What is fractional laser and what does it do?
Until recently, there have been two categories of laser skin rejuvenation–ablative and non-ablative. Ablative laser resurfacing destroys broad areas of the skin, gives good results but is associated with prolonged downtime and significant side effects. Non-ablative laser rejuvenation, on the other hand, does not damage the surface skin and therefore poses minimal or no risk, but generally produces only minimal results.
Fractional resurfacing is a relatively new and gradual laser procedure to rejuvenate the aging skin. With fractional resurfacing, only a tiny proportion of the skin receives the laser light, unlike earlier laser technologies. The laser delivers a series of closely spaced micro-sized laser-puncture holes into the skin while simultaneously preserving the normal healthy skin between. These small laser-puncture holes appear as faint tiny spots on the skin after the laser treatment.
Because there is plenty of normal skin in between the puncture holes, the cells from the normal skin rapidly repairs the holes and the skin heals quickly. As a result of this healing process, new collagen is formed and improvements in wrinkles, acne scars and pigmented spots are seen, and skin tightening may also result from the new collagen formed. This new techniques has been likened to a photograph getting high quality touch-ups. Fractional lasers strive to achieve the skin improvements obtained with ablative lasers without the associated side effects or downtime.
What does fractional laser treat?
Fractional lasers are used for skin resurfacing. This procedure treats resting wrinkles caused by chronic photodamage and aging, superficial skin growths, superficial pimentation such as age spots, and acne scars. Fractional lasers may also help improve skin texture and tighten loose skin.
How is fractional laser done?
Topical anesthesia is applied to the skin under occlusion one hour before the procedure. The skin is cleansed with a mild cleanser and gently patted dry. The procedure is performed using a special laser scanner which is held away from the skin surface and does not come into contact with the skin. A complete procedure consists of a single pass of the laser scanner which places with precision micro-laser spots on the skin. The procedure takes about 20 minutes. Mild pinprick pain is felt. Most patients are able to tolerate the pain without much problem.
What happens after fractional laser treatment?
There will be a burning sensation on the skin that lasts from 1-6 hours immediately after treatment. Paracetamol (panadol) or painkillers such as Arcoxia may be prescribed by the doctor to minimize the discomfort. Cold compresses over the treatment area will also help minimize the discomfort.
Treatment to the facial area will result in an appearance similar to a darker tan or sunburn for the first week. Fine pin-sized scabs will form as part of the normal healing process. Frequent use of a bland moisturiser will help the fine scabs to fall off. Makeup can be used after the scabs have fallen off. Redness may persist up to 5-7 days. The skin will get darker, and then start to flake off near the 5th-7th day. More intense treatments may take longer for recovery.
Avoid strenuous exercise, bending, straining, stooping or lifting heavy objects for 3-5 days after procedure. These activities may cause swelling and pain and slow down your recovery.
Avoid sun exposure for at least 6 months. A sunscreen of SPF 30 or higher should be applied every day after the first week. Use hat and sunglasses. The skin is extremely vulnerable to the sun after the laser treatment. Protecting the skin and limiting sun exposure ensures the best cosmetic results.
Over the following weeks and months, the skin repairs the deeper dermal tissues that have been affected by the laser treatment, producing longer beneficial changes associated with a healthier, more youthful appearance.
Number of treatments required
The fractional laser procedure may be repeated 3-5 times at 4-6 weekly intervals. Each treatment session typically targets about 20% of the skin’s surface. Results are progressive with optimal cosmetic improvement achieved in 3-6 months.
Potential side-effects include discomfort, redness, swelling, blistering, scarring, pigmentary changes. Post-laser hyperpigmentation may occur in 5-10% of cases and may take several months to clear – sun avoidance will help to reduce the risk of this complication.