Acne.org Products
non-ablative
Fraxel is an ABLATIVE laser! Ablative is a fancy catch-all phrase meaning "destructive/taking away/burning/vaporization/etc." However, Fraxel does not take off outer layers of skin which makes it different than other (older) ablative lasers.
Truly, non-ablative lasers are those like smoothbeam which produce enough heat to stimulate the skin cells, thus inducing the inflammatory response, but without actually killing the cells.
Nevertheless, Fraxel does kill cells in your skin! That's how it works. It just does this microscopically so that the skin heals within 24-48 hours. It also leaves the outter most layer of skin intact (stratum corneum). This layer is made of dead skin cells and the laser's heat doesn't ablate (destroy) it fully: 1) because there is less water there (most lasers target the water in skin to cause vaporization) and 2) because the fraxel treats only about 17 percent of the skin's total area (per session).
The deeper parts of the epidermis and dermis are ablated (destroyed) and become necrotic (dead) tissue--this is what causes the bronzed effect. Again, these necrotic areas are microscopic and re-epithelialize (heal) within 24-72 hours. Finally, since the wound is so small there is no new scar tissue.
Fraxel is very novel and is a very different kind of ablative laser, but it is still ablative. Any doctor who says it is non-ablative needs to attend another 8 hour seminar on Fraxel (and pay attention this time!).
I am in the health profession and constantly discuss Fraxel with other nurses and doctors. Many people mislabel Fraxel for many reasons. Some see it as so revolutionary (caution!) they refuse to put it in the same category as dermabrasion or CO2. Others are just misinformed. Some just want to promote it and make money off it. Still more just don't want to scare patients who are "too" familiar with the term "ablative."
Look on the fraxel website. It says "A different approach than traditional ablative lasers;" this does not mean it is non-ablative! It is also vaguely referred to as "non-invasive" and "novel" but never "non-ablative."
I think it's important not to get caught up in whether it is ablative or not. Understanding how the laser works and with what kind of results is more important.
non-ablative
Fraxel is an ABLATIVE laser! Ablative is a fancy catch-all phrase meaning "destructive/taking away/burning/vaporization/etc." However, Fraxel does not take off outer layers of skin which makes it different than other (older) ablative lasers.
Truly, non-ablative lasers are those like smoothbeam which produce enough heat to stimulate the skin cells, thus inducing the inflammatory response, but without actually killing the cells.
Nevertheless, Fraxel does kill cells in your skin! That's how it works. It just does this microscopically so that the skin heals within 24-48 hours. It also leaves the outter most layer of skin intact (stratum corneum). This layer is made of dead skin cells and the laser's heat doesn't ablate (destroy) it fully: 1) because there is less water there (most lasers target the water in skin to cause vaporization) and 2) because the fraxel treats only about 17 percent of the skin's total area (per session).
The deeper parts of the epidermis and dermis are ablated (destroyed) and become necrotic (dead) tissue--this is what causes the bronzed effect. Again, these necrotic areas are microscopic and re-epithelialize (heal) within 24-72 hours. Finally, since the wound is so small there is no new scar tissue.
Fraxel is very novel and is a very different kind of ablative laser, but it is still ablative. Any doctor who says it is non-ablative needs to attend another 8 hour seminar on Fraxel (and pay attention this time!).
I am in the health profession and constantly discuss Fraxel with other nurses and doctors. Many people mislabel Fraxel for many reasons. Some see it as so revolutionary (caution!) they refuse to put it in the same category as dermabrasion or CO2. Others are just misinformed. Some just want to promote it and make money off it. Still more just don't want to scare patients who are "too" familiar with the term "ablative."
Look on the fraxel website. It says "A different approach than traditional ablative lasers;" this does not mean it is non-ablative! It is also vaguely referred to as "non-invasive" and "novel" but never "non-ablative."
I think it's important not to get caught up in whether it is ablative or not. Understanding how the laser works and with what kind of results is more important.
that makes sense, no wonder it killed when i got my first fraxel done. If it is ablative, shouldnt they use more than just a numbing cream? Like some kind of anesthesia or pain killer or something, lol.
They give me Toredol one hour before the procedure, it's a pain killer. Then they apply the numbing cream and let it sit for 45 minutes to an hour. Pain isn't too bad, the worst spot (for me) is the upper lip (OUCH); it is also very sensitive around the eyes and close to the hairlines. The rest of my face, I would just call the pain very uncomfortable. Upper lip about killed me, I only let them do it one time, we skipped it on all treatments after that.
I imagine that other ablative procedures that actually remove the entire top layer of skin are MUCH more painful. Fraxel is only burning tiny holes straight down into the skin, similar to a needle.
Sean..
Make sure a DCD (dynamic cooling device) is used. DCD is a fancy term for a machine that sprays cold air or mist on your face. Some DCDs have a chilled piece that is actually pressed against the skin immediately after it is hit with the laser, although this is more for treatments like laser hair removal.
Aspirin derivates are contraindacted b/c of bleeding. Ibuprofen is a good choice; discuss it with the MD performing the procedure.
A lot of docs won't use the topical lidocaine anymore since there is some evidence that it can be absorbed into the bloodstream and lead to complications with the heart. (Lidocaine is a powerful anti-arrythmic drug as well.) I've found that the .05 percent cream barely does anything anyway. The cream most MDs use for Fraxel is .30 percent. At such a high dose I'm sure it is necessary for pain management.
I'm curious if anyone has taken a very close look at their face after a fraxel treatment.?
Supposedly the Microthermal Zones (MTZs) are microscopic. With increased intensity levels, I suspect they may be as large as the size of a hair.
Also, many of the post fraxel pics show an improvement in scars but the resulting texture of the skin has a dimpled/large pore appearance. I'm wondering if this is a result of the MTZs leaving behind microscars?.
Make sure a DCD (dynamic cooling device) is used. DCD is a fancy term for a machine that sprays cold air or mist on your face. Some DCDs have a chilled piece that is actually pressed against the skin immediately after it is hit with the laser, although this is more for treatments like laser hair removal.
Aspirin derivates are contraindacted b/c of bleeding. Ibuprofen is a good choice; discuss it with the MD performing the procedure.
A lot of docs won't use the topical lidocaine anymore since there is some evidence that it can be absorbed into the bloodstream and lead to complications with the heart. (Lidocaine is a powerful anti-arrythmic drug as well.) I've found that the .05 percent cream barely does anything anyway. The cream most MDs use for Fraxel is .30 percent. At such a high dose I'm sure it is necessary for pain management.
I'm curious if anyone has taken a very close look at their face after a fraxel treatment.?
Supposedly the Microthermal Zones (MTZs) are microscopic. With increased intensity levels, I suspect they may be as large as the size of a hair.
Also, many of the post fraxel pics show an improvement in scars but the resulting texture of the skin has a dimpled/large pore appearance. I'm wondering if this is a result of the MTZs leaving behind microscars?.
I've looked very closely in a mirror to see if I can see the MTZ's immediately after my treatment, they are not visible to the human eye. I've had levels 16, 18, 18 and 20.
As far as changes in texture, it is MUCH better than before; my pores look much smaller. I had lots of enlarged pores on my nose; most of them are gone or greatly reduced. My nose is very smooth now.
I haven't seen any fraxel before/after pictures where the skin texture was worse than before they started; where have you seen those at?
Sean..
After i had my fraxel i looked at my face and had some tiny lines in places. On my upper lip, where it hurt the most, i had kind of shook or moved my face a little when she did that area because of all the pain. There it left a line that looked like a burn mark for a few days but its pretty much gone now. I havent really noticed larger pores, my face feels a little bit tighter.
There was a picture i came across that a woman had one fraxel and after one fraxel it looks like her pores shrunk.
About the cooling machine, it may have helped a little but definately not enough, plus i had to hold it myself, and the pain was so bad that i couldnt hold it still.
I definately need to take a painkiller next time.
My doctor gives nerve block injections in addition to numbing cream and pain killer. That greatly helps with the pain tolerence ( I have taken nerve blocks before my chemical peels as well )
Only problem is, nerve blocks are not very effective on the sides of the face, sides of temples ( near hairline ) and upper lips. But they work great on cheek, chin, most part of the forehead and nose. ( so, atleast that much less pain )
Pls. check this with your doctor.
I took the toredol on my 2nd Fraxel and it really didn't do much for me.. It doesn't really bother me until they go over my cheeks a second time at a different setting(where most of my scarring is). I have to say it hurts alot but I just take it(wince a bit though). Lets just say I don't look foward to that part, other than that it's not really a problem.Upper lip and forehead don't seem to hurt for me.. Four more to go...Nothing substantial to report but I guess its still too early to tell, hope this ends up working..
I've looked very closely in a mirror to see if I can see the MTZ's immediately after my treatment, they are not visible to the human eye. I've had levels 16, 18, 18 and 20.As far as changes in texture, it is MUCH better than before; my pores look much smaller. I had lots of enlarged pores on my nose; most of them are gone or greatly reduced. My nose is very smooth now.
I haven't seen any fraxel before/after pictures where the skin texture was worse than before they started; where have you seen those at?
Sean..
Thanks!
On the fraxel website they show a microscopic pic of MTZs and there is a hair on the skin which is about the same size.
I just don't want to make things worse. My scars are so superficial and I mostly want an improvement in texture and pores.
My nose has big pores and I have to use biore strips or squeeze the sebum out by hand!
What was it like getting your nose done? The roller head of the laser doesn't seem like it would cover the nose very well?.
I will ask my doctor and PA about the things you guys listed. I remember i definately did not expect that much pain, since most people say it barely hurts. The second pass then the third, i thought i was going to die, and we did 8 passes of 8 and 2 passes of 12 in my more scarred areas. I remember getting up and i was shaking, i couldnt stop. And i guess it stressed me out so much from the pain and also being that i hadnt eaten in 4 hours, i fainted. Isnt that crazy, lol. Well i hope i dont have to go through that again.
I have first Fraxel set for March 9, assuming Dr gives ok in consult. I am then flying on March 14-16 trip. By that point, how will I look? Swollen, bronzed, sunburned? How are demarcation lines? I know they can feather with fewer passes and lower energy. But, is there a line around eyes, along jaw, under hairline? My sacrring is on cheeks/jaws/nose, but will want forehead for age wrinkles, but I don't want MTZs as all close to hairline. How close to hairline have your procedures been? Thanks
with my experience i started badly flaking and peeling on day 3 and 4, and by day 5 or 6 it was getting better and day 7 pretty much back to normal.... i was bronze/pink until day 5 or 6 i would say. However, make sure you wear sunscreen, since your going on vacation, thats really important. Demarcation lines not too bad, they go away after a few days, i would say you will probably be ok. About the hairline thing, i dont know how close she got, as i was in too much pain to pay attention to that.
Hi,
Just wondering if anybody who has had Fraxel done has been advised by their laser surgeon to stay off topical retinoids before the procedure takes place. Have the surgeons mentioned anything about retinoids and Fraxel at all? For example, will using retinoids prior to having Fraxel cause any adverse effects?
Also, I've been reading all of the posts and I'm unsure of what the downtime for this is. Are you able to go out the next day after you have Fraxel and feel comfortable in your skin, or is it extremely red and swollen?
And, let's say you have Fraxel on Friday--Would you feel comfortable going to work on Monday or is your face a swollen, discolored mess? If you were to wear makeup after Fraxel would you be able to tell that you've had the procedure done?
Thanks for any answers to these questions.
I've read that you should stop using retinoids for three weeks before having Fraxel done. If you want to try something in place of retinoids like Retin-A, try camilla oil. It is supposed to be nourishing to your skin while helping wrinkles. It can be used in place of a moisturizer too. I had been using Retin-A, but because Frxel might be in my near future, I switched to Silkia camilla oil. Go to goldportbeauty.com if interested.
I've read that you should stop using retinoids for three weeks before having Fraxel done. If you want to try something in place of retinoids like Retin-A, try camilla oil. It is supposed to be nourishing to your skin while helping wrinkles. It can be used in place of a moisturizer too. I had been using Retin-A, but because Frxel might be in my near future, I switched to Silkia camilla oil. Go to goldportbeauty.com if interested.
How will the retinoids affect your skin, though, if you continue to use them right before Fraxel?
Potential (additional) scarring or what?
Go on Fraxel website and look for presentations by Dr. Zakia Rahman to other MDs (she is primary research dermatologist Dr. behind Fraxel). I read this months ago, so I don't remember precisely, but I recall her protocol against retinoids had to due with "blockage". My impression was that retinoids might impede efficacy for theoretical reasons, perhaps because they increase cell turnover rate. I suspect there is no clinical data to support this because the established protocol from day one has been "no retinoids", but I am sure they have good reason for the protocol.
my doc didnt say anything to me about stopping retin a , and i had mentioned to him i was using it. Does using retin A cause more pain during the procedure?
maybe. I would suggest that confirm this with your doctor again. And yes, it's mentioned in the protocol suggested on Fraxel website. I tried to include a link but it seems they have changed the website recently and this is no more accessible.
[PDF] Microsoft PowerPoint - 1.3 Getting the Most from FLT.C. Henssler.ppt
File Format: PDF/Adobe Acrobat - View as HTML
Fraxel rx. a Tretinoin and any other retinol products. discontinued 10-14 days
prior to the first laser. session. a If the patient has a history of herpes ...
www.fraxel.com/insider/pdf/4gettingmost.pdf - Similar pages
Well that's interesting because I know that Retin-A usage prior to resurfacing procedures like dermabrasion is ENCOURAGED and it hastens the healing time. Its unusual that its not recommended for Fraxel...
I've read that you should stop using retinoids for three weeks before having Fraxel done. If you want to try something in place of retinoids like Retin-A, try camilla oil. It is supposed to be nourishing to your skin while helping wrinkles. It can be used in place of a moisturizer too. I had been using Retin-A, but because Frxel might be in my near future, I switched to Silkia camilla oil. Go to goldportbeauty.com if interested.
my doc didnt say anything to me about stopping retin a , and i had mentioned to him i was using it. Does using retin A cause more pain during the procedure?
okay, I figured a way to access that protocol. It's now on reliant website.
Click this :
http://www.reliant-tech.com/insider/test2.html
and then select webinar by Dr. Zakia Rehman. You would need to fill up a form. Then, it will open a powerpoint presentation.
Slide 8 talks about "Contraindictions to FLT" and slide 9 about "Pre-Op care"
It specifically says this : Discontinue topical retinoids 2 weeks prior to the treatment : Blunts HSP response to laser.
So, even my doctor's instructions are not exactly correct. But am not using retino A currently.
It doesn't mention anything in post-op care.
I've been on the micro retin-A for years and asked my Dr if I should discontinue it before the treatment. She said it didn't matter but I stopped using it just one day prior to my treatment. I had no adverse affects. But I would recommend following your own Dr. instructions.
I had my first treatment on Thursday and my face had recovered 90% by Sunday. I do have this purplish mark down the ridge of my nose that is bruising caused by her assistant scrubbibg to hard trying to get the blue ink off my face. I've been able to cover it up a bit with some foundation. Next time I'll tell her to take it easy.
Does you doctor say your results are typical with his other patients that he's treating with the same method? Just wondering if your results are exceptional or if they are common.. I don't see a lot of other people getting the results you seem to be getting so just thought I'd see if you had discussed this with your doctor or if he had mentioned...
I've been on the micro retin-A for years and asked my Dr if I should discontinue it before the treatment. She said it didn't matter but I stopped using it just one day prior to my treatment. I had no adverse affects. But I would recommend following your own Dr. instructions.
I had my first treatment on Thursday and my face had recovered 90% by Sunday. I do have this purplish mark down the ridge of my nose that is bruising caused by her assistant scrubbibg to hard trying to get the blue ink off my face. I've been able to cover it up a bit with some foundation. Next time I'll tell her to take it easy.
Anyway All suggested stop using it 3 weeks before.... You'll be easier to be hyperpigment with it... Anyway abou the blue dye my suggestion is...
use warm water and flush it at your face while you shower. use gentle cleanser... it words... About 2-3 wash its all out... even those at the edge.