My skin stayed pink for week or so and then bronzed.

Good luck

Hey guys,

I just got my first fraxel session. I am Chinese.

My settings were at 14mg 125density. He went over my face couple times, 4-6 ? The pain was almost unbearable sometimes, especially the forhead and the jawline!

I have a question, it seemed when I left I was pinkish, but now I am just darker. Is this normal?

The good news is all my rolling scars have disappeared due to the swolleness. Hopefully this is a good sign that I will get good results.

 

Perfectly normal. The scars will appear within the next several days due to the swolleness fading away. The longer you are pinker the better the results will be. That's a good sign of deep healing.

I'm fair skinned so my face looked like a tomato for at least 2 days and and then faded over the next few days from dark pink to pink to light pink.......Within one week, I was back to my normal color.

Mine hurt more this time too. But I think they used the weaker numbing gel which, in the long run, was better. Because they got all the blue dye off with minimal effort before I left the office, I didn't have to mess with it at all over the next day or two trying to remove the stuff. I just kept soaking my face with really cold, wet towels. HUGE difference from the first time: Less irritation, less redness, less itchiness, less roughness and no peeling. And the biggest plus: not having to use the heavy burn cream meant almost no new comedones. So, the pain sucked but it was worth it for the after treatment.

I have improved a severe depressed scar I had by at least 80% if not more by 3 chemical peels and massaging with Tazorac. However, fixing depressed scars takes a LONG time (many months to a year) because your body must restore the lost collagen. This won't happen if you don't massage your skin daily. The massaging action will encourage your body to fill in the depressed area and make it level with the rest of the skin. This is a proven method. I wouldn't suggest Fraxel because it is more effective for Skin Texture improvement as opposed to Scar revision. The surgeon I went to told me he didn't think I should get Fraxel because he couldn't provide before and after pictures that would be convincing enough. Trust me, massaging has been proven to work! Acne scars suck! I am a sufferer and have had to go to many dermatologist visits to figure it out. Massaging and applying glycolic acid and other retinoids to help exfoliate will smooth out the skin (gradually) over time. Unfortunatley it is a slow process....but it can be sped up by using Tazorac 0.1% (Twice daily for scars)....and by being religious about massaging the scarred area gently for at least 1-2 min each day until you notice it level out......Hope this helps any scar sufferes out there...If you ask your dermatologist about the massaging method they will confirm this works.

Has anyone gotten any additional news on the new Fraxel Laser tip "#1Cubs Fan" was talking about recently?

Greg06

Glad to hear of your improvement. I don't know if Tazorac and massaging would help me. I use a bit of Tretinoin between my Fraxels on the couple of areas where I have deeper scars. Derm suggested this, after a 7 day wait, to promote ongoing healing. Also, need to to stop it 10 days pre post op.

I disagree on your comments on Fraxel though. I am confident that most Cosmetic Dermatologists that treat acne scars would tell you that this is the most promising modality in terms or risk/reward, especially for shallow and widespread scarring. Every Doc I have seen has classified my scarring as mild as to depth and moderate as to quantity, so I think I am a really good candidate. And, while I am not satisfied yet, I notice some nice progress. I will also concede that there has not been sufficient long term testing to know how truly effective it is.

My guess is that your derm does not have a Fraxel; most don't.

Good luck

Thank you all for being very helpful. I have saved up some money and I want to try fraxel. Does anyone know of a good doc in the SOCAL area. i live in LA but am willing to drive a bit. I have struggeld to find a good doc as most of them seem like used car dealers. Any info will be greatly appreciated and I will surely post my progress....hopefully there is some!

Thanks.

Thank you all for being very helpful. I have saved up some money and I want to try fraxel. Does anyone know of a good doc in the SOCAL area. i live in LA but am willing to drive a bit. I have struggeld to find a good doc as most of them seem like used car dealers. Any info will be greatly appreciated and I will surely post my progress....hopefully there is some! :angel:

Thanks.

 

Dr. George Anterasian is in Santa Monica. He uses the fraxel. His office is one of the most high profiled dermos in so cali. He has many celebraties at his practice. You might want to check him out. It's about 4k for 5 treatments.

Fraxel Laser Garners High Patient

Acceptance June 2006 Issue

BY BOB KRONEMYER, ASSOCIATE EDITOR

The FraxelAA SR Laser from Reliant Technologies

(Mountain View, Calif.) achieves high patient satisfaction,

according to two separate patient surveys.

AaAIn our survey, results were better than we anticipated,Aa?

said Steven Cohen, M.D., a plastic surgeon in

private practice in La Jolla, Calif. AaAFor acne scar

patients, in particular, we were surprised how beneficial

the Fraxel laser appeared to be for that condition.Aa?

The first 59 consecutive Fraxel laser patients (202

procedures) at Dr. CohenAaas practice were included in

the survey. All patients had facial treatment and were

divided into three broad groups: scarring, fine lines

and wrinkles, and dyschromia. The average patient

had about 3.5 treatment sessions, spaced approximately

two weeks apart, and all subjects were treated at the

same energy setting.

Overall satisfaction was rated on a scale of 1

(below satisfactory) to 5 (outstanding). AaAThe ratings

were 4 or 5 in 75% of patients,Aa? said Dr. Cohen, who

shared results in April at the annual meeting of the

American Society for Aesthetic Plastic Surgery in

Orlando, Fla. AaABut 100% of the patients who were

treated for acne scars rated satisfaction as 4 or 5. In

addition, very few patients had hyperpigmentation. In

short, there were not many adverse effects.Aa?

When comparing patients who rated satisfaction 4

or 5 with those patients who rated satisfaction 3 or

less, AaAone thing that stood out was the number of treatments,Aa?

said Dr. Cohen, a clinical professor of plastic

surgery at the University of California, San Diego.

AaAThere were statistically higher satisfaction rates

in patients undergoing four or more treatments.

This makes sense because you treat about 20% of the

surface area of the face during every Fraxel laser session.

In addition, the patients in this study were the

very first we treated with the Fraxel laser; therefore

we were conservative and prescribed lower energy settings

then we presently use. Higher energy settings

may allow for increased collagen remodeling, and even

better resurfacing of fine to moderate wrinkles and

acne scars.Aa?

The Fraxel laser, which treats aging and sun damaged

skin with patterns of microthermal zones, was

also found to garner high patient satisfaction in a

European study of 29 patients who responded to a

mail questionnaire. AaAFractional resurfacing achieves

the same quality of rejuvenation as the UltraPulse

CO2 laser, but with a high level of security, no major

downtime and with no risk of hypopigmentation,Aa? said

Luigi L. Polla, M.D., medical director of Forever Laser

Institute in Geneva, Switzerland.

Patients rated satisfaction on a scale of 1 to 5 in 12

areas. For every category, results from two sessions

were rated higher than from a single session. Overall,

60% of patients achieved greater satisfaction than

they anticipated. Six areas were rated above 4 with

two treatments: brightness and luminosity, global

rejuvenation, rhytides improvement, tonicity/firmness

improvement, even color improvement and appreciation

of others.

AaAAs we continue to learn more and more about the

Fraxel laser and the optimal settings and ideal session

intervals, results will continue to improve,Aa? Dr.

Cohen said.

Thanks Blaster! Did anyone here actually participate in this survey???

I wonder what the overall rating for "scar revision" was? What is "global

rejuvenation"; overall results I guess??

Thank you all for being very helpful. I have saved up some money and I want to try fraxel. Does anyone know of a good doc in the SOCAL area. i live in LA but am willing to drive a bit. I have struggeld to find a good doc as most of them seem like used car dealers. Any info will be greatly appreciated and I will surely post my progress....hopefully there is some! :angel:

Thanks.

 

What part of Los Angeles?? What Doctors did you go see? I went for a few consultations before finding out that my Dermo offered Fraxel. She's in the Mid-Wilshire area. If you're interested I can forward you her contact info. I also went to see a Doctor in Irvine that I felt equally comfortable with but it was too long of a drive.

I agree, some of the Doctors out here, especially in Beverly Hills, are like used car salemen. It made me sick how they played on your insecurities and then pressure you into buying "packages" at ridiculous prices.

I read about him. I am worried that in one of your earlier posts you said his sister only promised you 15% inmprovment. Is he willing to do higher levels?? Thanks.

Blaster

Thanks for post. You add a lot of value to this thread.

From my experience with 3 treatments, I agree with everything in article as far as low risk. While a proponent, I would not rate it as high as a 5, probably a 3.5 to 4. But, maybe I will up the grade after I see results from #4.

Hi everyone!

Just wanted to share my Fraxel experience to those of you considering it...

I had my first one today. It wasn't nearly as bad as I thought it would be! (Of course, that may mean that I didn't have a strong enough number, though...)

The nurse told me she did 8 passes. She did 4 at 15 and then when she saw I could tolerate it, she bumped it up to 20. I didn't know what to expect, but it was pretty easy. (I had posted before that the nurse told me that I could take a Vicodin before and then have someone drive me home. I thought she meant that they would give me the Vicodin at the office once I could show them that I had someone there to drive, but no, she meant I had to call ahead of time and get a prescription. So no painkillers at all. As I sat there with the numbing cream on for an hour, I was thinking that I was going to be in horrible pain, but I really wasn't. Yes, I could definitely feel it more when she went to 20, but nothing unbearable.)

The hardest part is getting the blue off, as so many of you have mentioned. Otherwise, so far I have nothing else to report. I am doing spot treatments at 300 per visit. Full face is 1000, which is too much for me to spend right now, so I'll keep doing these for the next several months.

Thanks to everyone for all their help and encouragement here! I'm keeping my fingers crossed that this will work for all of us (and since it seems to be for so many who have been doing it, I'm really hopeful!)

Lesley (looking like a Smurf!)

The nurse told me she did 8 passes. She did 4 at 15 and then when she saw I could tolerate it, she bumped it up to 20.

Wow, those are pretty high settings for your first time. But if you can tolerate it, that's great. As I'm sure you've read, most everyone is in agreement that the higher your settings, the better your results. I also have a pretty high pain tolerance...I just need to convince them to do more passes next time.

I hope it works out well for you! (and the rest of us...;)

Fraxel Laser Achieves High

Efficacy for Acne Scars

BY BOB KRONEMYER, ASSOCIATE EDITOR

Many physicians who have looked long and hard

for safe and effective treatment of acne scars and other

atrophic scars are resting easier now, thanks to the

fractional approach of selectively heating tissue with

the FraxelAA SR Laser from Reliant Technologies

(Mountain View, Calif.).

AaAWe have been very pleased with how the Fraxel

laser treats acne scars,Aa? said Paul Friedman, M.D., a

dermatologist in private practice in Houston, Texas.

AaAWe have successfully treated a variety of scars, including

broader atrophic scars and pitted scars. The Fraxel

laser is an effective modality for acne scarring, because

of the depth of microthermal penetration you are able

to safely deliver.Aa?

Dr. Friedman generally recommends three to five

treatment sessions, spaced four weeks apart. A session

generally lasts around 20 minutes and all skin types

are candidates. AaAWeAaave seen significant improvements

on all areas of the face, particularly the cheeks and

temple area,Aa? reported Dr. Friedman, a clinical assistant

professor of dermatology at University of Texas

Medical School in Houston. AaAWe can also safely treat

the neck, chest and upper back. Patients can expect on

average a 50% improvement in scars.Aa? Patient discomfort

is alleviated with Zimmer air-cooling and application

of a topical anesthetic one hour before treatment.

AaAI believe the Fraxel laser has given us a no recovery

means of improving acne scars, in particular pitted

acne scars that donAaat respond ideally to any modality,

but seem to respond, at least to an extent, to

Fraxel treatments,Aa? observed Lawrence Bass, M.D.,

director of Minimally Invasive Plastic Surgery at New

York University. AaAIAaave also found that hypertrophic

scars or old thickened scars from surgery or trauma

like acid burns can be nicely flattened with a series of

Fraxel treatments.Aa?

AaATreatment is very safe, if you follow appropriate

guidelines,Aa? Dr. Bass said. AaATypically, you can expect to

achieve about a 50% reduction in scar depth after a

series of treatments. The Fraxel laser allows you to

vary both the density and depth of microthermal zones.

I think the key to success with treating scars is to have

relatively fewer zones that are relatively deep. The

ability of the Fraxel laser to provide a very deep thermal

effect, even compared to ablative laser resurfacing,

is what makes this technology in some ways more successful

at treating acne scars, and in particular pitted

acne scars.Aa?

A study of 17 patients with acne scars and atrophic

scars who were treated with the Fraxel laser recently

appeared in the Journal of Dermatologic Surgery.

AaAPatients were treated at four to six week intervals, for

a total of four to six sessions,Aa? explained co-author

Cameron Rokhsar, M.D., an assistant clinical professor

of dermatology at Albert Einstein College of Medicine

in New York City. Patients were evaluated by two

investigators for improvement on a quartile scale (1-4)

in scar color (defined as the degree of mismatch of scar

color in relation to the surrounding tissue), scar texture,

and overall scar appearance. AaASubjects also rated

their own improvement based on the same quartile

scale,Aa? Dr. Rokhsar said.

Patients felt their pigmentation had improved to

2.28 on the quartile scale, 2.39 for texture, and 2.30

for overall appearance. AaAThe two investigators found

similar results,Aa? Dr. Rokhsar reported. AaAThese are

great results. This probably has to do with the fact

that the Fraxel can penetrate fairly deeply at aggressive

settings. We can go as deep as 700 microns. The

laser also allows for collagen remodeling, which is

probably superior to the other available non-ablative

technologies.Aa?

The study found no adverse events. AaAHowever,

there is the risk of hyperpigmentation in darker

skinned individuals,Aa? Dr. Rokhsar cautioned. AaABut

this is on the order of 10%.Aa? For acne scars, in general,

AaAyou achieve results that approach ablative resurfacing,

such as erbium or CO2. At the same time, you

are eliminating significant risk of raw skin and a

prolonged recovery period. With very aggressive

treatment with the Fraxel laser, patients may be red

up to seven days and adenomatous two to four days.

So I usually like to schedule treatment on a

Thursday or Friday. Then, by the following Monday

or Tuesday, the patient should be fine. Fraxel has

become my number one modality of choice for treating

acne scars.Aa?

AaAI think with our new treatment protocols, where

we use higher intensity at more depth, results are

much better for acne scarring than about any other

modality,Aa? concurred Simeon Wall, Jr., M.D., a plastic

surgeon who exclusively performs cosmetic surgery in

private practice in Shreveport, La. AaAWe have found that

acne scars respond better to deeper penetration. By

penetrating down into the dermis, we have seen a lot

more flattening and smoothing. Fraxel uses higher

intensity with decreased density.With fractional resurfacing,

youAaare hitting only about 18% to 20% of the surface

at any time. The advantage is that healing occurs

in 18 hours.Aa?

Previously, Dr. Wall would treat scars at energies

of 8 mJ/cm2. AaABut in lighter skinned people, we now

always treat above 10 mJ/cm2, usually from 12 to 18

mJ/cm2,Aa? he said. The roughly five sessions are spaced

two weeks apart. AaAWeAaare seeing at least a 50%

improvement, and potentially much better,Aa? Dr. Wall

stated. AaAAlthough I try not to oversell results, IAaave been

really encouraged. Some patients are probably 80% to

85% better, which is pretty much on par with the best

of the CO2 lasers. But there arenAaat any side effects or

risks with the Fraxel laser.We donAaat see the hyperpigmentation

or the hypopigmentation. You also donAaat

have an open wound and the patient does not ooze.

There is not much risk of infection because you heal in

less than 24 hours.Aa?

Because there are no open wounds, AaAa man can

shave the next day and a woman can apply makeup,Aa?

Dr.Wall continued. AaAYou only have a sunburn effect for

about two days. I tell people that the Fraxel laser is the

biggest breakthrough in laser technology in 15 years

because of the fractional concept. Healing is so much

quicker because there is no open wound. YouAaare not

dependent on the deep dermal structures to regenerate

the skin. Fractional resurfacing depends solely on the

surrounding skin to heal.WeAaare treating a lot more people

for scarring than we ever did with the CO2 and

erbium lasers. Fraxel laser treatment is so much easier

and more convenient for the patient.Aa?

I read about him. I am worried that in one of your earlier posts you said his sister only promised you 15% inmprovment. Is he willing to do higher levels?? Thanks.

 

Dr. George Anterasian is in Santa Monica. He uses the fraxel. His office is one of the most high profiled dermos in so cali. He has many celebraties at his practice. You might want to check him out. It's about 4k for 5 treatments.

I had mine at 16 mj, 125mhz. I am going to ask for 18-20 mj next time. I am starting to see some results. the scars look softer, but still there. hopefully within time they will be gone. 🙂

I read about him. I am worried that in one of your earlier posts you said his sister only promised you 15% inmprovment. Is he willing to do higher levels?? Thanks.

 

Dr. George Anterasian is in Santa Monica. He uses the fraxel. His office is one of the most high profiled dermos in so cali. He has many celebraties at his practice. You might want to check him out. It's about 4k for 5 treatments.

You must have me confused with someone else. I never have been quoted a percentage of improvement by him or his sister. Sorry not me.

Has anyone seen improvements with just ONE session of fraxel?

Has anyone seen improvements with just ONE session of fraxel?

 

I've seen some. My scars look softer and the tone of my skin is a bit more even. Plus the skins seems a bit softer. I hope it's a result of the laser. 🙂

Previously, Dr. Wall would treat scars at energies

of 8 mJ/cm2. aoeBut in lighter skinned people, we now

always treat above 10 mJ/cm2, usually from 12 to 18

mJ/cm2,a? he said. The roughly five sessions are spaced

two weeks apart. aoeWeare seeing at least a 50%

improvement, and potentially much better,a? Dr. Wall

stated. aoeAlthough I try not to oversell results, Iave been

really encouraged. Some patients are probably 80% to

85% better, which is pretty much on par with the best

of the CO2 lasers.

It's interesting that they quote 50% improvement at lower settings. I can only imagine that higher settings will produce more consistantly good results.

I would like to see some studies on whether or not the number of fraxel procedures done greatly improves the results or if less treatments at much higher settings is better. I am scheduled for 7 full face treatments, maxed out at 20mj. (my 5th is on Friday) However, because what I am paying is so reasonable, I would like to get an additional series of spot treatments at higher levels as well. I wonder how they determine how much is 'enough' and if it reaches a point where the Fraxel is not doing anything beneficial to your skin at all?

Hey You - How would you rate your improvement?

These studies report more improvement than what I am seeing. There is a period after each treatment, I would not call it swelling, where my skin is very tight and looks good. My ratings would be highest at that time. But, later the skin becomes less tight and scars become more evident. I was hoping that 4 treatments at high settings would yield a 40% improvement, but I am not sure sure I am going to get it. Either I am an outlier or there is a little bit of PR behind these studies; 80% is inconceivable to me based on my personal experience to date, but wouldn't that be nice.

In theory, for acne scarring, I think that high energy settings are essential. Multiple sessions at lower settings simply won't affect the deeper dermis to promote a healing response in deeper scar tissue.

That said, i know Coolbreeze has reported nice results from many settings at lower levels.

OK I am confused. I have had 2 Fraxels (yesterday was#2) with the following settings:

(#1) 8/250 cheeks forehead

11/125 lower chin

12/125 upper lip

14/125 nose cheeks = 8.88 kj

12/250 neck = 4.06 kj

(#2) 8-9/250 face

11/125 cheecks

perorbital = 8.0 kj

13/250 neck = 2.80 kj

13/250 chest = 3.03 kj

These were spaced 3 weeks apart. This last one I wanted her to go higher but I still had redness on my nose and a few other areas where I had blistering. From the numbers I see she went up on the density (from 1250 to 250) but I am unsure if the settings are high enough to truely hit the collagen and create the remodeling I really want. Ive noticed alot of posts describing their settings with "mj's" however mine are all "kj's" what is the difference?

Hey You - How would you rate your improvement?

These studies report more improvement than what I am seeing. There is a period after each treatment, I would not call it swelling, where my skin is very tight and looks good. My ratings would be highest at that time. But, later the skin becomes less tight and scars become more evident. I was hoping that 4 treatments at high settings would yield a 40% improvement, but I am not sure sure I am going to get it. Either I am an outlier or there is a little bit of PR behind these studies; 80% is inconceivable to me based on my personal experience to date, but wouldn't that be nice.

In theory, for acne scarring, I think that high energy settings are essential. Multiple sessions at lower settings simply won't affect the deeper dermis to promote a healing response in deeper scar tissue.

That said, i know Coolbreeze has reported nice results from many settings at lower levels.

 

There is always PR behind this stuff! I would take it with a grain of salt. At the very best I would average what they say with the results posted on acne.org.

They say 80% (cleverly manipulated); acne.org posts say 30%; so expect about a 40-50 percent improvement--BUT ONLY IF YOU GET FIVE+ TREATMENTS!

From Dermatology Times -

Fractional laser helps alleviate acne scarring

Atlanta Aaa A new laser appears effective in treating acne scars even in darker-skinned patients, says Edgar F. Fincher, M.D., clinical instructor of dermatology at the University of California, Los Angeles, David Geffen School of Medicine and lead author of the unpublished study.

In the study, researchers treated 12 patients with moderate to severe acne scarring and skin phototypes II through V with the Fraxel SR (Reliant Technologies).

"Patients noticed improvement in their scars after three to four treatments. And all patients reported improvement after the treatment course, with an average of 2.2 points on a 5-point scale," Dr. Fincher says.

"Probably the most amazing finding was that we were able to treat people of darker skin type," he adds. "That's a big advance over previous lasers such as CO2 and erbium lasers. For other types of scars such as traumatic scars, we've even treated African-American patients with type six skin" without any adverse effects.

Hyperpigmentation concern

In the past, he says, he and his colleagues (co-authors Helen F. Fincher, M.D., and Ronald L. Moy, M.D.) would have turned away patients with darker skin out of concern for creating hyperpigmentation with CO2 and erbium laser treatments.

Skin type notwithstanding, he says, these lasers, moreover, required at least two to three weeks' downtime to achieve a significant improvement in acne scars. Conversely, Dr. Fincher says nonablative lasers provided only minimal (10 percent to 15 percent) improvement.

However, he says that although no laser can completely reverse scarring, "The Fraxel offers significant improvement and high patient satisfaction with minimal post-treatment recovery. The ability to safely treat patients of all phototypes makes this laser especially valuable and unique."

Study protocol

The study protocol involved performing a series of five to six treatments spaced two to four weeks apart. After each treatment, Dr. Fincher says, patients experienced redness and erythema for one to four days. However, no patients required changing bandages or missing work, he says.

"Our initial result was that we got a faster and better response with higher treatment energies," Dr. Fincher says. "Treatment settings were considered aggressive, with patients treated at 18 to 21 mJ/cm2 and receiving approximately 1,250 microthermal zones (MTZ, the manufacturer's method of measuring density)."

He explains, "The way the Fraxel works is that it has a scanner in the handpiece, so it basically fires a grid of tiny laser beams into the skin. There are two different density settings Aaa 250 or 125 MTZ per square centimeter."

Although Reliant provided researchers with no recommended energy levels for treating acne scars, the company typically recommends a setting of 10 mJ and a density of 250 MTZ for treating pigmentary changes, Dr. Fincher says. To achieve the desired response, he says, he and his colleagues treated patients for an average of 10 to 12 passes between 18 to 21 MJ/cm2 at the 125 MTZ setting.

"It's a new technology and a new method of treating the skin," he says. "Every other laser we've used basically treats every square pixel, so to speak, or skin cell. This one leaves normal skin in between" microscopic treated zones.

Study weaknesses

Potential weaknesses of the study include its small size and the fact that it relied on investigators and patients for subjective evaluations of patient progress, Dr. Fincher says.

However, he says, "The study provides a good initial look into how effective this laser is. Based on patients we have treated, the results have been outstanding. The laser's ability to treat darker skin types opens a new avenue to treat a large population of patients that we previously weren't able to treat. It's a very safe laser, and I believe we'll be using it to treat acne scars for many years."

Disclosure: Dr. Fincher reports no financial interests relevant to this article.