The photo above shows the result of a full face CO2 Laser Resurfacing for wrinkle removal done 10 years ago using the Ultrapulse CO2 laser, a revolutionary advance in 1995. While the wrinkle removal results were stunning, CO2 laser resurfacing created a “burn wound” that took months of recovery and after a year often left the skin white or hypo pigmented. Because of the prolonged recovery, the need for general anesthesia, and other side effects most people today do not choose to have this effective wrinkle removing procedure.

Over the past three years the concept of Fractional Skin Rejuvenation or fractional laser skin resurfacing has evolved. With Starlux Fractional Skin Rejuvenation the laser beam, an erbium laser beam, is broken up or fractionated into many small micro beams which are separated so that when they strike the skin surface small areas of the skin between the beams are not hit by the laser and left intact. (See Figure Below.)

The small areas treated by the Starlux and Fraxel fractional micro beams, called micro treatment zones, cause sufficient laser injury to promote new collagen production to replace collagen damaged by aging and sun exposure. The new collagen produced by the laser injury “plumps” skin wrinkles. The intact skin between the micro treatment zones allows for much more rapid healing-3-4 days as opposed to 2-3 weeks for the older CO2, and enough pigment cells are left intact that hypo pigmentation does not occur.

The diagram above shows the progression of laser skin rejuvenation technology from the older CO2 on the left to the newest Starlux fractional ablative lasers which have just been released. The Fraxel laser and the Starlux 1540 are depicted in the 3^rd illustration under Non ablative fractional laser resurfacing.

Starlux Fractional Non Ablative Laser Resurfacing

To ablate means to “surgically remove”. The Fraxel and Starlux1540 are non ablative lasers which mean that when the laser beam strikes the skin the skin is not removed immediately, rather the laser beam heats the skin to cause inflammation and new collagen production. The benefits of the Starlux 1540 non ablative laser skin treatments are dramatically reduced recovery time, but the results in terms of wrinkle removal and skin tightening are less dramatic than with ablative lasers.

However, the new Starlux 1540 fractional lasers are able to penetrate much deeper than traditional non fractional ablative lasers and we are discovering that deeper penetration of the laser produces a much more dramatic stimulation of new collagen formation which translates into a plumping effect on the skin. This is particularly useful in treating depressed acne scars.

Another diagram which helps explain the Starlux 1540 effect is the microscopic section of skin that has been treated with the Starlux fractional laser below.

In summary, the benefits of Starlux fractional non ablative laser skin treatments are:

1. Less down time- only pink skin for 1-2 days and a day or so of bronzing that can be covered with make up
2. Better new collagen production in the deeper skin layers causing skin plumping especially of acne scars
3. Fewer complications like hyper pigmentation (although with Fraxel there is a 15% incidence of hyper pigmentation (darkening of treated areas) especially in dark skinned people, but it is temporary.
4. Improvement in skin texture and possibly enlarged pores
5. Improvement in wrinkles (See Photos below of Lux 1540 Results)

Above-Before and after Starlux 1540 non-ablative fractional laser skin resurfacing, treatment-Photos courtesy of Palomar and Dr Dwight Scarborough

The Future-Starlux Fractional Ablative Laser Resurfacing

Recently several new fractional ablative lasers have been developed which have the benefits of fractional treatments, less down time and complications, as well as the benefits of ablative skin resurfacing, better wrinkle removal and facial rejuvenation. The Starlux fractional ablative lasers are depicted in the last or 4^th picture in the first comparative fractional laser diagram above.

The fractional ablative lasers remove the tissue in the micro treatment zone rather than just heating it as is done with Fraxel and the Starlux 1540.

The benefit of ablation is that more sun damaged, wrinkled skin is removed than with the Starlux 1540 or Fraxel, and better wrinkle removal and skin surface smoothing and textural improvement is achieved. This however comes at the price of some recovery time, redness and pinkness for 4-6 days. The Starlux fractional ablative lasers however require much less recovery time than the traditional non fractional erbium and CO2 ablative lasers which required weeks of recovery. Reliant, the company that makes Fraxel has released a new CO2 fractional laser called the Repair, Lumenis has released a CO2 fractional ablative laser called ActiveFX and DeepFx for Bridge Therapy, and Palomar has released the Starlux 2940, an Erbium fractional ablative skin resurfacing laser.

Impressive wrinkle removal and improvement in skin texture is achieved with the Starlux 2940 fractional ablative laser (see Photos of my patients Below).

Above: Before and after Starlux 2940 fractional laser skin resurfacing.

Above: Before and after Starlux 1540 and 2940 combined fractional laser skin resurfacing.

Above: Before and after Starlux 1540 and 2940 combined fractional laser skin resurfacing.

The first non ablative fractional laser on the market was the Fraxel. The Starlux 1540 and 2940 are newer and improved fractional laser skin resurfacing technology.

The field of laser skin rejuvenation is advancing rapidly and new technological breakthroughs occur frequently. The benefit to you is that better wrinkle removal results are possible with less down time and fewer potential side effects.

The applications of fractional laser technology are expanding to other fields like skin tightening and eventually to fat and cellulite removal.

For further information on the Starlux fractional erbium laser skin resurfacing laser for skin rejuvenation and facial aging read Save Your Face or contact me. In my practice I use the new Starlux 1540 Fractional Non ablative erbium laser and the Starlux 2940 ablative fractional laser for skin rejuvenation.

Be sure to sign up fro my free email newsletter to keep up on new developments.

Dr Seckel
978-369-4499

Concord, Massachusetts

Boston, Massachusetts

However CO2 laser resurfacing has several limitations including a prolonged and difficult recovery period, often lasting three weeks, prolonged facial redness that can last three months, hypo pigmentation or lightening of skin color, and the potential for infection which can lead to scarring.

During the past three years new technology called fractional laser resurfacing has been developed which has dramatically shortened recovery time and lessened the occurrence of complications.

With fractional laser resurfacing the laser beam is broken up or fractionated into many small micro beams which are separated so that when they strike the skin surface small areas of the skin between the beams are not hit by the laser and left intact. These small areas of untreated skin promote a much more rapid recovery and healing with less risk of complications. The small areas treated by the fractional micro beams, called micro treatment zones, cause sufficient laser injury to promote new collagen production and resultant facial skin rejuvenation. ( See Diagram Below)

In the above skin diagram, the first red area on the left represents traditional non fractional ablative CO2 and Erbium laser resurfacing. To ablate means to surgically remove and the skin tissue is removed by the heat of the CO2 or Erbium laser. Since these lasers were not fractional, all of the skin in the treated area is removed creating an open wound that takes a long time to heal.

The second drawing is the Lumenis® ActiveFX fractional CO2 laser which fractionally ablated the surface of the skin down to a depth of 70-100 microns. This laser is fractional and the skin heals much quicker, but depth of penetration is not deep enough to produce substantial wrinkle removal, skin tightening and skin rejuvenation.

The third red areas represent the non ablative fractional laser technologies which heat but do not ablate the skin. These lasers use an Erbium laser to heat small columns of the deep skin layers to promote new collagen production and plump the skin and skin wrinkles. Recovery time is much less than with traditional ablative CO2 and Erbium lasers. Examples of the non ablative fractional lasers are the Fraxel® and the Palomar® Lux1540 fractional non-ablative lasers. These lasers are excellent for improving skin texture, plumping wrinkles and acne scars, and shrinking pores, but multiple treatments are required.

More recently several new fractional ablative lasers (ablate means to surgically remove-see last column on right in diagram below) have been developed which actually remove the heated column of skin tissue and provide more substantial wrinkle removal and superficial skin tightening than the non ablative fractional lasers (See Last Figure on Right in Above Diagram). The Fraxel® Repair laser and the Lumenis® Bridge laser are ablative fractional CO2 lasers and the Palomar® Lux2940 laser is an ablative fractional Erbium laser. These new ablative fractional CO2 and Erbium lasers have the advantage of producing better wrinkle removal and skin rejuvenation than the non-ablative fractional lasers, the Fraxel® and Palomar® Lux1540 with less down time than the traditional non fractional ablative CO2 and Erbium lasers.

These fractional ablative CO2 and Erbium lasers reach much deeper into the skin, 600 to 1000 microns, and can produce much more effective wrinkle removal and skin rejuvenation with significantly less down time and recovery than traditional CO2 and Erbium non fractional ablative laser resurfacing. The Erbium laser produces less heat than the CO2 laser and traditionally recovery time, the time for redness of the skin to go away, has been less with the Erbium laser than with the CO2 laser.

The photo below shows the wrinkle removal results achieved with the new Palomar® Lux2940 micro fractional ablative Erbium laser with only 4-6 days of down time as compared to 3 weeks of down time and 3 months of redness with a traditional CO2 laser resurfacing.

The new micro fractional ablative Erbium and CO2 laser resurfacing techniques are very exciting advances in the field of non surgical facial rejuvenation and wrinkle removal. Many new applications are being developed which will likely improve our ability to rejuvenate the skin and possibly improve scars, stretch marks, and remove pigment.

To learn more about non surgical facial rejuvenation, read Save Your Face or contact me.

Dr. Seckel

Concord, Massachusetts

Boston, Massachusetts

978-369-4499