Have any of you heard if it is recommended not to get Fraxel done while you have a tan? Would the results differ if you got it done while you have a tan?

Also, anybody try this place or here anything about it in NYC (Queens)? Advanced Dermatology

 

My doctor told me its extremely important not to tan before the procedure. He said stay out of the sun if at all possible.

Of those who have gotten a full or almost full series of fraxel treatments, would you, given the results you got, still do them over a one-shot deal like the Portrait PSR laser (the new-ish laser that is supposed to leave you pink for anly a couple weeks)? Basically, my doctor recommends Fraxel primarily because it requires less healing time, but because I have mild shallow scars, he seems to think I could get equally good results from a single ablative laser treatment like Portrait.

It just sounds to me like there is a fair amount of downtime with fraxel done at the high settings, and in the end the downtime is longer but just spread out over several months. It's also easier for me to take two weeks off of work at once rather than take a Monday and Friday off every month for five months. I'm also in a profession where I can't show up looking like I've had anything cosmetic done.

Any thoughts from fraxel patients would be helpful. Thanks

I've had 3 fraxels so far. The first one was at a low setting so I only took a Friday off and went back to work on a Monday. The second one was over Memorial Day Weekend so I took Friday off and and went back to work on a Tuesday. I live in San Francisco and both times the weather was nice here (sunny) so that when I went back to work, it was "explanable" why my face was red/burnt. When I went to a higher setting with #3, I actually took about a 4 days off because I knew I would not be able to recover in time and I definitely did not want to show up at the office looking like I had something done.

I think Fraxel is great (so far) and I'm doing #4 next week. I hope to do #5 and maybe #6 if I don't get the results I'm looking for after #4. People say there is no downtime. Yes, that's true in the sense that you can pick up where you left off and go back to work, activities right after the procedure. But, realistically, it would be nice to have a few days off in cases where you have to meet with clients or you work in a profession where your face is visible.

I wish I could offer you a better answer, but I think fraxel is great if you have the time (and money) to invest in such a procedure. Good luck.

My scarring was caused by using Retin-A. We all know that Retin-A is a godsend for some acne sufferers. In my case, it ruined my skin. When asking 'why did this happen?' to various derms and my PS, no one had an answer. Along the same lines, there IS a chance of blistering and scarring occurring while using very high Fraxel settings. If there wasn't any risk and it absolutely produced the best results, I can't imagine why there would be so many discrepancies between the treatment plans of all the Dr's who currently use Fraxel for acne scarring.

I'm curious why you think your scarring was caused by Retin A?

Hi ChrissyC,

I never had that much trouble with my skin...a few breakouts usually, but never cystic acne. I noticed a little increase in the small breakouts so I went to a derm who put me on Differin, which did nothing, 2 kinds of antibiotics and then Retin-A. He told me a would probably 'purge' for a few weeks. A few weeks turned into three months with worse breakouts than I have ever had in my life. I did not pick at my skin but it seemed like every new blemish scarred no matter what I did. He even put me on steroids at one point to try to control it. Even after I stopped using the Retin-A, my skin did not return to normal and was dry to the point of bleeding at times.

I have very fair skin with almost invisible pores....I almost did have alabaster skin looking back on it. It makes me absolutely sick that I didn't stop the Retin-A sooner, but that was back at a time where I actually TRUSTED derms. One new derm did say that some people have a bad reaction to retin-a and that my old derm never should have kept me on it.

I'm not blaming the derm (well, not completely), I should have either left well enough alone or followed my instincts and gone to someone else.

Had 1st treatment 1 wk ago for rosacea and prior acne scarring,low setting ,high power resulted with a bulk burn on the right cheek(currently healing)overall pleased with initial results texture and tone = noticeable improvement,scarring(shallow rolling type typically flat with the help of a dermabrasion some years ago) = slight improvement. thus far encouraging and motivating enough to keep my appointment for the 2nd treatment

Hi,

 

My doc mentioned quite clearly if you are treating skin spots and improving texture than sure lower settings will work fine, but anything to do with acne scarring requires modelling in the dermis, where lower settings cannot reach. Hence regardless of the number of treatments you do at lower settings, they will have no bearing on your acne scar improvement. Your skin texture will be great, but the depth of the scars is unlikely to change.

 

Ideally high settings with 6-8 treatments would cover 100% of the face. There is a point of diminishing return he tells me and he generally recommends patients to take 6 months off to let the collagen remodel before deciding for another course of treatments.

 

Fewer treatments at high settings wouldn't do much as there would be insufficient coverage of the skin. Each fraxel only treats 12-20% of the skin at one time. Hence an average of 16% coverage would require 6 treatments at least.

 

So the best course appears to be 6-8 treatments at high settings (>20mj) for acne scarring treatment. The studies seem to support this. See earlier posts by me on this thread.

 

Blaster

 

I've had 6 treatments so far and will go for my 7th on Friday. I am already planning to have 3 more done after that. I have had improvement in the texture of my skin and some smoothing out of the scarring overall. But I have widespread 'shallow' scarring. I do have two deeper little scars and the Fraxel may have improved them a bit, but not nearly to the point of having them even with the rest of my skin.

 

I also was treated at relatively low settings compared to others in this forum. The big question is whether or not fewer treatments with high settings is more effective or many treatments at mid-level settings. No one really has a concrete answer to that, including many docs.

 

Someone asked about 1 time ablative vs several Fraxels. For me, the key issue is risk, especially pigment risk. Fraxel leaves enough melanocytes in place, that will migrate back to the healed skin, that there is virtrally no risk of hypo.

Derms advised me that my scarring was not sevre enough for this risk pre Fraxel. I am really glad I did not go forward with ablative and later learned of Fraxel. I am not getting fantastic improvement in scarring, but I am really happy with how my skin looks.

medusa,

portrait can be done as a one-shot deal, or in a series of three treatments, from what i have seen. the one-shot deal has major downtime. from what i have read, two weeks off from work would be the bare minimum without ppl looking at you with their head slanted.

i think it'll be at least another year before they know which procedure is "better" per se.

I am not getting fantastic improvement in scarring, but I am really happy with how my skin looks.

 

Hi Billyboy. I was wondering what you are happy with in regards to your skin if your scaring is not being improved.

I have a consultation on August 2nd with a Dr for Fraxel. I have some real shallow scarring all across my forehead with some red marks. I also have a lot of deeper rolling scars on both temples. I'm doing needling on my temples, but find it almost impossible to get my forehead and think Fraxel would be the best bet. If it cleared up the shallow scaring on my forehead and made the slight red marks go away I would be really happy as it would make the front of my face even when viewing it. If the scars on my temples were made smaller then I would be totally thrilled. I'm not expecting a whole lot with temple scars though. In conjunction with needling though it may do the trick.

Do you have any shallow scaring? Do you have any red marks where the skin color is uneven? If so, did those clear up for you and how much did they clear up?

Actually this can go to anyone.

Okay here is an example of what I was talking about.

Will Fraxel help the scarring seen here?

If not, what is a better suggestion?

Thanks

I'm 55, so I have not have red marks for decades, but i had a little redness under eyes form long term sun damage. I am most happy about texture, tone, and pigment. My skin is baby soft with even color that glows with a nice tan look. Moreover, I would have periodic flares of seb derm (basically dry, red, flaky skin) around nose and in eyebrows. I have not had an outbreak in several months. Could be coincidental, but I don't think so.

As far as scarring and forehead wrinkles, I would rate my improvement at about 25%. I have been told to expect further improvement as collagen rebuilds, but I don't have high expectations. It does a really good job on very shallow scars, but there is only slight softneing of deeper scars. I got a good price for the package and, in my value system, I think I look better than the cost.

I'm 55, so I have not have red marks for decades, but i had a little redness under eyes form long term sun damage. I am most happy about texture, tone, and pigment. My skin is baby soft with even color that glows with a nice tan look. Moreover, I would have periodic flares of seb derm (basically dry, red, flaky skin) around nose and in eyebrows. I have not had an outbreak in several months. Could be coincidental, but I don't think so.

 

As far as scarring and forehead wrinkles, I would rate my improvement at about 25%. I have been told to expect further improvement as collagen rebuilds, but I don't have high expectations. It does a really good job on very shallow scars, but there is only slight softneing of deeper scars. I got a good price for the package and, in my value system, I think I look better than the cost.

 

I've had 3 fraxels so far. The first one was at a low setting so I only took a Friday off and went back to work on a Monday. The second one was over Memorial Day Weekend so I took Friday off and and went back to work on a Tuesday. I live in San Francisco and both times the weather was nice here (sunny) so that when I went back to work, it was "explanable" why my face was red/burnt. When I went to a higher setting with #3, I actually took about a 4 days off because I knew I would not be able to recover in time and I definitely did not want to show up at the office looking like I had something done.

I think Fraxel is great (so far) and I'm doing #4 next week. I hope to do #5 and maybe #6 if I don't get the results I'm looking for after #4. People say there is no downtime. Yes, that's true in the sense that you can pick up where you left off and go back to work, activities right after the procedure. But, realistically, it would be nice to have a few days off in cases where you have to meet with clients or you work in a profession where your face is visible.

I wish I could offer you a better answer, but I think fraxel is great if you have the time (and money) to invest in such a procedure. Good luck.

 

Thanks tenntenn, billyboy, and everyone else for the responses. It's encouraging to hear positive results--congrats to you. I'm seeing the Dr. who did the Fraxel study posted way back in this thread (by blaster, I think) so I feel confident, well hopeful, that I'd get good treatment whatever I decide to do. The periodic time off from work needed may preclude me from getting fraxel, which is unfortunate, or it may just have to take a couple of years to get all the treatments I need.

Billyboy, I'm interested that your Dr was concerned about hypopigment rather than hyperpigment with ablatives. I'm more worried about hypopigmenting as well since I've dealt with hyperpigmentation all my life and would rather have it than depressed scars. Hypo, though, would be a total nightmare for me because I am also olive skinned and my skin tans at the drop of a hat. I couldn't imagine getting stuck with white spots all over my face. I've had other treatments with no pigment problems though. More to mull over . . .

Medusa

Hypo is bad news. My understanding is that it has a low probability, but why take that risk. I have a neighbor who had a chemical peel years ago (probably phenol) and she has no pigment in her face; looks like death to me. Personally, I like the healthy tan look.

Hi,

Just had my fifth fraxel. Will probably be my last for this batch and possibly of all.

This one really hurt - I went for 30 x 14 passes x 125 = 52500 Unfortunately due to the extent of treatment I have quite a lot of pinpoint bleeding on my forehead and nose and a bit on my cheeks. Was pretty intense treatment, probably the most painful of them all.

Anyway I have reached the maximum tolerance of my skin, so doc advised me to take 3 months off and then re-evaluate if I want to have more treatment. I'm going to take his advise and lay off for 3 months and see how it goes. I think this treatment should push me to 50% improvement in scars overall. He did comment that my skin was so smooth that the dye would not stick, and just glided off. I think that's a good thing for my skin, but it did delay treatment while they struggled to get the dye on. Will post photos once I get them from the clinic in 2 months time.

I feel like a burnt steak right now, level 30 at 14 passes is a whole new level in treatment. I'm pretty sure my skin can't tolerate 35 at multiple passes, and my doc feels I don't really need it. So I guess this is the limit of how far I can go. Glad at least I know and I utilised the fraxel as best I could.

Will now have to wait for 3 months before I give the final verdict on this treatment. Should be an interesting x'mas.

No regrets,

Blaster

form1025,

you must mean low density, high energy settings.

cm77,

look at the link to baylor.edu i posted a few pages ago. it shows 50 percent improvement to a girl with temple scarring.

another guy with forehead wrinkes had probably 90 percent. check it out.

there's even a woman who had improvement on the pores of her cheek.

furo,

look for posts by floridaguy. you can find him on the first page of this thread. he spent a lot of time in this thread then decided to do fraxel.

his scarring was same as you. he had about 70 percent improvement. his pics even went on his docs website.

they can be cured,

fraxel for pores has mixed results on here. some have said it worked on their normal pores, but not scarred pores. others experienced the opposite. some said it enlarged everything. this tends to make me think it's based on settings.

for pores you're going to want low energy settings with a high density and 2 or less passes.

Hello all

I'm new to this forum so please bare with any mistakes I make.

I have just had my first Fraxel treatment yesterday and am somewhat swolen. WOW Blaster! I cant believe your tolerance for pain. I was at 14-16 and 4 passes and then the doctor went over some scars at 20. I'm not 100% clear on the settings but he used 2 different handpieces as well.

I'm optimistic about these treatments but also realistic. If I see 20% improvement overall I will be happy but naturally I would like to see 50% or more.

I'm not new to this, i'm 42 years old and have had 2 "old style dermabrasions", 4 scars excised and get collegen on a regular basis so I sympathise with all the people on this forum.

The thing that bothers me most about the scars on my face is that if I had been given Accutane 4 months before I did, I would have 75% less scarring...75%!!!

Anyway, just thought I would register on this forum and share my optimism and hopefully great results.

Cheers,

Anyone else know if Fraxel will help a case like this here?

Also, what kind of scarring is that called on the chin? I am not very educated on the meaning of "ice pick" or "boxcar" or "rolling" etc...

How about the cheeks region?

And again, would anyone recommend something besides Fraxel for what you see here?

Thanks

Hello all

I'm new to this forum so please bare with any mistakes I make.

I have just had my first Fraxel treatment yesterday and am somewhat swolen. WOW Blaster! I cant believe your tolerance for pain. I was at 14-16 and 4 passes and then the doctor went over some scars at 20. I'm not 100% clear on the settings but he used 2 different handpieces as well.

I'm optimistic about these treatments but also realistic. If I see 20% improvement overall I will be happy but naturally I would like to see 50% or more.

I'm not new to this, i'm 42 years old and have had 2 "old style dermabrasions", 4 scars excised and get collegen on a regular basis so I sympathise with all the people on this forum.

The thing that bothers me most about the scars on my face is that if I had been given Accutane 4 months before I did, I would have 75% less scarring...75%!!!

Anyway, just thought I would register on this forum and share my optimism and hopefully great results.

Cheers,

 

The two different handpieces are just different sizes for smaller or larger areas of the face. Ur settings seem consistent with what I've read so far on here. Does anyone have links to the clinical papers for Fraxel? I can't find any on the trials for acne scars or melasma.

Isn't it distressing about the Isotretinoin. I should have gotten it years before I did. But it wasn't even mentioned by any of my derms, until I asked for it. And then he was like, "Accutane? Sure I'll write you a prescription for 80mg!" I think the real drug the FDA should have a problem with is antibiotics. Long term antibiotics for acne is just crazy, has more side effects, and doesn't work well at all. Antibiotic resistant acne/bacteria is also much more of a public health concern than a few teenage abortions.

I take it your acne cured? I'm in month two, hoping it's a cure for me. Then all I have to cope with is scars and balding . . .

The periodic time off from work needed may preclude me from getting fraxel, which is unfortunate, or it may just have to take a couple of years to get all the treatments I need.

 

Hi Medusa:

I understand your dilemma about the time off work but it seems a shame that you will forego a treatment that you really want because you don't want your co-workers to know. (assuming of course that this why you need to take time off)

Why not just tell people you are having your scarring treated. You will be surprised at how many people will relay similar stories of treatments they had or someone they know has had. You may also find that some of them become a good support group, giving you positive feedback on how they see your skin improving. I know because this was my experience. Obviously it is no secret that you have acne scarring so why should it be a secret that you are trying to get rid of it. Many people will applaud your decision and guts to take control of it.

Of course there will always be a few negative responses, but who cares what they think. The majority of people either could care less or will be supportive. Some may even thank you and end up doing the treatment themselves.

Good Luck to you.

Peach Pie

I had severe cystic acne and Accutane did cure it completely for about ten years and then I had some cysts return and had another 4 months treatment. I agree that too many derms. are simply prescribing antibiotics instead of Accutane especially for cystic acne.

Accutane had only been around for a few years when I needed it and my Derm at the time was an "old schooler" but COME ON. The cysts that I had were unreal. I finally had someone tell me about another Derm and he instantly prescribed me Acutane.

This is a great site, I didn't realise how much it encompassed. I first fount it when I read the "Clear skin regiment" which I have been doing faithfully for about 2 months now. I really find it makes a difference. Obviously it doesn't work miracles for scarred skin but it does give a nice glow to my face anyway. It also keeps blackheads at bay. The Benzoyl Peroxide is truely a great product.

 

The periodic time off from work needed may preclude me from getting fraxel, which is unfortunate, or it may just have to take a couple of years to get all the treatments I need.

 

Hi Medusa:

I understand your dilemma about the time off work but it seems a shame that you will forego a treatment that you really want because you don't want your co-workers to know. (assuming of course that this why you need to take time off)

Why not just tell people you are having your scarring treated. You will be surprised at how many people will relay similar stories of treatments they had or someone they know has had. You may also find that some of them become a good support group, giving you positive feedback on how they see your skin improving. I know because this was my experience. Obviously it is no secret that you have acne scarring so why should it be a secret that you are trying to get rid of it. Many people will applaud your decision and guts to take control of it.

Of course there will always be a few negative responses, but who cares what they think. The majority of people either could care less or will be supportive. Some may even thank you and end up doing the treatment themselves.

Good Luck to you.

Peach Pie

 

I guess iPLEDGE is good news for Fraxel. There will be a whole new generation of children with acne scarring.

Is this a Yag laser?

Oops, sorry, I just posted an empty reply by accident.

Peach pie, thanks for the encouragement. The staff really wouldn't care what I do to my face, but my colleagues definitely would. I work in a company with mostly male colleagues, and they are great (I'm not male-bashing here), but it's can be a very aggressive environment and revealing that you're having any cosmetic procedure done would underscore my difference from them. It's just part of the culture of this particular workplace, but I have a lot of freedom otherwise and am happy here.

Hi all. Just had my fourth and last fraxel treatment. This time the dr. came in to look at my skin before the blue dye was put on and marked the "trouble" areas with a pen so he could go more aggressively there. I go for a follow up in 8 weeks to decide what course of action to follow (continue with fraxel, do TCA Cross, etc). We looked at my before pictures. The fine lines around my eyes that extended downward are GONE. I didn't know I even had those until I saw the picture. He thinks the right side of my face looks better than the left. I think that's funny, because it's the right side that I'm so self conscious about. Just goes to show you - the things that bother US the most are not necessarily the things that other people notice.

I'm feeling ok about my progress so far. I'm far from scar free, but my scars are much softer and my skin tone is much more even. My husband said to me the other day, "I can't believe how much different your skin looks" - and he's not the kind of guy that pays lip service. WHether it'll be good enough for me or not, I don't yet know. Being satisfied by #3 and being satisfied at #4 are two different things. At #3 there is still the hope for further improvement. After #4 you know that's as good as it's going to get from your fraxel package.