INTRODUCTION
This is a safe and effective way to treat:
- Superficial sun damage and skin pigmentation due to sun damage such as solar lentigos (age spots)
- Fine lines
- Poor skin quality
- Acne scars (see the section on acne scars)
- Melasma (second-line treatment after topical treatment has been tried)
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How Fraxel skin rejuvenation works
The Fraxel laser uses a 1927nm wavelength of light which is highly absorbed by the epidermal (outer layer) of the skin. It penetrates to a depth of 0.2mm. This allows complete replacement of the full thickness of the epidermis. The outermost layer of skin is what people see every day. Poor skin quality due to sun damage and ageing result in a dull, thickened and irregularly pigmented epidermis with fine lines.
Fraxel laser removes the old epidermis and replaces it with a new one. The change in appearance is quite dramatic. Please look at the photos below of clients that Dr Hussein has treated with the Fraxel laser. The new epidermis is uniform, smooth and pigment-free and immediately rejuvenates the face.
The procedure requires a mild local anaesthetic cream to be applied to the face for 30-45 minutes. Following this, the Fraxel laser procedure is performed and lasts for about 30 minutes. Protective eyewear is worn during the procedure so you will not be able to see what is going on around you. Most clients will complain of a mild prickly heat sensation at most.
Following treatment clients will feel a sunburn sensation for the first 24 hours. The face will be red and puffy for the first 24-48 hrs. Darkening and shedding of the outer layer of skin occurs from day 3-6.
Complete recovery is usual after 7 days. There may be a mild residual redness that will take a few more days to settle but this can be easily hidden with make-up.
During the 7 day recovery period you will have to follow a simple skincare routine which will be issued to you in written format. The skin products you require for this are issued to you during your treatment visit. It is normal to take antiviral tablets to prevent cold sore virus infection whilst healing.
Potential complications of Fraxel treatment
Dr Hussein is an expert in cutaneous laser surgery the incidence of side effects is low. In Dr Hussein’s hands, Fraxel laser is a very safe treatment.
However with any laser resurfacing treatment complications are possible. In Fraxel laser these include the following:
Post Inflammatory Hyperpigmentation (skin darkening)
This is the most common side effect. It is most common on darker skin types. Thankfully it usually spontaneously improves. Improvement can be speeded up by the addition of topical treatment. Duration usually depends on the severity of the inflammation that created it in the first place. Complete resolution can take anything from a few weeks to 6 months depending on severity. Sun exposure is the most common aggravating factor and this is why strict sun avoidance is important in the first few weeks following treatment.
Infection (bacterial/viral/fungal)
This can happen in any kind of laser resurfacing but is exceptional in Fraxel laser resurfacing. HSV infection (cold sore virus) is the most common kind but is usually prevented by taking an acyclovir tablet twice daily for 7 days during the recovery period. Uncontrolled infection can then go on to result in hypertrophic (raised bumps) scarring. Thankfully if treated early any problems can be prevented. This is why Dr Hussein monitors the healing closely with the use of ‘selfie’ photos every two days for the first week.
Scarring
This is a possibility but exceptionally rare in Fraxel treatment due to the superficial penetration depth of the 1927nm wavelength. Theoretically, if there was uncontrolled infection this could cause scarring. This is highly unlikely due to insistence by Dr Hussein on direct photo monitoring in the first week of post treatment.
The second reason is due to a thermal injury directly created from the laser (burn). This is extremely unlikely due to Dr Hussein’s level of experience and expertise.
Prolonged redness (erythema)
This is not really a complication. Mild redness that remains for a couple of weeks after the treatment is normal. It will spontaneously settle.
Post resurfacing contact dermatitis
Again this is a rare complication of Fraxel but more likely in more aggressive forms of laser resurfacing. This is a form of an increased sensitivity of the skin that is encountered by a proportion of individuals post laser resurfacing. In some cases, it can be quite severe. Mild irritants can trigger a disproportionately large irritation of the skin (burning and itching) that then can result in prolonged redness and darkening of the skin. It is usually treated by topical steroid ointment if it occurs and eventually spontaneously settles. Triggering can be minimised by the use of mild perfume-free cleansers and skin product post-treatment. Dr Hussein can advise on these.
DR HUSSEIN’S BEFORE & AFTER PHOTOS
AFTERCARE
Fraxel 1927nm is a skin resurfacing treatment. The laser removes the outer (epidermal) layer and a very small proportion of the inner (dermal) layer. The removed layers will grow back quickly thanks to Fraxel technology that spares small amounts of tissue from which rapid healing takes place. The treatment is designed to renew the surface of the skin and to remove the existing epidermis. Sun damage, pigmented spots, rough texture and fine lines will be removed as these problems are to a large extent contained within the epidermis. The result will be a much more uniform, smooth and blemish/pigment free epidermis.
What you will experience following the treatment:
- You will experience some redness and your skin may be slightly puffy immediately after the treatment.
- Over the next 48 hours skin will start to bronze and begin to flake or shed in small fragments.
- This shedding process will take about 4 to 5 days to complete.
- Following this you may the new skin underneath stays a little pink/red for a further 1-2 weeks.
- Almost all of the healing process occurs within the first week following treatment.
- It will usually be safe to return to your normal skin care regime 10 days post treatment.
Skincare in the first 7 days post Fraxel 1927nm
It is imperative that you adhere strictly to the following skin care routine after Fraxel 1927 treatment. Remember the epidermal (outer layer) barrier has been impaired by the laser. Use of your normal skincare products will result in inflammation, irritation and slow healing.
Morning
- Wash the face in the morning with Dermol or Avene Cleanance face wash and allow to air dry OR pat dry gently with a clean face towel (DO NOT RUB).
- Apply CU3 barrier cream to the face. This will protect the skin and stop it from drying out while the epidermal barrier is healing.
- Take any antiviral and/or antibiotic tablets that your Doctor may have prescribed.
Throughout the day
Top up the CU3 cream at any point when the skin starts to feel dry and tight. This should be at least twice throughout the day. Never let the skin dry out.
Evening
Repeat steps 1 & 2 (and step 3 if your Doctor has prescribed the medication) before going to bed.
NOTE: Dr Hussein may have prescribed FUCIBET – Do not use unless discussed with him first.
Dr. Hussein will review you a week following treatment but do not hesitate to contact him before this if you need earlier advice/review/information.
Caution
If you develop any of the following after treatment:
- Red, raised areas and increasing swelling
- Yellowish crusting (not flaking)
- Increasing soreness or pain
- Small acne like spots/blisters
Please contact Dr Hussein immediately for advice. This could represent infection post treatment.