General Information

The Fraxel SR 1500 is the second generation Fraxel laser developed by Reliant Technologies and uses a 1500 nm wavelength vs the older model’s 750 nm wavelength.  The Fraxel SR 1500 is still used in many offices and has the potential to provide great results over the course of many treatments.  It also must be in the right hands, there are many people out there who claim to get marvelous results with the Fraxel but the proof is really in the results.  A lot of offices actually market their device using Fraxel’s own results that are available on their website.  It is important that before you book a case with any one that you see results that they are responsible for and also understand exactly how many treatments it will take to see results.

  • How long does it take to see results?

Most likely, you will not see significant results after only one treatment as Fraxel provides a more gradual change.  You may not start seeing a change until after the 3rd or 4th treatment.  Of course, this depends on how agressive the specialist is and what exactly you are treating.

Fractional Co2 Laser Vs. Fraxel

With the new fractional co2 laser, many physicians are moving away from the Fraxel or other similar Erbium lasers and moving towards the more aggressive Fractional Co2 Laser.  The Fractional Co2 Laser provides patients with noticeable results after only one treatment so many patients and physicians are seeing this as a more effective treatment option when it comes to cost and results.  The fractional co2 laser does require more recovery time and in the wrong hands your experience will be no better than any other laser out there.  Fraxel laser provides a treatment option with little side effects or risks of complications.  As with every laser, it is very important that you visit someone with experience and proven results.

Fraxel SR 1500 Treats:

  • Acne Scars
  • Pigmentation
  • Fine Lines and Wrinkles
  • Destruction of Skin Lesions
  • Actinic Keratosis

Pre Op

  • Every physician has their own pre-op method so be sure to follow the instructions given
  • You cannot wear makeup on the day of your treatment
  • Usually your physician will ask you to discontinue the use of any acne products containing certain acids
  • If you are unsure, ASK, it is better to know that you are doing everything correctly then to have something to blame in the event of bad results

Post Op

  • During the procedure you will experience some discomfort much like a iron that is being rolled on your face with the heat turned down some
  • You can usually expect moderate pain, much like a severe sun burn which lasts a couple days
  • During recovery it is important that you keep your skin very hydrated by applying moisturizer often
  • After initial burning feeling, you will still have redness that lasts for about a week

Article on Fraxel SR1500

by Bates, Betsy

Skin & Allergy News • Feb, 2007 • Dermatologic Surgery

LAS VEGAS — A new version of the Fraxel laser penetrates more deeply–yet causes less pain and requires fewer treatments–than does the original Fraxel system, speakers said at the annual meeting of the American Society of Cosmetic Dermatology and Aesthetic Surgery.

The new Fraxel SR1500, approved by the Food and Drug Administration in August 2006, promised enhanced efficacy and safety, said Dr. Richard Fitzpatrick, a dermatologist in private practice in La Jolla, Calif.

“For the most part, I think that has held up,” he said.

The idea behind Fraxel lasers is to deeply penetrate dermal tissue in a specific pixel-like pattern, leaving behind healthy tissue surrounding the tiny wounds.

The original Fraxel was approved by the FDA in 2003 for the treatment of wrinkles, melasma, and scars from acne and surgery, among other indications. The new Fraxel, which costs in the range of $110,000, is capable of deep penetration–to 1,200 microns-and includes a telescopic lens and dosage-control system that permits the use of much higher energy ranges.

“You almost have to rethink Fraxel” in adjusting to the new device, said Dr. Vic Narurkar, who is in private practice in San Francisco. “Depth really does matter.”

Moreover, it is important to understand the confusion regarding the term “fractional resurfacing,” he said in an interview following the meeting.

True nonablative fractional resurfacing requires a midinfrared wavelength, such as the 1550-nm wavelength of the Fraxel SR1500 and the original Fraxel SR750. “Most other fractional devices are marketing toys and are not supported by clinical and histologic studies,” Dr. Narurkar said.

Although Dr. Fitzpatrick limited his energy settings to about 8-20 mJ/[cm.sup.2] on the face with the first-generation Fraxel, he feels comfortable using the midteens to 30 mJ/[cm.sup.2] with the new Fraxel, and has even “pushed the envelope” beyond that.

Dr. Narurkar now routinely treats Fitzpatrick skin types I-III at 40 mJ/[cm.sup.2] for moderate photodamage, and reports being comfortable using higher fluences in acne scar patients of all skin types.

“Coverage”–the number of microthermal zones of damage required–depends on the condition being treated and the anatomical location, the speakers agreed.

A level 6 setting on the laser translates to 20% coverage, with levels building or declining in 3% increments, Dr. Fitzpatrick explained. A level 7 achieves 23% coverage, for example.

The ease of the system does not negate the importance of being careful, however. The laser’s capability of going to extreme depths with a high degree of energy can produce “an intense collimated dermal reaction,” which Dr. Fitzpatrick said is unlike any he has ever seen.

Choosing a coverage setting that is too high can be dangerous.

“You will reach the point, if you go too far, where you will risk bulk heating. You will generate thermal necrosis of the area,” he said.

On the other hand, significant swelling and erythema are very unusual, and the increased energy delivery makes for better results, Dr. Fitzpatrick said, adding, “High pulse energies are more effective for almost everything.”

For mild to moderate photodamage on the face, he performs four treatments using energy in the range of 10-20 mJ/[cm.sup.2], opting for 26%-32% coverage at each session for a total 85% coverage by the end of the treatment series.

For acne scars, he starts at 25 mJ/[cm.sup.2] and about 26% coverage, unless patients “will put up with a little more” for more immediate results. In that case, he begins at 40 mJ/[cm.sup.2] and aims for 32% coverage.

“The Fraxel does better with acne scars than any device I’ve ever used,” he said.

Dr. Narurkar agreed, saying that both the first- and second-generation Fraxel lasers are “rapidly becoming the treatment of choice” for this indication. Across indications, fewer treatments are required with the second-generation Fraxel, although patients can expect more edema when higher settings are used, he said.

“They will see results in three treatments instead of five,” Dr. Narurkar said. “It hurts less and my patients are extremely satisfied with the treatment.”

Both speakers disclosed that they have received grant or research support from Reliant Technologies Inc., maker of the Fraxel laser. Dr. Fitzpatrick is a paid consultant to the company as well.

BY BETSY BATES

Los Angeles Bureau


Technical Data:

Fractional photothermolysis, based on creating spatially precise microscopic thermal wounds, is performed using a 1550-nm erbium fiber laser that targets water-containing tissue to effect the photocoagulation of narrow, sharply defined columns of skin known as microscopic thermal zones. According to the authors, Fraxel resurfacing has been shown to be both safe and effective for facial and nonfacial photodamage, atrophic acne scars, hypopigmented scars, and dyspigmentation. Because only a fraction of the skin is treated during a single session, a series (typically 3 to 6 treatments) of fractional resurfacing at 2- to 4-week intervals is required for the best clinical improvement. It is the authors’ experience that a series of Fraxel treatments can achieve a similar clinical result for atrophic scars compared with traditional ablative laser skin resurfacing. However, the improvement seen after a series of Fraxel treatments for perioral laxity and rhytides often falls short of the impressive results that can be achieved with ablative laser skin resurfacing.