To understand the differences, one must understand the similarities. The Active Fx and Fraxel Re:pair are both lasers using CO2 technologies. (Active Fx is made by Lumenis which is based in Santa Clara and Fraxel is made by Reliant in Mountain View which got acquired by Thermage.)
They fractionate the CO2 whereby they leave areas of untreated skin juxtaposed with areas of treated skin. The idea is that the untreated skin allows for faster recovery times; plus it is much less painful then its predecessor which required general anesthesia. How they differ is how deep the laser goes down. Fraxel’s philosophy is that you need to go real deep (1.6 microns vs 600-700 microns) in order for you to heat the collagen so that you can stimulate collagen to get the tightening effect. Active Fx does not go as deep. The overall question is how far do you need to go to have optimal results. The answer is nobody knows. Both lasers will show you histology slides that show collagen stimulation and both have some impressive results. Generally, the deeper you go the more painful it is and more recovery time required. When Lumenis first came out with Active Fx, they did not believe you had to go that deep to acheive optimal results. They later found out that the results were not that good. They later came out with Deep Fx to punch deeper holes in the skin which turn has provided better results especially for acne scars.
1. They both have excellent results for brown spots, moderate improvement for deep lines, and some improvement with skin laxity. For deep lines and laxity they do not compare to a face lift. So if you have real loose skin or deep, deep lines you still need a face lift.
2. Both procedures are painful and each person will have a different tolerance for pain. You must have proper pre-treatment to make it through. You cannot have a low threshold for pain if you want to go through with this. There are ways to make it more tolerable i.e., the right topical numbing cream, blocks, Ativan, vicodin,
3. Active Fx has 5-7 days of downtime; Fraxel has at least 7 days – Fraxel also has more blood involved right after the treatment (remember it goes deeper) Each person’s recovery time will be different and is dependent upon how aggressive the physician was in the treatment. Downtime and when you will feel comfortable could be two different things so it is best to speak with your physician and obtain a doctors note stating how long you will need off.
4. Remember the provider can control the strength of the treatment – if you want more results – then more pain and downtime – if you don’t want much downtime or pain then they will lower the settings. The difference in these settings is why it is so critical to utilize the services of someone who has a lot of experience with these devices.
By: John Tang, M.D. in Saratoga, California
