This site is designed to provide physicians and consumers with information on the latest Laser technology.  There are many physicians who perform this procedure but you need to be sure that you do your research before paying thousands of dollars for a procedure that may not be what you need.
There are many fractional co2 laser devices and there has not been one laser that has emerged as the premium or most effective laser resurfacing device.  The fact remains, that there are many devices that may work for you but the efficacy is only as good as the hands that are using it.  You need to be sure that the physician or ancillary provider has adequate experience and proven results before allowing them to laser your face, hands, neck, or any other part of your body.

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Frequently Asked Questions Regarding Fractional Co2 Laser Treatments

What is fractional laser skin treatment?

Fractional laser skin treatment is an exciting new technology that successfully corrects many dermatological and cosmetic skin conditions, with increased comfort and minimal post-treatment pain and care. Fractional laser skin treatments give excellent results for skin resurfacing and when correcting skin conditions including scars, superficial lesions, epidermal nevi, actinic chelitis, warts, skin tags, and keratoses.

Who first developed fractional lasers for treating skin?

Palomar Medical Technologies, Inc. (NASDAQ: PMTI) is the co-inventor and exclusive licensee of the seminal patent for fractional laser skin treatments (United States Patent #6,997,923).

How do fractional laser skin treatments work?

Fractional laser skin treatments create areas of treated tissue surrounded by untreated, healthy tissue. Some fractional skin treatments (e.g., Palomar’s Lux1540 and Lux2940) create narrow, deep columns that extend through the epidermis into the dermis through an array of intense laser energy microbeams. These columns can either be “non-ablative” (the laser beams coagulate the affected tissue) or “ablative” (the laser beams vaporize the affected tissue). The body’s natural healing process creates new, healthy tissue to replace the columns of affected tissue – improving the skin condition being treated.

What do “non-ablative” and “ablative” mean? When is it appropriate to use each?

Non-ablative treatments coagulate epidermal and dermal tissue without removing tissue, and the body’s natural healing process then removes and replaces this coagulated tissue with healthy, new tissue.

Ablative treatments vaporize and remove epidermal and dermal tissue completely, allowing new, healthy tissue to fill in. Non-ablative treatments offer improvement for many skin conditions, with little to no “downtime,” although multiple treatments are generally required. Ablative treatments can provide a single-treatment solution for more pronounced skin conditions, though some amount of downtime typically will be experienced. Providing both types of treatments helps you and your patients balance the results they want to see versus how much downtime they want to experience.

What does “downtime” mean?

“Downtime” refers to the period of time following a laser treatment where patients may choose not to appear in public while their skin is still red or swollen. One of the key benefits of fractional laser treatments is that downtime is significantly minimized. For fractional non-ablative treatments, there is little to no downtime – following the treatment, patients can resume normal activities immediately. For fractional ablative treatments, downtime may be as short as 4 days as compared to traditional full-surface ablative treatments which can result in weeks to months of downtime.

How do fractional laser skin treatments differ from traditional laser skin treatments?

Traditional full-surface ablative laser skin treatments are performed using a beam of intense laser energy that is passed over the entire skin surface to vaporize the entire top layer of skin. The damage to the tissue is extensive and takes significant time to heal and regrow a new top layer of skin (i.e., re-epithelialize the entire top layer of skin).

Fractional skin treatments deliver laser or high-powered light energy in a pattern. The fractional pattern leaves untreated areas of skin between the treated areas of skin. As these treated areas are much smaller than the surrounding healthy tissue, the healing time is significantly shortened.

Traditional full-surface ablative treatments deliver effective results but require significant downtime – patients experience a much longer healing process, and the risk of complications, including infection, is much greater. Fractional ablative treatments provide results as good as traditional ablative treatments, with far less downtime and risk.

What are the benefits of fractional laser skin treatments?

Fractional laser skin treatments have three significant benefits as compared to traditional laser skin treatments:

Increased Comfort – The fractional array of microbeams does not cause bulk damage as traditional ablative treatments do but instead cause small areas of damage each surrounded by undamaged tissue. As a result, fractional treatments are a much gentler laser treatment. Many patients tolerate the treatment well without anesthesia; other patients may opt for a light topical anesthetic.

Increased Safety – Following a fractional ablative procedure, each tiny fractional column re-epithelializes (i.e., regrows the missing tissue and closes over) typically within one day. This minimizes the risk of scarring, infection, or long-term pigmentation changes.

Decreased Downtime – Depending on the type of procedure, most fractional patients can return to normal daily activities almost immediately (for fractional non-ablative treatments) or typically within 4 days (for fractional ablative treatments).

What is the difference between Erbium lasers and CO2 lasers?

“Erbium” and “CO2” refer to the materials used to produce laser energy. A CO2 laser uses CO2 gas to produce laser energy. Erbium lasers are solid-state lasers that use Erbium-doped Yttrium Aluminium Garnet (Er:YAG) or Erbium-doped glass (Er:glass) to produce laser energy.

What is the difference between fractional Erbium lasers and fractional CO2 lasers for use in aesthetic treatments?

Fractional Erbium is a significant improvement over fractional CO 2 lasers. Due to the lower wavelength of the Erbium laser as compared to the CO 2 laser and the different water absorption of these two wavelengths, Erbium lasers can provide significantly deeper penetration. Palomar has pioneered developments in fractional Erbium lasers which have been clinically proven to penetrate as deep as the treatment requires – over one millimeter – to achieve the “wow!” results your patients want.

Additionally, Palomar’s developments in long pulse technology allow these lasers to create desired amounts of coagulation. Fractional CO2 lasers deliver heat – sometimes too much for a specific patient’s desired treatment. This bulk heating can cause significant unwanted downtime and erythema.

What is “re-epithelialization” and why is it important for ablative procedures?

Re-epithelialization refers to the body’s natural process of wound healing. During re-epithelialization, intact stems cells create new cells that multiply, migrate, and cover over a wound in the skin – in this case, areas of tissue affected by a laser treatment. The fractional approach leaves the laser-affected areas surrounded by healthy cells which helps re-epithelialization happen quickly.

A rapid re-epithelialization helps reduce the chance of infection and minimize complications by quickly protecting the treated tissue while it continues to heal. Palomar’s fractional approach to laser skin treatment results in re-epithelialization typically within one day, helping to minimize patient risk.

Are fractional laser skin treatments comfortable for my patients?

Fractional laser skin treatments are far more comfortable than traditional laser treatments. Some patients have described the feeling following a non-ablative procedure as a mild “sting,” not unlike sunburn, that diminishes following the treatment. Ablative treatments typically require a light topical anesthetic before the procedure, and mild post-treatment pain management.

How many fractional laser skin treatments will my patients need?

The number of treatments necessary will depend on the condition being treated, and if it is an ablative or non-ablative procedure. It may take four or five non-ablative treatments to achieve the desired results, where most desired results can be realized in a single ablative treatment. Patients should consider how quick they would like to see results and how much downtime they are willing to experience when deciding on what type of treatments to have.

What should my patients expect after treatment?

Immediately following the treatment, skin may be mildly red (erythema) and swollen (edema). These effects are normal, and indicate a successful treatment. Any swelling typically subsides within a day, and most redness dissipates within a few days. For ablative procedures, light superficial bleeding and “oozing” may occur. As the redness and swelling subside, a brownish “bronzing” effect will become visible. The bronzing will fade over the next few days as new, healthy skin replaces the laser-treated tissue.

Other side effects may include discharge, crusting or scaling, and milia – these too typically resolve within one week.

What precautions should my patients follow after treatment?

For best results and to prevent complications, all patients should strictly follow their post-treatment care protocol. Cool, moist compresses applied immediately post-treatment may soothe the treated skin. A neutral, occlusive ointment may be applied until the skin re-epithelializes. Cool packs used after treatment may provide comfort, if necessary. Soaking and gentle cleansing may aid exfoliation as new tissue replaces old tissue. For two weeks following treatment, avoiding sun exposure is important.

How long will it take before my patients can put on make-up, go out in public, go to work, the gym, etc.?

With a fractional non-ablative treatment, there’s little to no downtime – most patients may resume their daily activities immediately or after only a couple days. For fractional ablative treatments, depending on the level of treatment provided, patients may be able to apply make-up and resume their normal schedule and activities within four days.

….Fractional C02 Laser Resurfacing and All About Lasers Blog….

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