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Fractional Laser Skin Resurfacing

Since the early 1990s, ablative lasers have become the high tech equivalent of dermabrasion or deep chemical peels for skin resurfacing; the removal of the outer layer of the skin to promote new fresh skin growth.

There are two main types of ablative laser - the original machines used were carbon dioxide lasers, and more recently erbium: YAG laser systems have been introduced. These so called 'ablative' or skin resurfacing lasers briefly direct an intense burst of laser energy onto the surface of the skin. This energy heats water within the surface layers of the skin, causing both the water and the tissue of the skin to turn to vapour. Every time the laser passes over the skin, some of the outermost layers of the skin are removed in a precise and controlled way to the appropriate depth.

This 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 or fractional laser skin resurfacing, seeks to only damage certain zones within the selected target area, hence only causing fractional damage through the heat of the light source.

The Fraxel™ SR Laser was the first fractional laser system to become available in the UK in 2005; since then a variety of similar devices including Pixel® have been developed. The Fraxel™ machine fires a 1550nm diode pumped erbium fibre laser beam which is then split into thousands of microscopic beams, producing tiny dot, or pixel-like treatment zones on the skin; referred to as MicroThermal Zones (MTZs).

These MTZs penetrate deep into the skin, like an ablative laser, destroying the old cells. With approximately 1,500 – 2,500 MTZs per cm2 they are invisible to the naked eye, other than as an overall 'bronzed' look which they give to the skin. For every MTZ that the laser has targeted and therefore treated, it leaves the surrounding tissue unaffected and intact. This allows the skin to heal much faster than if the whole top layer of skin were removed as with an ablative laser. The Fraxel™ laser treats between 12 - 20% of the skin with each treatment session and claims to achieve comparable skin improvements as obtained with conventional ablative laser resurfacing with a CO2 laser.

Fractional laser skin resurfacing is used for the 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, the reduction of age spots and blemishes, acne scars and hyperpigmentation (areas of darker pigment or brown patches in the skin).

Depending on the device being used a topical local anaesthetic cream may be used on the area to be treated to aid patient comfort during the procedure, a lubricating gel or tint may also be applied, and a chilled air device may be available. The procedure can take up to 30 minutes for a full face treatment, and most people can return to work immediately following 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.

Unlike with ablative laser resurfacing, where one treatment is usually enough; multiple treatment sessions are required with fractional resurfacing to obtain optimal results.

Private costs can range from approximately £250 - £350 for one small area of the face or neck to £750 for a full face or décolletage (the area between the neck and breasts) treatment.

Please note that all clinics offering laser, IPL or LHE treatments should be registered with the Healthcare Commission, as they need to follow certain standards for the safe operation and maintenance of these machines and receive regular inspections to ensure that National Minimum Standards are met.

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