Fractionated laser treatments (updated 8/4/08)
A lot of excitement has been generated by the introduction of the ‘fractionated’ laser treatment. There are a few different varieties of fractionated laser, such as PIXEL and FRAXEL. The reason for the excitement is that these lasers offer the opportunity for reduced ‘downtime’ after treatment.
The idea (simplified here) is that with each laser pass, the amount of skin actually ‘hit’ with the laser is only a ‘fraction’ of the area covered. That is, a single pass with the laser may only actually ‘hit’ 25% of the skin. The benefit is that the surrounding, unaffected skin can more quickly heal over the affected areas. This is in distinction to standard ‘resurfacing’ laser techniques, whereby the entire surface of the skin is affected. The earliest fractionated lasers are non-CO2 (e.g., Erbium-based). These fractionated lasers may require several treatments to see results. At the Mid-Winter meeting in Vail, Colorado in January 2007 and 2008, some of these results were presented (though not by me). While these early fractionated lasers show some results, treatment of rhytids (wrinkles) is not as effective as one may like. Interestingly, more than one speaker mentioned that we are ‘going back’ to CO2 laser treatments. A new laser has been introduced which combines fractionation technology with CO2.
I already have begun using fractionated lasers in patients, and it seems that these patients are seeing some nice results. The recovery is typically a few days (versus weeks or months with standard CO2 laser). It is perhaps not as effective as a standard CO2 laser or deep chemical peel, but the risks appear to be lower.
Newer, higher powered fractionated CO2 and erbium lasers hold the promise of improved results.
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