Understand, when Fraxel first came out ~3 years ago the first equipment was a prototype to get the technology to market. A basic laser, it had two settings and an optical requirement in the laser head itself to fire only when it detected a color difference in the skin as a safety feature. Thus blue dye was applied on the skin over which was applied an ointment called “glide” to allow the laser a smooth traverse over the skin’s surface.Â
Parenthetically, one could operate this early laser without the dye or glide with the laser firing due to color variances in the skin in someone with a lot of sun damage — but this would not benefit those without such color variation such as in acne scarring. Â
Even with this prototypical machine Fraxel set the cosmetic industry on its ear with their astounding results. It was only a matter of time for other laser manufacturers to imitate the Fraxel gold standard by coming out with “fractional laser resurfacing”. Â
These imitators fall far short of true Fraxel technology in two areas: laser wavelength to penetrate deeply enough to produce comparable results, and in their delivery systems which do not follow the uniform computer generated even distribution of energy. The results seen from these fractional handpieces are complicated by uneven laser coverage, resulting in disturbing “stamping” (circles of resurfaced skin) and “striping” (streaks of resurfaced skin). I repeat, the energies and wavelengths of these imitators leave much to be desired when compared to those of the true Fraxel.Â
These differences widened with the advent of the Fraxel SR 1500. This newer version of the first prototype no longer requires blue dye, and allows for infinite variation of the depth of energy penetration, important in acne scarring and deeper remodeling in clients with severe sun damage or aged skin. It also allows for customizing the percentage of coverage per treatment. For optimal results it makes sense to treat as much of the skin as possible without excessive heat generation. This is for two reasons: patient comfort and avoidance of unnecessary and unwanted skin damage. Therefore in cases requiring deeper treatment, percentages of coverage can be distributed over more visits. Most are sold as a series of treatments designed and individualized to match various clinical applications for optimal results and comfort.Â
I have had six Fraxel treatments of my face at deeper energies, with minimal discomfort, and with astounding results.Â
Graphs of comparable wavelengths of the other fractionating handpiece machines demonstrate the limitations of these lasers in that they do not penetrate deeply enough to effect the same results as Fraxel. Also, since the coverage uniformity of fractionating devices is operator dependant (and not computer generated as in Fraxel) the outcomes for results of fractionating imitators are suspect.Â
To be sure, these imitators actually pitch their fractionating laser client experience as faster and less painful than Fraxel. They may be right, because their technology treats only the surface at best and you don’t need much to produce transient and superficial results. Â
These fractionating lasers are usually sold as add-on handpieces for multiplatform boxes to which other handpieces can be added. The other handpieces may be IPL, YAG, or green light laser devices. This allows practices to have one box with various applications — all in one. These machines are good for GP’s and those with inadequate laser technology understanding. Unfortunately, the public doesn’t know the difference and gravitates to fast results with minimal discomfort. The downside is less-than-optimal results and disappointment over time. Â
Fraxel stands far and above these imitators with results which even improve over time, and minimal discomfort as well. I know, as I stated before, I’ve had my series at maximal energies with results of looking at least ten years younger, with steady continued improvement over time.Â
My advice is always to choose technology dedicated to the purpose intended, and avoid those offering shortcuts.Â
You do get what you pay for.Â
James C. Fairfield, MDÂ
