Fractional CO2 Laser

Fractional laser treatment is a non-invasive treatment that uses a device to deliver a laser beam divided into thousands of microscopic treatment zones that target a fraction of the skin at a time, analogous to a photographic image being enhanced or altered pixel by pixel.

Fractional laser treatment has bridged the gap between the ablative and non-ablative laser techniques used to treat sun-damaged and ageing skin. While ablative laser treatments work mainly on the epidermis (surface skin cells) and non-ablative treatments work solely on dermal collagen (mid-layer of skin) only, fractional laser treatment works at both the epidermal and dermal layers of the skin.

The first fractional laser marketed was the Fraxel® device [Reliant Technologies now Solta], which emits a non-ablative 1550-nm wavelength. There are now some machines available that use fractional technology, based on erbium:YAG lasers for superficial treatments and CO2 lasers for deeper ablative treatments (eg Fraxel Repair [Solta Medical], Active and Deep FX [Lumenis], Quadralase [Candela] and Pearl Fractional [Cutera]).

For deeper scars, we advise you to undergo fractional co2 laser treatment. Though the down time is more, the results are superior to other lasers. Fractionated or “pixilated” carbon dioxide (CO2) lasers are one of the latest advances in non-surgical acne scar skin treatments. These lasers are excellent for treating deeper wrinkles, more severe textural changes on the face, and body . We can also treat acne scars and other scars that have been difficult to treat with other methods. It is also a very impactful treatment for sun damage and precancerous growths.

Now in Mumbai,India under young and experienced surgeon ,Director of Elements of Aesthetics under Dr.Stuti shukla Khare guidance these procedures are FDA approved and can offered for better results to the patients under nominal prices compared to other cosmetic centres.

It is very important that this procedure is done by an expert and Dr. Stuti shukla Khare will personally perform all CO2 laser treatments at her clinic. Because of the pixilated technology, your skin will heal very quickly after the treatment because we are only creating tiny dots in the skin which are surrounded by normal tissue. Your skin will generate new collagen and continue to become firmer, tighter and more youthful in appearance over the next 1-3 months after treatment, scars (acne, trauma, stretch marks) become shallow, fainter and less visible with every session.
The Carbon Dioxide (C02) Fractional Laser Resurfacing erases layers of skin tissue in a fractionated method.
This treatment will take some time to heal but if you have the ability then having this one treatment is like having multiple other non-invasive treatments at once.
It is an in-office process that needs pre and post-treatment medications to ensure proper healing and comfort during the procedure. Uneasiness varies depending on the depth of the treatment. For your comfort during the treatment, a topical anesthetic is applied to reduce discomfort. Most patients describe the post-procedure feeling as bad sunburn for about couple of days.

What is fractional laser treatment used to treat?

Fractional laser treatment is used for the treatment of:

• Facial lines and wrinkles (rhytides)
• Sun damage
• Skin pigmentation associated with photoageing
• Surgical and acne scarring.

Although fractional laser treatment has been advocated in the treatment of pigmentation disorders such as melasma, the treatment itself can lead to postinflammatory pigmentation.

Fractional laser treatment can be used on any part of the body but is particularly useful on the neck, chest and hands when compared to traditional ablative modalities.
Fractional laser treatment may also be of benefit for poikiloderma of Civatte and stretch marks.

Fractional laser treatment can be used in all skin types and patients, but techniques vary depending on patient age, skin type, sun exposure and body location. Fractional laser treatment can be combined with surgery and other skin treatments.

How does fractional laser treatment work?

To understand how fractional laser treatment works a basic understanding of skin structure is required. Briefly, skin consists of 3 layers, the epidermis (uppermost layer), dermis (mid-layer) and subcutis (lower fat layer). The epidermis contains pigment-producing cells called melanocytes, which are responsible for skin colouring. The dermis is made up of collagen and elastin fibres that provide skin with strength, toughness, elasticity and pliability (click here for detailed information on skin structure).
As the body ages, the appearance and characteristics of the skin alter. The epidermis becomes thinner, so blemishes become more visible, and collagen in the dermis is gradually lost which contributes to the formation of facial lines, sagging skin and wrinkles.

Fractional laser treatment works by targeting both the epidermis and dermis. It does this by delivering a laser beam that is divided into thousands of tiny but deep columns of treatment into the skin. These are called microthermal treatment zones (MTZs). Within each MTZ old epidermal pigmented cells are expelled, and the penetration of collagen in the dermis causes a reaction that leads to collagen remodelling and new collagen formation. By using MTZs, the laser targets and treats intensively within the zone while surrounding healthy tissue remain intact and unaffected and helps heal the wound. This fractional treatment results in a faster healing process than if all tissue in the treatment area was exposed to the laser.

What does fractional laser treatment involve?

The following is an outline of the Fraxel® procedure:

Pre-treatment assessment/preparation

• Define problem areas and tailor a treatment pattern to target the areas for correction.
• Take pre-treatment photographs.
• Pre-treatment with bleaching cream (eg, hydroquinone) or chemical peel may be necessary for patients with darker skin or pigmentation problems.
• Consider aciclovir or valaciclovir prophylaxis against herpes simplex infections (cold sores)
• The patient needs to remove all jewellery and makeup. Wash face with soap and water before treatment.
• An anaesthetic cream is applied to the treatment area. It takes about 45-60 minutes for the anaesthetic to take full effect.
• The anaesthetic cream is removed, and a gliding gel is then applied to the treatment area, which helps the laser to lay down an even MTZ spot pattern.

Application of fractional laser

• The gliding gel acts as the contact lubricant for the robotic handpiece that glides across the skin surface.
• Treatment time will depend on the areas being treated, but a full face will take around 30 minutes.
• The pain associated with the procedure is dependent on the energy delivered to the treatment site. It is essential that the strong anaesthetic cream provided with the Fraxel laser is used.
• A cooling device, called a Zimmer™ machine, is used to reduce the discomfort during the procedure.

Post-treatment and recovery

• The gliding gel is washed off after the treatment.
• Patients may experience a mild sunburn sensation for about an hour after the procedure.
• Swelling is usually minimal and should resolve in 2–3 days.
• The skin will have a pinkish tone for 3–5 days.
• Within 24 hours new epidermal skin develops and the skin will have a bronze appearance that can last 3–14 days. Flaking of the skin may also occur as new skin replaces dead skin tissue, which can be treated with a moisturising cream.
• Skin peeling can be pronounced after ablative therapy when the skin should be gently removed with tap water, petrolatum and gauze once or twice daily.
• During the healing phase and for several months after treatment, it is recommended that the treatment area is protected using a moisturising sunscreen  with an SPF of at least 50+. Protective clothing and wide-brimmed hats should also be used to protect the skin from sun exposure.