Understanding Fraxel® Repair and Lumenis® Bridge Fractional Ablative CO2 Lasers and Palomar® Lux2940 Fractional Erbium Ablative Laser for Fractional Laser Skin Resurfacing
CO2 ablative laser resurfacing has been the “Gold Standard” for non surgical facial rejuvenation and removal of facial skin wrinkles and photo aging since 1995. CO2 ablative laser resurfacing using the Ultrapulse CO2 laser can achieve very significant facial rejuvenation including wrinkle removal, skin tightening and removal of pigment and photo aging skin changes. (See Photo Below Before and After Ablative CO2 Laser Resurfacing).
However CO2 laser resurfacing has several limitations including a prolonged and difficult recovery period, often lasting three weeks, prolonged facial redness that can last three months, hypo pigmentation or lightening of skin color, and the potential for infection which can lead to scarring.
During the past three years new technology called fractional laser resurfacing has been developed which has dramatically shortened recovery time and lessened the occurrence of complications.
With fractional laser resurfacing the laser beam is broken up or fractionated into many small micro beams which are separated so that when they strike the skin surface small areas of the skin between the beams are not hit by the laser and left intact. These small areas of untreated skin promote a much more rapid recovery and healing with less risk of complications. The small areas treated by the fractional micro beams, called micro treatment zones, cause sufficient laser injury to promote new collagen production and resultant facial skin rejuvenation. ( See Diagram Below)
In the above skin diagram, the first red area on the left represents traditional non fractional ablative CO2 and Erbium laser resurfacing. To ablate means to surgically remove and the skin tissue is removed by the heat of the CO2 or Erbium laser. Since these lasers were not fractional, all of the skin in the treated area is removed creating an open wound that takes a long time to heal.
The second drawing is the Lumenis® ActiveFX fractional CO2 laser which fractionally ablated the surface of the skin down to a depth of 70-100 microns. This laser is fractional and the skin heals much quicker, but depth of penetration is not deep enough to produce substantial wrinkle removal, skin tightening and skin rejuvenation.
The third red areas represent the non ablative fractional laser technologies which heat but do not ablate the skin. These lasers use an Erbium laser to heat small columns of the deep skin layers to promote new collagen production and plump the skin and skin wrinkles. Recovery time is much less than with traditional ablative CO2 and Erbium lasers. Examples of the non ablative fractional lasers are the Fraxel® and the Palomar® Lux1540 fractional non-ablative lasers. These lasers are excellent for improving skin texture, plumping wrinkles and acne scars, and shrinking pores, but multiple treatments are required.
More recently several new fractional ablative lasers (ablate means to surgically remove-see last column on right in diagram below) have been developed which actually remove the heated column of skin tissue and provide more substantial wrinkle removal and superficial skin tightening than the non ablative fractional lasers (See Last Figure on Right in Above Diagram). The Fraxel® Repair laser and the Lumenis® Bridge laser are ablative fractional CO2 lasers and the Palomar® Lux2940 laser is an ablative fractional Erbium laser. These new ablative fractional CO2 and Erbium lasers have the advantage of producing better wrinkle removal and skin rejuvenation than the non-ablative fractional lasers, the Fraxel® and Palomar® Lux1540 with less down time than the traditional non fractional ablative CO2 and Erbium lasers.
These fractional ablative CO2 and Erbium lasers reach much deeper into the skin, 600 to 1000 microns, and can produce much more effective wrinkle removal and skin rejuvenation with significantly less down time and recovery than traditional CO2 and Erbium non fractional ablative laser resurfacing. The Erbium laser produces less heat than the CO2 laser and traditionally recovery time, the time for redness of the skin to go away, has been less with the Erbium laser than with the CO2 laser.
The photo below shows the wrinkle removal results achieved with the new Palomar® Lux2940 micro fractional ablative Erbium laser with only 4-6 days of down time as compared to 3 weeks of down time and 3 months of redness with a traditional CO2 laser resurfacing.
The new micro fractional ablative Erbium and CO2 laser resurfacing techniques are very exciting advances in the field of non surgical facial rejuvenation and wrinkle removal. Many new applications are being developed which will likely improve our ability to rejuvenate the skin and possibly improve scars, stretch marks, and remove pigment.
To learn more about non surgical facial rejuvenation, read Save Your Face or contact me.
Boston, Massachusetts
978-369-4499
