What is the fractional laser?
In recent years the progress in technology has made available lasers with so-called fractional technology (the laser beam is fractionated at the source and hits the skin in the form of a high number of discontinuous micro rays,) which makes it possible to concentrate the ablative properties and the thermal stimulus of the laser on the tissues only in some points which are separated by areas of healthy skin. This enables us to rejuvenate the skin with a considerable depth of action and a significant thermal stimulation of the connective tissues, but reducing the aggressiveness with respect to the traditional ablative laser treatments, and therefore consequently reducing or eliminating the convalescence time. According to the type of laser source used, fractional technologies can have an ablative effect, that is, with the removal of the superficial layers, and therefore with a visible exfoliation and a few days convalescence (fractional CO2 laser), or a non ablative effect, without removing the superficial layers and therefore with no convalescence (fractional 1540 laser).
1540 laser non ablative
The 1540 non ablative laser emits a “rain” of micro rays which hits the skin causing coagulation processes “in columns”, deep in the tissues, leaving the surface skin practically intact. The micro areas of skin coagulated by the laser stimulate the healing process, restructuring and remodeling the skin in a way similar to what is obtainable with a massive treatment of the whole area treated, but in this case limited to the single “columns” of laser-skin interaction. This means that, since the effect of the laser is wholly produced in depth, la surface remains almost intact even after carrying out high energy treatments. In this way there is no exfoliation and the post-operative effects are limited to some reddening and a slight swelling, which lasts for a varying time from a few hours to a few days. The lack of convalescence downtime means that there is no interruption in social and work routines.
Fractional laser treatment
The treatment, on the other hand, is not able to eliminate wrinkles or deep folds and dynamic wrinkles caused by muscular contractions. The treatment is not recommended for very dark or black skins, due to the high risk of alterations of the pigmentation, for those who have had systemic anti-acne therapy with retinoids in the previous 6 months, for those who tend to develop hypertrophic and keloid scars, or when there is an on-going infection.
In this case, preparation for the treatment can even be null, although a preventive use of smoothing creams, for example alpha hydroxic acid based products, helps the laser to work better. The only limitation is the need for the skin not to be sun-tanned. The treatment is slightly uncomfortable but can be made more agreeable by applying a preventative anaesthetic cream an hour beforehand. The treatment is usually carried out on the whole of the face with the intention of improving the texture of the skin and the pores, but there are also other uses, such as for treating acne scars and stretch-marks, which achieve extraordinary results with this laser. The treatment is carried out on an outpatient basis, in varying lengths of time according to the areas to be treated (30-40 minutes for a full face, 10-15 for reduced areas, such as the contours of the eyes and the mouth, a varying time in other uses, which can be from 1-2 minutes for the treatment of small scars or even more than an hour for extensive, numerous stretch marks). The post-operative downtime is minimal with respect to almost any other photo-rejuvenating procedure such as non-fractional laser resurfacing, or fractional laser resurfacing. The patient can go back to her social and work routine immediately and there is no interruption in relationships. In fact, the effect of the treatment consists of a slight redness, which is easily played down with light make-up, and a little swelling which lasts from 24-48 hours. The healing process is completed in 5-6 days but actually no modification of the surface of the skin is to be noted. Only in cases using very high energy, and above-all in the non facial areas, there may be a residual redness for a few weeks. The fractional 1540 non-ablative laser produces a remodeling effect of all the layers of the skin that it crosses, for a depth that can be even more than a millimeter, with a resulting improvement of the skin texture, of the pores, of the micro wrinkles and of other minor blemishes of the skin. Modeling obtained in this way is especially appreciable on structural lesions of the skin, such as stretch marks and scars. Acne scars encounter a dramatic improvement following the remodeling of all the deep layers of the skin, with a stable, durable outcome. Even stretch marks encounter a really efficacious therapy with this laser – (Starlux Palomar 1540 is the only laser to have obtained the FDA American authorization for this type of treatment): obviously the effect will not be to eliminate the stretch-marks, but to remodel the surface of the skin to the extent that they appear almost invisible.
Effects of photorejuvenation with fractional laser
The side-effects are almost non existent, since the method of delivering the energy means that the superficial layer of the skin is saved from the treatment, which favours very fast healing, with an immediate return to one’s normal complexion and sensitivity of the skin itself. Furthermore the reduced thermal insult to the tissues means that there is practically no residual redness. Even after this treatment, however, it is absolutely essential to apply a total sun-screen for at least two months. Complications are extremely rare but can include skin infections (usually caused by poor hygiene immediately after, in the post-operative period), flaring up of Herpes (as for any laser procedure) the risk is limited by taking anti-viral medication before the operation), major sensitivity of the skin to thermal and luminous stimuli (the use of appropriate sun-screens minimizes this risk).
Therefore, this laser combines the advantages of a great therapeutic effectiveness with the possibility of returning to one’s daily routine immediately. The clinical effects will be achieved after a series of sessions (from 3 to 8 usually) repeated at monthly intervals, resulting in a progressive and profound renewal of the epidermis and the dermis.