Guide To Fraxel Dual Laser

Please read the article on the Fraxel for all the basic information about Fraxel.  This article is meant to highlight the differences between Fraxel and Fraxel Dual.

What is the difference between the Fraxel and the Fraxel Dual?

The bottom line for you is that the Fraxel Dual is much more effective for brown spots and excess pigment.  And, due to improvements in the tip of the laser, the Fraxel Dual is better for treating large areas like the back, chest, arms and legs.

Its effect on melasma is still in question, so be careful and skeptical if that is your main problem.  I do not recommend this laser for melasma unless you are being treated by a nationally know laser expert.  There is a definite possibility your melasma could become worse.

Is the comfort/discomfort level the same as the Fraxel during and after the treatment?

Most patients describe their discomfort with the Fraxel Dual at about 2-5/10.  With the Fraxel Dual the discomfort is just slightly higher usually – like 3-6/10.  There are always people who seem to feel almost no discomfort and will be a 1/10 and some who have a lot 7-8/10 but the majority of patients fall in the middle range.  Body sites tend, in general, to be more comfortable than the face.

Is the healing the same?  What differences are there?

As for healing, the sensation of heat (like a mild sunburn) lasts about the same time (usually 2-24 hours) and redness, if it occurs, lasts 1-4 days generally, which is similar to the Fraxel laser.  With the Fraxel Dual there is more bronzing and more accentuation of the brown pigment for 1-2 weeks and there is also more visible’ peeling’ starting at about day 3-4.  That sandpapery feel that lasts about 7-10 days for the Fraxel is about the same for the Fraxel Dual.

Remember body sites heal more slowly.  For the chest about 2-3 weeks, arms and back about 3 weeks and legs 3-4 weeks.  Remember this ‘healing’ time is the bronzing and sandpapery feel.  The redness and swelling go away in 1-4 days.  There are no open areas like a burn usually.  Also, consider your age and your health.  The shorter healing times are for younger, healthy people.

The healing time can be 1-4 days longer depending on the exact settings.  As with the Fraxel recovery there is, redness and some swelling for the first few days.  The redness usually goes away in 2-4 days and is replaced by a light bronzing which looks like a tan.  With the Fraxel Dual there is more darkening of the brown spots initially and more ‘peeling’ starting around days 3-7 as the excess pigment sheds.  The pigment may take 1-2 weeks to shed on the face/neck and 2-4 weeks for body sites.

Are there differences between treatments on the face and body sites like the chest, arms, legs, and back?

Yes, laser treatments for the face and neck heal the most quickly.  See the paragraph above to help you.  The further you go down the body, the longer it takes to heal and you must adjust for your age and health.

Does this laser work for melasma?

Melasma often gets worse with laser treatments so I don’t recommend Fraxel or Fraxel Dual treatments unless you are being treated at a nationally recognized laser center and, even then, there is no guarantee that you won’t have problems.

How well does it treat acne scarring?

The original Fraxel is still a better treatment for acne scarring. The only reason to use the Fraxel Dual is if there are pigment problems associated with the acne scarring.

Is the Fraxel Dual system safe for darker skin types?

The original Fraxel system is safer for darker skin types.  The Fraxel Dual is more a risk for causing post laser hyperpigmentation (usually temporary but very annoying).  That is precisely because it does affect the outer layer of the skin (epidermis) more than the original Fraxel (which bypasses the outer layer more).  Settings for the original Fraxel have been worked out for darker skin types and can be done quite safely in experienced centers.   Again though, it’s very important to seek out board certified dermatologists and nationally known laser centers, in my opinion.

In summary the Fraxel and Fraxel Dual systems excel at the following (remember that pigment/brown spots will clear best with the Fraxel Dual):

  • Sun damage, fine wrinkles, and aging on the face, neck, chest and hands as well as the arms, legs, and back especially in younger patients (under 50);
  • Brown spots;
  • Certain cases of melasma (see above);
  • Certain kinds of acne scarring and surgical scars;
  • To improve the crepiness and fine lines around the eye and on the eyelids.
  • To improve skin texture and tone.
  • To reduce precancerous lesions by replacing sun damaged skin with new skin (series of 3-5 needed).

Fractional lasers are generally NOT good for redness. A series of treatments (usually 3-5) are needed, usually one every 3-8 weeks. The benefits of fractional laser treatments are achieved with little discomfort and minimal risk.

See the main Fraxel article for all the information on pregnancy, sun exposure, and compatibility with other cosmetic treatments, costs etc.

For the More Technically Inclined:

The Fraxel is a 1550nm erbium laser and the Fraxel Dual is that PLUS a second laser which is 1927nm thulium fiber laser.  This new addition can be used in combination with the erbium laser or by itself.

One of the advantages to the design of the new system is the ability to get maximum customization for you!  For example, if 8 passes with the laser are usually done over the same area, 8 passes could be done with the erbium or 8 passes with the thulium, or any combination of them like 4 passes with the erbium and 4 passes with the thulium.

Next, learn about Thermage for skin tightening.

See Dr. Irwin’s expert answers to other reader’s questions on Fraxel Dual Laser:
What is more effective- Thermage or Fraxel?
Is it OK to use the Dual Fraxel laser for melasma and brown spots?