Fractional Ablative Laser

Fractional lasers have bridged the gap between the ablative and non-ablative used to enhance photorejuvenation. Whilst ablative laser treatments work mainly on the epidermis (surface skin cells) and non ablative treatments work solely on dermal collagen (mid-layer of skin) only, fractional laser treatment works at both the epidermal and dermal layers of the skin. Erbium laser works at a 2940nm wavelength.

 

How does it work? The skin consist of 3 layers, the epidermis (uppermost layer), dermis (mid-layer) and subcutis (lower fat layer). The epidermis contains pigment-producing cells called melanocytes, which are responsible for skin coloring. The dermis is made up of collagen and elastin fibers that provide skin with strength, toughness, elasticity, and pliability. As the body ages, the epidermis becomes thinner so blemishes become more visible, and collagen in the dermis is gradually lost which contributes to the formation of facial lines, sagging skin and wrinkles.

 

This laser delivers a laser beam that is divided into thousands of tiny but deep columns of treatment into the skin. Within each microthermal treatment zones old epidermal pigmented cells are expelled and penetration of collagen in the dermis causes a reaction that leads to collagen remodeling and new collagen formation. It treats intensively within the zone whilst surrounding healthy tissue remain intact and unaffected resulting in a faster healing process than if all tissue in the treatment area was exposed to the laser.  The Erbium Pixel is less deep than the CO2 laser, therefore less downtime and more safe in darker skin types.

 

Pre-treatment assessment/preparation

  • An anesthetic cream is applied to the treatment area for 30-45 minutes prior.
  • Treatment time will depend on the areas being treated, but a full face will take around 20 minutes for a single pass.
  • The pain associated with the procedure is dependent on the energy delivered to the treatment site.
  • A cooling device, called a Zimmer machine, is used to reduce the discomfort during the procedure.

 

 

Post-treatment and recovery

  • Patient may experience a burning hot sensation that peaks 30 minutes after procedure
  • Swelling is usually minimal and should resolve in 2-3 days. Notify us if severe swelling occurs.
  • The skin will have a pinkish tone with darker crusting of the brown spots for 2-3 days after a single pass or after 4-7 days with a double pass.
  • Within 24 hours new epidermal skin develops and the skin will have a bronze appearance that can last between 3-5 days for a single pass and 7-14 days after a double pass. Flaking of the skin may also occur as new skin replaces dead skin tissue. This can be treated with moisturizers or our recommended repair creams.
  • During the healing phase and for several months after treatment, it is recommended that the treatment area be protected using a moisturizing sublock (SPF of the least 30+ and with zinc oxide as a main ingredient). Protective clothing and wide-brimmed hats should also be used.

 

Downtime and Expectations

  • You may need four to five treatments with Erbium lasers, depending on the energy level used. These are spaced  at least one month apart. The results are not immediate and are slowly progressive, with optimal improvement visible over a three to four month period. Fractional laser treatment appears to be well tolerated by most patients. After a mild treatment makeup can be applied after 2 days, but a more aggressive treatment may need 7 days before makeup can be used.

 

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– Peter Paul Rullan, M.D.