Troubled Skin: Okay so the Actual Size does mean Density. I was confused why that was much higher than my previous treatment. But I'm not as swollen and red as 2nd treatment. I did tell her to concentrate on my surgical scars and anyone other scars she thought was deep. Do you think this method is better or should I just let her decide next time? What do you mean by longer passes? I also had a new nurse to prep me this time and I heard the doc. mentioning that she used too much vaseline (that usually is applied over the dye). What would too much Vaseline do to the treatment?

edited:

I'm just paranoid about the setting levels. Don't really understand it. That's why I am asking Trouble Skin or anyone else. Also Trouble Skin, do you think my doc. know what she is doing?

Troubled Skin: Okay so the Actual Size does mean Density. I was confused why that was much higher than my previous treament. But I'm not as swollen and red as 2nd treatment. I did tell her to concentrate on my surgical scars and anyone other scars she think was deep. Do you think this method is better or should I just let her decide next time? What do you mean by longer passes? I also had a new nurse to prep me this time and I heard the doc. mentioning that she used too much vaseline (that usually is applied over the dye). What would too much do to the treatment?

Mz,

The treatment level, for example 8 on your last treatment is what controls density with Fraxel 2. Longer passes with the Fraxel hand piece would mean the same as for example: a longer stroke i.e "One longer stroke with a paint brush would use more paint then one short stroke". Now use that in the context of density with the Fraxel. It sounds like your Dr. is experimenting in an attempt to strike the right balance for you. Keep watching the numbers and most importantly the results and you will do fine.

Troubled Skin: Okay so the Actual Size does mean Density. I was confused why that was much higher than my previous treament. But I'm not as swollen and red as 2nd treatment. I did tell her to concentrate on my surgical scars and anyone other scars she think was deep. Do you think this method is better or should I just let her decide next time? What do you mean by longer passes? I also had a new nurse to prep me this time and I heard the doc. mentioning that she used too much vaseline (that usually is applied over the dye). What would too much do to the treatment?

Mz,

The treatment level, for example 8 on your last treatment is what controlls density with Fraxel 2. Longer passes would mean longer strokes for example: one longer stroke with a paint brush would use more paint then a short stroke. Now think density. It sounds like your Dr. is attempting to strike the right balance. Keep watching the numbers and most importantly the results and you will do fine.

 

Hey, I'm glad you could answer my questions. I know now that she follows her treatment from a chart by Reliant. I looked at it and It showed 2 different setting patterns for energy level 20-25 for acne scarring. Those are 1st: treatment level 10, passes 10 and 2nd: tx level 8, passes 8. That is why I think she is conservative or does every doc. look at this chart? Its so hard to find a great doc. and I hope she is one of them. Is energy level 25 high enough to treat acne scars? After seeing JJ007's settings, I really wanted my doc. to be more aggressive. But I also know that I have darker skin than JJ007. Again, as for the longer stroke, by that do you mean leaving the tip on the skin longer (ie. moving it up and down w/o picking up the tip or is that not possible)? If she is covering the same areas of my cheeks as last time then how can she do longer strokes. Sorry, I hope i'm making sense.

TROUBLED,

Hi there, I know you have tried to explain this before but I was hoping for one more time or maybe a simpler explanation. My last fraxel treatment was very painful, the first was not. I am assuming it has to do with treatment levels since everything else was the same. I was noticing that even though some of us on the board have the same treatment levels (level 8 or level 10 for fraxel II), the KJ's differ greatly even for full face. For acne scarring, is it best to have higher MJ's, KJ's, or what and what is density? I know some of it has to do with face size, etc. but I am sooo confused...it seems like my PA knows what she is doing but I have two more treatments left and want to make sure I get the most out of them. Also, this last one hurt pretty bad and I am not looking forward to another one at that level if it was the level that caused the pain. If that is the only way to get results I will do it but I want to make sure....thanks.

Nantynannie,

There are several factors at work which can explain why your pain is increasing with each TX. Among the most common is increasing mj/density with each treatment. Also, your body may still be in the healing phase from your last TX. The more aggressive your treatments are the longer healing takes. Other factors that may contribute to additional pain would be the SR1500 increases total skin coverage by 3% with each level increase until as much as 32% total surface coverage is reached at treatment level 10. It also reaches a depth of 1.2mm at 40mj/cm2! That is a lot of punishment for those acne scars and unfortunately you in the process! While Fraxel 2 is said to be less painfull when compared to equivalent setting on the old Fraxel. Treatment with Fraxel 2 is usually much deeper/more aggressive and for this reason you might consider asking your doctor for a nerve block next time. They usually work quite well.

Regarding the confusion about kJ levels, I understand where you are coming from. This confuses even many doctors that are still in the learning curve.

The variance in kJ levels can be explained by understanding a little bit about the dynamics at work. As mj/cm2 increases, density automatically decreases as the lasers spot size increases. This begins to reduce total kJ levels more substantially as treatment moves upward beyond the 20/mj/cm2 range and continues exponentially up to 40mj/cm2.

Keep in mind that although density and kJ decrease, the relative coverage level increases due to the larger spot size and greater amount of thermal damage surrounding the MTZ ablation points. Most experienced doctors understand this and treat at variable mj to bring up density and kJ and then do additional passes at 40/mj to cover all bases. Shyones signature is a good example of textbook treatment. Of course treatments levels can vary substantially by individual doctor preference and the condition being treated. Hope this clears up any confusion you might have.

 

Hi, also keep in mind that the above explanation only applies to the Fraxel 2 which most medical facilities do not have yet. The original machines are only capable of being exact up to 20mj. After that the spot size cannot increase.

Troubled Skin: Okay so the Actual Size does mean Density. I was confused why that was much higher than my previous treament. But I'm not as swollen and red as 2nd treatment. I did tell her to concentrate on my surgical scars and anyone other scars she think was deep. Do you think this method is better or should I just let her decide next time? What do you mean by longer passes? I also had a new nurse to prep me this time and I heard the doc. mentioning that she used too much vaseline (that usually is applied over the dye). What would too much do to the treatment?

Mz,

The treatment level, for example 8 on your last treatment is what controlls density with Fraxel 2. Longer passes would mean longer strokes for example: one longer stroke with a paint brush would use more paint then a short stroke. Now think density. It sounds like your Dr. is attempting to strike the right balance. Keep watching the numbers and most importantly the results and you will do fine.

 

Hey, I'm glad you could answer my questions. I know now that she follows her treatment from a chart by Reliant. I looked at it and It showed 2 different setting patterns for energy level 20-25 for acne scarring. Those are 1st: treatment level 10, passes 10 and 2nd: tx level 8, passes 8. That is why I think she is conservative or does every doc. look at this chart? Its so hard to find a great doc. and I hope she is one of them. Is energy level 25 high enough to treat acne scars? After seeing JJ007's settings, I really wanted my doc. to be more aggressive. But I also know that I have darker skin than JJ007. Again, as for the longer stroke, by that do you mean leaving the tip on the skin longer (ie. moving it up and down w/o picking up the tip or is that not possible)? If she is covering the same areas of my cheeks as last time then how can she do longer strokes. Sorry, I hope i'm making sense.

 

Most use the chart as a reference point and then adapt parameters to each patient based on need. If she sticks with the chart only results should still be good as the charting is based on much clinical testing. 25mJ - 40mj is the reference range for acne and surgical scars. Re: The stroke/pass most doctors use several different directions to place a variable MTZ pattern. I thought I remembered you saying a while back that your Dr. was treating your cheeks all the way to your jaw. That would be considered a long pass.

Troubled Skin: Okay so the Actual Size does mean Density. I was confused why that was much higher than my previous treament. But I'm not as swollen and red as 2nd treatment. I did tell her to concentrate on my surgical scars and anyone other scars she think was deep. Do you think this method is better or should I just let her decide next time? What do you mean by longer passes? I also had a new nurse to prep me this time and I heard the doc. mentioning that she used too much vaseline (that usually is applied over the dye). What would too much do to the treatment?

Mz,

The treatment level, for example 8 on your last treatment is what controlls density with Fraxel 2. Longer passes would mean longer strokes for example: one longer stroke with a paint brush would use more paint then a short stroke. Now think density. It sounds like your Dr. is attempting to strike the right balance. Keep watching the numbers and most importantly the results and you will do fine.

 

Hey, I'm glad you could answer my questions. I know now that she follows her treatment from a chart by Reliant. I looked at it and It showed 2 different setting patterns for energy level 20-25 for acne scarring. Those are 1st: treatment level 10, passes 10 and 2nd: tx level 8, passes 8. That is why I think she is conservative or does every doc. look at this chart? Its so hard to find a great doc. and I hope she is one of them. Is energy level 25 high enough to treat acne scars? After seeing JJ007's settings, I really wanted my doc. to be more aggressive. But I also know that I have darker skin than JJ007. Again, as for the longer stroke, by that do you mean leaving the tip on the skin longer (ie. moving it up and down w/o picking up the tip or is that not possible)? If she is covering the same areas of my cheeks as last time then how can she do longer strokes. Sorry, I hope i'm making sense.

 

Most use the chart as a reference point and then adapt parameters to each patient based on need. If she sticks with the chart only results should still be good as the charting is based on much clinical testing. 25mJ - 40mj is the reference range for acne and surgical scars. Re: The stroke/pass most doctors use several different directions to place a variable MTZ pattern. I thought I remembered you saying a while back that your Dr. was treating your cheeks all the way to your jaw. That would be considered a long pass.

 

Yes u remembered. She always starts from the far left of the cheek and she would pull the tip down all the way to the jaw line (going vertical). She would do that a couple or as many as needed on the spot and move on going towards the nose. Then she goes across starting from the top far left and pulls toward the nose. Sometimes she would do another pass on the spot couple of times. She would pick the tip up and continue down until all of the areas are covered. This time after she finished w/ the horizontal and vertical passes, she went and did spot treating on individual scars. I always lose count on the passes myself due to the amount of pain I was in.

Day 3 (over 72 hours) since my 1st Fraxel treatment... (Energy = 20, Density = 125, Passes = 9)

My scars are still near invisible. The redness and bronzing is about 85 % faded. The flaking has really picked up. My skin is so dry in the patches that were treated. I am using a tweezer to remove obvious flakes that are ready to come off.

I don't feel like my skin is swollen. The treated patches are completely flat with the surrounding untreated skin. It is just very dry and rough right now (that is probably why my scars are still near invisible).

Also, I am getting a few (3 - 4) small follicular pimples. I don't know if that is because the doc made me apply sun-screen (and I have been using it daily)... Or if that is a side-effect of the treatment...

But, I am still pleased with the results...

hey all,

i just had my 2nd fraxel 1 treatment earlier this morning. i was treated at 20mjs full face and 4 additional passes on my worst scarred areas and also 4 more additional passes on my nose since i wanted to treat the blackheads and enlarged pores there. the settings are as followed:

20mjs

125 density

8 passes total on full face, 4 additional passes on worst scarred areas and nose

as of right now, i'm reddish and pinkish and swollen. i just ate a lot of protein earlier and now is just waiting to digest so i can take a little nap. i did have some pinpoint bleeding at some spots but nothing serious. my nose keeps dripping this white oozes from this spot where a acne use to be and i just put cetaphil moisturizer all over my face to keep it good. i asked my doc if i should moisturize and he said yes with a funky look in his eyes like of course obviously, dumb question. lol, my doc is very nice, i feel that i am in great hands. i just took MSM and vitamin C with rose hip oil supplement also. this is day 1 of course and i go back to work on monday, which is not that long since today but i sure hope i look decent enough to not draw so much attention. aside from that, i have nothing further to report, good luck everyone. keep your head up!

Day 3 (over 72 hours) since my 1st Fraxel treatment... (Energy = 20, Density = 125, Passes = 9)

My scars are still near invisible. The redness and bronzing is about 85 % faded. The flaking has really picked up. My skin is so dry in the patches that were treated. I am using a tweezer to remove obvious flakes that are ready to come off.

I don't feel like my skin is swollen. The treated patches are completely flat with the surrounding untreated skin. It is just very dry and rough right now (that is probably why my scars are still near invisible).

Also, I am getting a few (3 - 4) small follicular pimples. I don't know if that is because the doc made me apply sun-screen (and I have been using it daily)... Or if that is a side-effect of the treatment...

But, I am still pleased with the results...

Ralphie, congrats on your first so far. LIsten to me, do not pick those patches of dry skin, or what i like to call it, the scabs, its there for a reason to shelter and shield your baby skin under neath so it has time to mature, leave it alone bro if you want the best results, thats my 2 cent, listen or not its up to you. good luck

Day 3 (over 72 hours) since my 1st Fraxel treatment... (Energy = 20, Density = 125, Passes = 9)

My scars are still near invisible. The redness and bronzing is about 85 % faded. The flaking has really picked up. My skin is so dry in the patches that were treated. I am using a tweezer to remove obvious flakes that are ready to come off.

I don't feel like my skin is swollen. The treated patches are completely flat with the surrounding untreated skin. It is just very dry and rough right now (that is probably why my scars are still near invisible).

Also, I am getting a few (3 - 4) small follicular pimples. I don't know if that is because the doc made me apply sun-screen (and I have been using it daily)... Or if that is a side-effect of the treatment...

But, I am still pleased with the results...

Don't pick. Billy boy made that mistake . . .

I did not pick. Where did you get that?

Hi Billy,

You did say in an earlier post that you picked off the flakes and you thought that might have something to do with not getting optimal results.

Day 3 (over 72 hours) since my 1st Fraxel treatment... (Energy = 20, Density = 125, Passes = 9)

My scars are still near invisible. The redness and bronzing is about 85 % faded. The flaking has really picked up. My skin is so dry in the patches that were treated. I am using a tweezer to remove obvious flakes that are ready to come off.

I don't feel like my skin is swollen. The treated patches are completely flat with the surrounding untreated skin. It is just very dry and rough right now (that is probably why my scars are still near invisible).

Also, I am getting a few (3 - 4) small follicular pimples. I don't know if that is because the doc made me apply sun-screen (and I have been using it daily)... Or if that is a side-effect of the treatment...

But, I am still pleased with the results...

Don't pick. Billy boy made that mistake . . .

 

That makes me chuckle. picking off the dead falking skin is NOT gonna do jack. Get real rubbign off

flaking skin is getting rid of dead skin that will fall off in a day or so anyway. Unless it is connected

and bleeds when picked (which I dont imagine happened) then the picking of DEAD already flaking

skin did nothing harmful. Old wives tales I think for sure.

My memory may be bad, but my firm recollection is that I would avoid washing my face for about 5 to 7 days while I had flaking, as I was instructed to keep flakes on as long as possible. I knew any application of water would take it off. I was told to put vaseline on by nurse to keep it moist. While I tried to be careful in application, flakes would come off in this application. If I said picking, that was a mistake. I thought I was super carfeul to preserve the flakes, so I am surprised by these posts, which are misleading.

Anyway, now I am curious what others have been told to do as far as moisturizing and preserving flakes.

My memory may be bad, but my firm recollection is that I would avoid washing my face for about 5 to 7 days while I had flaking, as I was instructed to keep flakes on as long as possible. I knew any application of water would take it off. I was told to put vaseline on by nurse to keep it moist. While I tried to be careful in application, flakes would come off in this application. If I said picking, that was a mistake. I thought I was super carfeul to preserve the flakes, so I am surprised by these posts, which are misleading.

Anyway, now I am curious what others have been told to do as far as moisturizing and preserving flakes.

I had 6 done and rubbed the dead skin off. I had to do things and really did not have any time to take sitting

around for recovery time. It did nothing at all except get rid of the crappy flaky looking skin. I would do them

on Friday and return to work on Monday. They worked out great and I am happy about all of it. Iw as never

instructed to take any special care of the flaky skin. I was told it would turn red, swell and then bronze and

flake. I did have redness and flaking, but definately no swelling to my face. I moisturized anyway and was

told to just keep using what I was using on it nothing special. Most of the healing takes place under the skin

anyway. If this were CO2 or something like that then the surface would be a huge concern. WIth Fraxel

I would not 2nd guess myself it seems to work or not for certain people and scars.

Masterk

Would you provide your treatment data in your signature? Thanks

Regarding flaking skin. It's easy to get carried away with this. The "flakes" or MENDS are simply dead tissue that has ALREADY been replaced by reorganized epidermal skin. The new epidermal skin fills in the MTZ's within 24 hours post Fraxel. Think about it, if there were not already healthy new skin cells in place would your body be shedding the old already?

ALL of the scar remodeling that takes place is in the deeper dermal tissues anyway far beyond the epidermis. Just use common sense, if the flakes are difficult to remove LEAVE them alone otherwise, there is little need to walk around with chunks of dead skin partially hanging off your face. Just keep the area moisturized properly by using Aquaphor or if you are still acne prone, a quality, fragrance free, non comedogenic moisturizer that has thick enough properties to avoid being absorbed too quickly. The Obagi line is ideal.

How much is for Fraxel treatment for the whole face?

or Fraxel 2?

Regarding flaking skin. It's easy to get carried away with this. The "flakes" or MENDS are simply dead tissue that has ALREADY been replaced by reorganized epidermal skin. The new epidermal skin fills in the MTZ's within 24 hours post Fraxel. Think about it, if there were not already healthy new skin cells in place would your body be shedding the old already?

ALL of the scar remodeling that takes place is in the deeper dermal tissues anyway far beyond the epidermis. Just use common sense, if the flakes are difficult to remove LEAVE them alone otherwise, there is little need to walk around with chunks of dead skin partially hanging off your face. Just keep the area moisturized properly by using Aquaphor or if you are still acne prone, a quality, fragrance free, non comedogenic moisturizer that has thick enough properties to avoid being absorbed too quickly. The Obagi line is ideal.

Well said troubled! The misinformation around here is amazing sometimes.

I think that if it has to be "picked" then it is not ready to come off. if it flakes off during moisturizing thats different. it's like picking a scab vs. waiting for it to flake off naturally.

does the new fraxel sr1500 use a new different laser tips?

so guys whats the latest on fraxel and your results so far?? im seriously considering doing fraxel starting in the new year, not sure if its going to be fraxel 1 or 2, but im in canada so im thinking fraxel 1.

so any updates on results would be great,

Day 5 since my 1st Fraxel treatment... (Energy = 20, Density = 125, Passes = 9)

The dried skin flakes have mostly exfoliated off. Now that the dried skin flakes are mostly gone, my skin is no longer bronze... it is now slightly pink and shiney in those areas. (People easily noticed at work. I was slightly embarrassed)

Also, my scars (which were once totally invisible from the dried rough skin above them) are now slightly visible. BUT, they look MUCH MUCH better. The center is more shallow and the edges (rim of the craters) are almost perfectly smooth with the the healthy skin.

The scar on my nose has shown about 60% improvement! (the scar is now difficult to notice)

The scar on my cheek has shown about 35 % improvement (much more shallow and softer edges)

Day 4 (yesterday) was the worst day for peeling and flaking! It was at its worst after showering. I used a damp cloth to help exfoliate, and tweezers to removed small flakes from the edges (don't worry... these flakes were not attached to any healthy skin below).

If my scars stay where they are right now, and do not improve or worsen - I will be extremely happy. If they continue to improve with more treatments, then I will be ecstatic.

So far, this has been totally worth it... BUT, remember, I am only 5 days post 1st treatment...

good luck ralphie, i hope that you will be saying that 3 weeks from your first treatment, as w/ my 1st treatment, i had wonderful skin just like you for about 2 weeks, then the third week, my scars re-appeared but much better though, i'm on my 2nd fraxel btw, same settings as yours, 20mjs, 125 density. however i did 8 full face passes, and 4 additional passes on scarred areas and nose for blackheads and pores treatment, so i guess a total of 12 passes on scarred areas. i went to work today, and told my boss whats up, to my surprise he said his ex gf used to do a peel for her acne and scarring, i told him i'm dong this for my scarring, to make them shallower, and to help boost my self esteem, and he was okay with it, even let me wore my fedora, lol. i will continue my diet of high protein for now and hope for the best, my next treatment will be in 4 weeks, which is january 5th of 2007. so far 2 down, 2 to go, if the results is really good this time around, i will continue at 20mjs full face and addition 4 passes on scarred areas or i might crank it up to on scarred areas, have him do like 22mjs, i learn to tolerate the pain pretty good now, eventhough my doc doesn't even have a zimmerman cooling machine, i told him to crank up the air condition and i do my breathing exercise which is when he first starts the passage i take a deep breath and hold it til he gets to the end of the pass and let go, which really helps, he say doing that help releases endorphin (chemical that hold off pain). hope that helps someone.

Going for my first Fraxel in two weeks and was wondering if Fraxel can be used over an active pimple or two without causing further scarring? I am on acne medication and mostly acne free but always seem to break out in a small area on my chin which by the way is in the scarred area that needs to be treated by Fraxel. I digress If any of you have actually had treatments over an active pimple or cyst I would like to hear your thoughts.