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Fractional Laser resurfacing

Fractional laser skin resurfacing (ablative and non-ablative)  achieves skin improvements close to conventional ablative laser skin resurfacing but with fewer side effects. Examples of branded devices include FraxelandPixel,etc

The process of directing a light source to target a selected area of the skin to damage it is technically known as "selective photothermolysis"; where “thermolysis” refers to ‘decomposition by heat’ and “photo” refers to ‘light’.


Unlike with selective photothermolysis, where the whole of the selected target area is damaged; “Fractional Photothermolysis” seeks to only damage certain zones within the selected target area, (producing tiny dot, or pixel-like treated areas on the skin), leaving the other zones within it perfectly intact; hence only causing fractional damage through the heat of the light source. This allows the skin to heal much faster than if the whole area was treated, as the ‘healthy’ untreated tissue surrounding the treated zones helps to fill in the damaged area with new cells.

The costs for fractional laser skin resurfacing depend on the area(s) being treated and the type of device being used.


This fractional approach (ablative and non-ablative) achieves comparable skin improvements of an ablative laser but with the downtime of a non-ablative laser resurfacing e.g an Er:YAG or CO2 laser, (depending on depth and severity of wrinkles).


Optimal improvement after fractional treatment is usually visible in about 2 - 3 months as collagen remodelling and skin tightening continues. Results depend on future ageing, the effects of gravity and sun exposure.



Fractional CO2


The Fractional CO2 laser machine has a wavelength of 10,600nm which is split into thousands of microscopic beams, producing tiny dot, or pixel-like treatment zones on the skin; referred to  as MicroThermal Zones (MTZs).


At 1,500 – 2,500 MTZs per cm2 , the MTZs are invisible to the naked eye. Each MTZ is about 30 - 70 microns in diameter, (a micron is one millionth of a metre), and 400 - 700 microns deep. This is in contrast with the typical depth of 200 - 400 microns achieved with ablative resurfacing; where any deeper and you risk scarring. The Fractional carbon dioxide laser treats between 12 - 20% of the skin with each treatment session.




  • Fractional photothermolysis is used for the treatment known as skin rejuvenation/resurfacing, which includes;
  • Reduction Of Acne Scars Grade 3
  • Reduction and possible removal of fine lines and wrinkles
  • Improvement of deeper wrinkles, 
  • Repair of sun damaged skin on the face, neck, shoulders and hands,
  • Reduction of age spots and blemishes, acne scars and hyperpigmentation (areas of darker pigment or brown patches in the skin
  • Reduction in Stretch marks Grade 3 And 4



  • History of skin sensitivity to light or scarring problems
  • An Active herpes (cold sores) infection or other
  • Skin infections such as impetigo
  • H/O of Isotretinoin
  • People with some darker skin types, particularly skin types IV, V and VI; Hispanic, Latin, Asian, Indian, Middle Eastern and both lighter and darker toned black skin.
  • Pregnant or nursing women,



  1. Give realistic idea about the treatment. Sign the consent form and take before and after photographs of the patient.
  2. The skin is first cleansed and a topical local anaesthesia is applied to increase patient comfort during the procedure, the hand piece also has a built in cooling mechanism.
  3. The anaesthetic is removed before treatment
  4. The laser treatment head is then passed over the surface of the treatment area in a series of horizontal and vertical overlapping passes, until an erythema or mild redness is noted in the skin.
  5. Treatment of the face will take approximately 20-25 minutes.


Repeat Procedures:

Multiple treatment sessions are often required with fractional resurfacing to obtain optimal results. The number of treatment sessions required depends upon the individual patient and the condition undergoing treatment.

Due to the way the laser treats the skin, it remains relatively strong, therefore any redness can be camouflaged with make-up straight away without any ill effects; and men are also able to shave almost immediately after the treatment. Fractional photothermolysis or laser skin resurfacing offers speedy healing and minimal to no downtime.


Post treatment

Depending on the area of your body treated and the type of device used, the procedure is said to be well tolerated; feeling like a mild prickling or burning sensation, or like elastic bands flicking on the skin. However, you can apply a topical anaesthetic to your skin prior to treatment to reduce any pain and discomfort.


For several hours afterwards the skin will feel tight and have the appearance of a “sunburned” look. The skin will continue to look “pinkish” for 2 - 7 days (depending on the device used) and any swelling, which should be minimal, usually disappears after 1 – 3 days.


With Fraxel™, a bronzed, sun tan look caused by the dead, burnt cells at each MTZ will then remain for 3 – 14 days before naturally exfoliating.

Generally, as the skin heals itself, you will find mild to moderate skin flaking, which may last for up to 2 weeks.


Side effects or risks- Minimal swelling and redness.

Limited risk of infection or scarring, with no oozing or crusting of the skin .


No risk of hyper- or hypo- pigmentation (areas of darker or lighter skin colour) with fractional photothermolysis due to the fact that areas of healthy tissue are kept intact between the treated areas, unlike with ablative lasers, meaning that lasting pigment change does not occur.


If the laser is used at higher powers, there is a risk of mild blistering (mainly on the chin and temple areas) and/or temporary skin discoloration, especially in darker-skinned patients


Post – treatment advice may include:

  •  Women can camouflage skin redness with make-up straight away if desired.
  • Apply a hypoallergenic moisturiser which can help mask any bronzing and skin flaking symptoms.
  • Avoid creams with active ingredients such as AHAs or Retinoids which irritate the skin and could impede the healing process.
  • Do not sleep on the treated area, to help avoid any swelling; e.g., sleep on your back rather than your side if your face has been treated.
  • Cool compresses (not ice packs) or cooling gels such as aloe vera can be applied to the treated area if required.
  • Avoid sun exposure during treatment and healing phases and/or wear sunscreens with an SPF of 30+ which contain zinc oxide and Protection factor A.

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