Fractional Laser Resurfacing

Fractional laser resurfacing is the use of laser to heat up / destroy a fraction of the skin tissue while leaving a fraction of normal, untreated tissue to promote quicker healing and a lower incidence of side effects. The laser energy is aimed at the skin in columns and generates heat that destroys only that tissue; the surrounding unaffected tissue then comes in to promote quicker healing with less downtime or side effects. Fractional laser resurfacing comes in two primary modalities:

  • Nonablative fractional resurfacing
  • Ablative fractional resurfacing

Below is a discussion of each type of laser resurfacing.

Nonablative Fractional Laser Resurfacing

Nonablative fractional resurfacing uses infrared laser wavelengths to heat up the second layer of the skin (dermis) while leaving the top layer of the skin (epidermis) intact. The laser energy is aimed in columns as described above, but does not damage the top layer and thus does not have any crusting, scaling, bleeding, or peeling associated with the procedure. The advantages are that there is less pain, downtime, and cost. The disadvantage is that it isn’t as effective as ablative laser resurfacing and may need many treatments to achieve the desired result.

This laser is best used for treating fine textural wrinkling, primarily around the eyes or mouth, and may achieve a small degree of skin tightening for upper and lower eyelids.

Ablative Fractional Laser Resurfacing

Ablative fractional laser resurfacing uses CO2, Erbium, or post-infrared wavelengths in order to heat up water in the first and second layers of the skin. Again, this modality heats up the tissue in columns and the sparing of normal skin allows for quicker healing with decreased side effects. Since the top layer of the skin (epidermis) is being destroyed along with the second layer (demris), there is significant peeling, crusting, scabbing associated with this procedure. The downtime is significantly longer than nonablative treatments. The advantages are that it is more effective with a less number of treatments. The disadvantages are the increased cost, increased downtime, and increased pain. This treatment is best for full face rejuvenation, eyelid rejuvenation, more vigorous anti-aging rejuvenation around the mouth, acne scarring, scar revision, and for removal of dark spots and preceancers. In many cases, ablative resurfacing does still require more than one treatment.

We offer the Matrix CO2 Ablative Fractional laser in our office. Read more about the Matrix CO2 laser here.


Nonablative Fractional Resurfacing

  • Doesn’t destroy the top layer of skin
  • Less pain, no scabbing, crusting, peeling
  • Less downtime (3-5 days)
  • Less cost
  • Need more treatments vs. ablative
  • Great for slight tightening, around eyes/mouth

Ablative Fractional Resurfacing

  • Destroys both layers of the skin
  • More pain, does have scabbing, crusting, peeling
  • More downtime
  • More cost
  • Need fewer treatments vs. nonablative
  • Great for full face rejuvenation, acne scarring, scar revision

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