Also known as fractional photothermolysis, fractional laser resurfacing is a relatively new method of skin rejuvenation in which the targeted areas of the skin are precisely spaced out at a microscopic level, leaving some skin perfectly intact while other zones are treated with laser light. The effect is visually comparable to the pixels in digital images, as the tiny spots of treated skin replace old, destroyed cells with new, healthy ones, and the untreated areas maintain the tissue’s stability for quicker recovery.
Fractional lasers have revolutionized the skin resurfacing market in this era. Dr. Gold and his staff have been and continue to be influential thought leaders globally, working with many of the laser companies to determine the optimum use of these devices and to teach them to clinicians world-wide.
Fractional lasers are typically divided into two categories – non-ablative and ablative. Non-ablative means that when you fire the laser, it actually passes through the skin, leaving the top layers unaffected by the laser light. These were the first of the fractional devices that were developed, and research conducted at the Tennessee Clinical Research Center early on in this endeavor led to the FDA approval of one of the first non-ablative laser systems. With the non-ablative fractional lasers, small zones of tissue are heated under the skin, leaving skip areas next to the damaged areas, and over time new collagen is formed in the areas treated, making the skin smoother, tighter, and with better texture and tone. Further research has shown that skin pigment changes, both too much pigment (hyperpigmentation) and too little pigment (hypopigmentation) responds to this form of therapy, as well as acne and traumatic scars and perhaps even burn scars and stretch marks. Individual results vary somewhat between patients, but this gives a realistic option for some of these more difficult skin concerns.
Sublative: Also good for acne scarring
- Venus Viva: acne scarring, fine lines/wrinkles, hyperpigmentation, improvement in texture and pore size
- Syneron eMatrix: acne scarring, fine lines/wrinkles, hyperpigmentation, improvement in texture and pore size
- InMode Fractora
Ablative: Also good for acne scarring
- Alma iPixel: erbium 2940 wavelength – fractionally ablative
- Lumenis Active FX: Co2 – fractionally ablative, more superficial than Deep FX
- Lumenis Deep FX: Co2 – fractionally ablative
- Ultrapulse ActiveFx: Co2 – fine lines/wrinkles, improvement in texture and pore size, resurfacing
- Lumenis Acupulse: Co2 – fine lines/wrinkles, improvement in texture and pore size, resurfacing
- Cynosure Ellman Cortex: CO2& Er:YAG Laser – fine lines/wrinkles, improvement in texture and pore size, resurfacing
- Cynosure Affirm: scars, stretch marks
- Alma Harmony Clearlift: skin tightening, hyperpigmentation
- Syneron Candela PicoWay Resolve
Non-ablative fractional laser treatments work over time and our skilled clinicians will work with you during your consultation to determine if you are a candidate for this type of therapy. Non-ablative fractional resurfacing works over time, and usually takes 4-6 treatments spaced at one month intervals to achieve the desired result. The advantage of non-ablative fractional resurfacing is that the procedure has minimal to no downtime, with many patients experiencing some redness of the treated skin which lasts usually from several hours to no more than 24 hours. Most patients have no impact on their daily activities and are able to resume work immediately after their non-ablative fractional therapy. The results can be life-changing – lines and wrinkles diminished, scars reduced, and pigment changes back to normal.
Ablative laser treatments are more severe and can cause epidermal burning. Recovery time is longer and can extend up to several weeks. However, ice pick and boxcar acne scars respond well to ablative treatments, as do deeper wrinkles. For patients with older skin or those with a great deal of sun damage, the ablative laser may be best, even with the more significant downtime. We utilize excellent topical anesthetic creams and our ablative lasers have built-in cooling capacity to make the procedure more comfortable.
Ablative fractional devices are typically divided into erbium laser systems and carbon dioxide (CO2) laser systems – the traditional resurfacing lasers – but now made into fractional modes. Dr. Gold and his staff have worked with many of the laser companies to develop protocols to make these devices more efficient and efficacious.
Our office currently utilizes several of these ablative laser systems. They are effective in treating lines and wrinkles, to enhance texture and tone issues, and to treat scars – from acne scars to traumatic scars to burn scars. Ablative fractional laser treatments usually give the desired effects in 1-2 treatment sessions, and the staff of The Laser and Rejuvenation Center will work with you to determine which device is best for you and how to best proceed with your fractional therapy.
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