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Fractional Face Resurfacing

Laser resurfacing uses a laser to send out brief pulses of high energy light that are absorbed by water and other sub layers in the skin called chromophores. Fractional laser resurfacing removes layers of skin tissue in a fractionated method (columns of skin are removed leaving the skin surrounding each column intact to aid in healing.)

The light is changed into heat energy and the heat then destroys (vapourises) section of skin layer by layer. As the wounded area heals, new skin grows to replace the damaged skin.The carbon dioxied (CO2) laser is the most common type of laser used for resurfacing. Erbium lasers are also used.

Fractional laser treatment is a non- invasive treatment and uses a device to deliver a laser beam divided into thousands of microscopic treatment zones(MTZ) that target a fraction of skin at a time.
Fractional laser has bridged the gap between the ablative and non-ablative laser techniques as it treats both upper epidermal and lower dermal layers of skin.

There are number of machines available that uses fractional technology based on Erbium ;yag lasers for superficial treatments and CO2 lasers for deeper ablative treatments.

What is Fractional laser treatment used to treat?

  • Surgical and acne scars.
  • Facial lines and wrinkles.
  • Sun damage/ skin pigmentation.
  • associated with photo ageing.
  • Stretch marks.

It can be used in all skin types and patients.

How does fractional laser treatment work?

The dermis ( mid- layer of skin) is made up of collagen and elastin fibers that provide skin with strength ,elasticity and pliability.

Fractional device delivers a laser into skin layer which is divided into thousands of tiny but deep columns of treatment. These are called micro thermal zones(MTZ). Within each MTZ old epidermal pigmented cells are expelled and penetration of dermal collegen causes a reaction that leads to collegen formation , hence smoother firm skin with filling effect on scar depth. By using MTZs the surrounding healthy tissue remains intact and unaffected and helps to heal wound faster.

What does fractional laser treatment involve?

  • Pre treatment with lightening creams or chemical peel may be necessary in patients with darker skin or pigmentation.
  • Consider cold- sores prophylaxis.
  • An anaesthetic cream is applied to treatment area for 45-60 minutes prior treatment.
  • Gliding gel is applied just before treatment which helps laser to lay down an even MTZ spot pattern.
  • Treatment time for full face will take around 30 minutes.
  • Post treatment redness and swelling is usually minimal for 2-3 days.
  • Within 24hrs new epidermal skin appears and it will have bronzed appearance, which may last for 3-14 days.
  • Flaking of the skin can appear which may be treated with moisturizers.
  • During healing phase protection with hydrating sunscreen is essential.
  • 4-5 sessions are necessary which are usually spaced a month apart, the results are not immediate and are slowly progressive ;optimal visible improvements seen after 3-4 months.

What are the complications of fractional laser treatment?

  • Well tolerated by most patients.
  • Patients can return to work directly after treatment or next day.
  • Rarely post inflammatory pigmentation develops and acneform eruption occurs.


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