What You Need to Know About Fraxel Laser Treatments

As the weather cools, lasers at dermatologist offices are heating up. The main reason: Fall is an ideal time for a laser treatment.

Right now, you're less likely to get as much intense sun exposure, which is especially dangerous to skin post-procedure because of the skin's temporarily weakened barrier, says Paul Jarrod Frank, M.D., a cosmetic dermatologist in New York. Another potential factor? Our new normal (read: COVID-19). "Now that some patients have more flexible work-from-home schedules, the downtime that comes with a laser treatment seems doable to more people," says Dr. Frank.

There's one laser in particular that has earned its status as the office's workhorse: The Fraxel laser. It's so good at evening out tone, fading scars, shrinking pores, and plumping skin that dermatologists turn to it for most of their patients' anti-aging needs. In fact, many make sure to get an annual treatment for themselves (BTW, a session with the Fraxel laser costs about $1,500 per treatment). "It's the only device I've seen in my career that can do a little bit of everything effectively," says Dr. Frank. "After injectables, it was the top request when my office reopened after the coronavirus shutdown. I'd tell my patients to invest in a yearly Fraxel treatment over a slew of expensive anti-aging products any day."

How Fraxel Lasers Work

Skin cells have one of the fastest turnover rates in the body," says Dr. Frank. But as it slows down with age, pigmented cells begin to pile up. The production of new collagen—the substance in skin that keeps it plump and smooth—starts to lag too. "To turn that around, we injure the skin intentionally with a laser, which stimulates the healing process that builds new, healthy cells and collagen," says Anne Chapas, M.D., a dermatologist in New York.

The injury tool of choice for dermatologists is the Fraxel Dual 1550/1927. This device uses non-ablative fractionated resurfacing technology, meaning that instead of blanketing the skin's entire surface with its light, which would cause an open wound everywhere, it creates tiny channels from the uppermost to the deepest layers of the skin. "Its ability to target its energy means the skin heals much quicker than it would with other resurfacing lasers," says Dr. Chapas. "But it still hits enough area to destroy excess pigment and stimulate collagen formation."

To achieve both results, the Fraxel Dual has two settings: "The 1,927 nm wave-length treats the skin's superficial epidermis layer to help resolve discoloration, while the 1,550 nm wavelength targets the lower dermis level, which improves texture by fading deep lines and scarring," says Dr. Chapas. Within those settings, a doctor can customize the laser's level of penetration based on the patient's needs. This is important for skin of color. "Unlike other lasers, there aren't significant issues with using Fraxel on darker skin tones, but a skilled doctor needs to get the energy levels right to avoid hyperpigmentation," says Jeanine Downie, M.D., a dermatologist in New Jersey.

What a Fraxel Laser Treatment Looks Like

First, Dr. Downie recommends patients stop using retinol one week before a Fraxel laser treatment. At your appointment, after numbing the skin with a topical cream, a dermatologist methodically guides a handpiece across skin in sections for 10 to 15 minutes. The laser's energy feels like hot, small rubber band snaps.

"Immediately afterward you'll experience redness and some swelling, but the swelling will go down by the next day," says Dr. Downie. "Your skin may have a brownish-red flush for a few days." Fraxel laser treatments are often done on a Friday (#FraxelFriday is a thing) so you can hideout for the weekend and reappear on Monday with makeup. "By then, your skin will look like it has a puffy sunburn, but it shouldn't hurt," says Dr. Frank.

After a Fraxel laser treatment, he recommends keeping skin hydrated with a gentle cleanser and moisturizer. Skip products like retinol and exfoliants, which contain potentially sensitizing active ingredients, for one week on your face and two weeks on your body (it takes longer to heal). You'll have a bit of downtime after a Fraxel laser treatment; Avoid direct sunlight for two weeks, wearing a mask, sunscreen, and a big hat when you go outside.

The Glowing Results

As soon as one week after a treatment, you'll notice that the texture of your skin is smoother — pores are smaller, scars and wrinkles aren't as deep — and dark spots and patches, like melasma, have faded (which you can see in some of the Fraxel laser before-and-after photos below). Most people will see benefits from an annual or semiannual treatment, but if you have more extensive concerns, you may need more sessions. "That may mean five appointments over five months for deep scars and wrinkles. For pigmentation issues like melasma, you may need one more treatment," says Dr. Frank.

There's also a more intense version of the laser, the Fraxel Restore, that can further fade and smooth stretch marks and other hard-to-treat scars reduces dark on the body. "Patients often ask me to treat C-section scars and uneven pigmentation on their knees and elbows," says Dr. Downie. Expect about six Fraxel laser treatments spaced one month apart to see a 75 to 80 percent improvement.

One welcome outcome that you won't be able to see: "Fraxel can repair sun damage lurking under the skin's surface, which could appear eventually," says Dr. Downie. In fact, the laser has been proved to decrease your risk of non-melanoma sun damage, "specifically pre-cancerous basal and squamous cells," says Dr. Frank. If they're caught early enough, they can be zapped away before becoming a problem. "It's a great tool for anyone with a history of skin cancer and precancerous cells," he says. "Ideally, these patients get Fraxel twice a year."

How to Protect Your Fraxel Laser Results

Of course, you'll want to take care of this youthful skin as much as you can. "A good anti-aging regimen includes a vitamin C formula and a broad-spectrum sunscreen in the morning and a retinol at night," says Dr. Chapas. Try Beautystat Universal C Skin Refiner (Buy It, $80, amazon.com), La Roche-Posay Anthelios 50 Mineral Ultra Light Sunscreen Fluid (Buy It, $34, amazon.com), and RoC Retinol Correxion Line Smoothing Night Serum Capsules (Buy It, $29, amazon.com). These topical products are a great maintenance plan — until your next Fraxel laser treatment.