Laser skin rejuvenation (Photorejuvenation)

Aging face rejuvenation using Fraxel laser treatment

Thermal skin lifting using Erbium laser 2940nm

Applications:
- removes rhytides
- skin lift
- pitted acne scars softening
- pigmentary problems
- skin texture and dilated pores improvement
Anaesthesia
Not required
Recovery time
Not needed

Fraxel laser treatment produces the resurfacing effects of corneal skin layer removal, treats pigmentary changes, improves rhytids, and stimulates tissue remodeling. Compared with other classical approaches, it has the advantages of no recovery time and pain treatment, no open wound, few non-responders, few complications, and the ability to be used on all skin types. It has no need for pain treatment, no open wounds, few non-responders, few complications, no recovery time and can be used on all skin types.

Fractional photothermolysis.

This is a relatively new method of skin rejuvenation in which the targeted areas of the skin are precisely separated at a microscopic level, leaving some skin perfectly intact while other zones are heat treated. The effect is visually comparable to the pixels in digital images, as the tiny spots of treated skin replace old, destroyed cells with new, healthy ones, and the untreated areas maintain the tissue's stability for quicker recovery. Roughly 100nm spots are used with 250-500nm spacing.

A. Ablative resurfacing B. Non-ablative resurfacing C. Fractional

A picture of hands after Fraxel laser treatment – checkerboard order of skin crusting

Fotothermolysis
Rather than creating a global tissue effect at the surface of the target tissue, or in the dermis alone, this treatment creates injury in a tiny fraction of the skin treated, coagulating multiple columns of tissue, 70 to 100 μm in diameter, extending through the epidermis and deeply into the dermis.

Fraxel Asclepion method implies a controlled, safe and effective way of photorejuvenation and skin cleaning that does not require a long recovery period.

Even though the epidermis in these microthermal zones is coagulated, it remains intact, leaving no open wound. The large volume of normal tissue surrounding such zones on all sides provides a generous reservoir of source cells for healing. Over several weeks the body expulses the coagulated tissue, replacing it with new healed tissue. Since this process is invisible to the naked eye, there is no downtime. Over the course of multiple treatments, in a piecemeal fashion, most of the skin surface is replaced. The appearance of rhytids, scars, varied pigment irregularities, and vascular lesions is improved after each treatment with a Fraxel laser. Treatment is usually offered in a series of 4 weekly visits.

Laser- skin interaction
The 1530-nm wavelength is a mid-infrared wavelength of light, largely absorbed by intracellular and extracellular water in the skin, similar to the way that the light from resurfacing lasers is absorbed.


The penetration of light into the skin is much deeper than with carbon dioxide or Erbium:YAG (Er:YAG) laser wavelengths. Each pulse of laser light fired into the skin creates a column of coagulated tissue, extending from the surface of the epidermis into the dermis. The energies used in each pulse are below the threshold of ablation,
creating no tissue vaporization. An exposure area of 50 to 70 μm results in an MTZ about 100 μm in diameter and extending to a depth of 350 to 750 μm, depending on the amount of energy used per pulse.


Fraxel laser treatments are administered as a series of 4 to 6 treatments spaced at 1- to 2-week intervals.

Treatment of the face and neck requires about 15 minutes. The treatment sensation is one of warmth and prickling. Most patients are able to tolerate moderate energy treatments, such as 12 mJ/pulse, although local anesthesia can be augmented with oral agents. Following the treatment, protective moisturizer should be applied.

Patients have a sunburned appearance and experience the sensation of sunburn after the treatment; this sensation may persist up to several hours. Erythema abates within 24 hours, although in an occasional patient it may persist up to 2 to 3 days.
Some clinical improvement can be assessed even after the 1st treatment session.