlight, are used to ease the symptoms of seasonal affective disorder (SAD), a form of depression occurring at certain times of the year, usually during winter when natural sunlight is in short supply. Ophthalmologists use light emitting lasers to correct eye conditions such as short sightedness.

Lasers are the latest step in the evolution of light used for medical purposes.

From its infancy in the 1960s, laser technology has progressed remarkably. One aspect of light technology, fractional laser, promises to improve many skin conditions. Fractional laser treatment is the hi-tech equivalent of dermabrasion or deep chemical peels and is rapidly gaining momentum as the treatment of choice for skin resurfacing.

Introduced in 2003, the term fractional simply refers to the method by which light is transferred. Devices that fall under this category are CO2 (carbon dioxide), Erbium or YAG.

Fractional laser therapy is used to treat sun-damaged skin, spider veins, acne scarring, stretch-mark scarring and other aesthetic skin issues such as the removal of lines, wrinkles, brown spots, freckles and hair.

How fractional laser resurfacing works

Fractional lasers work by creating microthermal zones deep below the surface layer of the skin. They trigger the body’s natural healing process, which stimulates the production of collagen and new skin cells. The new skin then replaces the older, damaged skin.

The word  “ablative” means, “removing a top layer of skin.” In general, fractional lasers are ablative, but they have two modes of delivery: ablative fractional resurfacing (AFR) and non-ablative fractional resurfacing (NFR).

AFR lasers direct an intense burst of laser energy onto the surface of the skin, stimulating the production of collagen. NFR lasers are a new entry in the fractional laser field. Less invasive than AFR lasers, they are quickly gaining popularity. NFR lasers have lower energy levels than AFR lasers, and, unlike their AFR cousins, affect the dermal layer of the skin without damaging the epidermis, the skin’s outermost layer. Another major difference is the duration of the procedure and the healing time. With NFR treatments the procedure and healing time are usually shorter. AFR, however, is more commonly used than NFR because the results are more predictable.

Reasons for choosing to have fractional laser resurfacing

Fractional laser resurfacing is a relatively new modality, now widely used for its minimal cost and healing time.

The effectiveness and safety of this procedure is high.

People consider fractional laser resurfacing for the following reasons:

  • Fractional laser therapy is a non-invasive treatment that delivers positive results with minimal side effects and complications.
  • The procedure requires very little downtime, as the surface layer of skin heals much faster than it would after surgery where multiple layers of skin are damaged.
  • Because it is non-surgical, the treatment itself does not take as long as cosmetic procedures involving surgery. Depending on the device and area to be treated, Fractional Laser treatments usually take at most 1 hour.

Nearly anyone who has a skin problem can undergo fractional laser resurfacing.

Your skin type is relevant to the type of Fractional Laser that is right for you. Skin types I-III in the Fitzpatrick scale

Type I (White – Very Fair), II (White – Fair), III (cream white) can be treated more safely with AFR than can darker skin types. AFR on dark-skinned patients has been correlated with post-inflammatory hypo- and hyper-pigmentation. Skin Types IV, V and VI are therefore better treated with non-ablative devices.

People discouraged from undergoing fractional laser resurfacing include:

  • People with active herpes (cold sores) or other infections on the area to be treated.
  • People who have used the acne medicine isotretinoin within the last year.
  • People who use medication that increases photosensitivity.
  • People with a history of bleeding disorders.
  • People with Skin Types IV (Beige with a brown tint – Mediterranean Caucasian), V (Dark brown), and VI (Black).
  • Pregnant and breastfeeding women (Note: Very little is known about the effects of lasers on pregnant and lactating women, it is better to be safe than sorry.)

Things to consider once you’ve decided to have fractional laser

Of primary importance when undergoing fractional laser resurfacing is the doctor or dermatologist performing the procedure. While there is no specific certification required for a doctor to perform laser procedures in Australia, it is wise to research a suitably trained doctor with years of experience in fractional laser resurfacing.

According to studies on fractional (ablative) laser resurfacing, complications may occur due to a lack of technical ability. Scarring, for instance, may be the result of an overly aggressive treatment.

What to expect

The time it takes to perform fractional resurfacing will depend on the specific device the practitioner will use. The procedure itself may last from 10 minutes to 1 hour, depending upon the device and area to be treated.

Discomfort during and after the treatment ranges from mild to moderate, depending upon the patient’s tolerance for pain. You might need an anaesthetic applied to the skin, which would require extra preparation time.

Fractional resurfacing is performed on an outpatient basis. You will go home straight after the treatment.

Before and after your treatment

Prior to the procedure, you must not use exfoliants containing ingredients such as tretinoin, AHA or glycolic acid. You may be advised to take painkillers (like panadol and neurophen) an hour before the treatment.

Even after topical anaesthetic and painkillers, your skin may still tingle and feel hot, just as if you had sunburn. A cold compress on the area treated will relieve this uncomfortable feeling.

The reddened skin will fade and “bronze” within 1-3 days. The treated skin will then turn into a dark crust that feels like sandpaper. Approximately 10 -14 days later, this top layer of damaged skin will fall off and allow new skin to come to the surface.

After Your Treatment

  • Apply a cold compress to the treated area for 5-10 minutes immediately after the procedure.
  • Avoid direct sun exposure for at least 6 months.
  • Apply a hypoallergenic moisturiser to ease your symptoms after the treatment, but avoid creams with active ingredients such as AHAs or Retinoids.
  • During the healing period, apply sun block with a minimum SPF of 30+ at least 30 minutes before going out into the sun.
  • Avoid scrubbing the laser-treated areas with any abrasive materials.
  • Sleep on the opposite side of your treated area to help avoid swelling. If you have had treatment on your face, sleep on your back.
  • Keep cool, because sweat on freshly treated skin will sting.
  • It is best to wait to wear makeup until the 3rd day after treatment. If you must wear makeup, be sure the ingredients are as natural as possible.
  • Do not swim in a chlorinated pool for 1 week following treatment.
  • Do not pick at the damaged flaking skin, as this may scar the skin underneath.

After the treated area has completely healed, patients usually notice that their skin is smooth and glowing.

Rough costs involved

The cost of fractional laser skin resurfacing depends on a number of variables, such as the type of device, the area being treated, and the doctor’s fees. The type of machine and area being treated will also determine extra costs such as gels and dyes needed. For instance, you can choose to undergo some treatments without a numbing gel. Without the numbing gel, you may qualify for a fee reduction.

One fractional laser resurfacing treatment can cost anywhere between $2500 and $4000 (AUD).

You should expect the costs to be higher if you are having combined treatments at the same time.

This information is correct as of 2019.

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