Why does fractional laser skin resurfacing work?

Fractional resurfacing has been a buzzword for the last few years with the introduction of the Fraxel device. Things have progressed and new machines have been introduced that have made treatments more effective. Fractional resurfacing is a laser procedure that treats only a fraction (or portion) of the skin surface. The laser puts down a series of spots that treat typically from 5-30% of the skin surface area per treatment – leaving 70-95% of skin untreated. The theory is that the partial injury creates an environment under the skin that leads to collagen changes and therefore improved skin. The devices are broadly grouped into non-ablative and ablative lasers. Non-ablative fractional lasers create a column of dead skin that the body eradicates while ablative lasers create an ablation channel.

For the record, laser skin resurfacing was one of the big movers in the American Society of Plastic Surgeons' 2007 report (PDF), being performed 32% more times than in 2006. I expect this trend to continue in 2008, as the faster turnaround time and less scary perception of non invasive surgery seems to be en vogue right now.



Thanks for reading,

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center

Treating dark skin for acne with laser

Treating adult acne with lasers instead of risky pills is one of the hottest topics that plastic surgeons and dermatologists alike are focusing on. Dr. Goldberg just came from the ASDS meeting, where they talked about lasers and laser-like devices such as Isolaz that can help lead to radiant skin texture without taking antibiotics and/or Accutane.

One of the big roadblocks in all laser treatments has been the risks that darker skinned and Asian patients face, especially regarding hyperpigmentation. We posted on that here for laser hair removal.

I was just at the Sciton users group meeting in Los Angeles, where I was lecturing on advanced laser resurfacing and fractional laser resurfacing. An interesting topic related to this was presented was by Dr. Todd Besinger (who provided the above photo), a dermatologist from Hawaii. He presented some excellent data that shows that acne scarring can be treated very successfully in Asian patients with minimal post-inflammatory hyperpigmentation. For laser wonks out there, he had especially good results with the smaller spot size Sciton with each spot at 250 microns.

Experienced doctors out there have figured out how to treat all skin types with lasers. This is going to be a big story in 2009 as it becomes more widespread.

Dr. Jason Pozner
Sanctuary Plastic Surgery
Sanctuary Medical Aesthetic Center