What is the Fraxel dual laser (FDL) and what does it do?

The FDL utilizes two distinct wavelength of light which target different layers of the skin. The 1927nm (thulium) wavelength targets the upper layers of the skin to remove brown spots and discoloration, melasma, and actinic keratoses (precancerous), improving both texture and skin tone. This wavelength penetrates more superficially, and is often known as the “laser peel.”

The 1550nm (erbium) wavelenth targets deeper layers of the skin and is effective for smoothing fine to moderate wrinkles and scars, improving texture, tone, elasticity, and minimizing pore size.

Fraxel Laser Effect

Any area of the body can be treated such as face, chest, neck and hands. The result is smoother textured, more youthful and radiant skin with manageable downtime. The two distinct wavelengths allow for customization of treatments to address a patient’s individual needs. When wrinkling, texture, and/or discoloration are a concern, the 1927nm and 1550nm may be used during same treatment, or scheduled separately.

Before After Fraxel ExampleFraxel Example

Before Fraxel (left) and 1 month after treatment #2 (right)

How many treatments are needed, and how soon will I see results?

Usually 1 to 2 treatments are needed for the 1927nm laser peel, but certain skin types may require additional treatments. Results are typically seen immediately after peeling. Treatments are typically scheduled 4 to 6 weeks apart. The 1550nm requires at least three treatments to achieve optimal improvement for wrinkling and scarring. Treatments are performed 4 to 6 weeks apart. Many patients will see improvement in texture and tone immediately following the treatment. However, maximal improvement for wrinkling and scarring will take 3 to 6 months, as new collagen is being produced.

For patients with pigmentation, darker skin color, or history of darkening of the skin after injuries, previous laser treatments, or surgery 4 to 5 sessions may be needed since we will be performing more gentle treatments. Treatments are spaced 6 to 8 weeks apart instead of the typical four weeks apart. You will need to use a lightening cream at least four weeks prior to treatment and continuing for 3 to 6 months post-treatment.

How long do the treatments take?

The treatments typically take between 20 and 60 minutes to perform, depending on the area(s) being treated. We will numb your skin with a topical anesthetic for one hour prior to starting your treatment. For your comfort, you may also elect to use Pronox (laughing gas) during your procedure.

How should I prepare for my treatment?

  • We advise patients to avoid sun exposure and self tanners, and wear a SPF 30 sunscreen daily for two weeks before treatment. Treatment areas cannot be tanned prior to treatment
  • Products that contain retinol, retinoids, or glycolic acids should not be used for two weeks prior to treatment.
  • For darker skin types, patients treating pigmentation, or patients with a history of post inflammatory hyperpigmentation, should use a skin bleaching product for at least four weeks prior to treatment and 3 to 6 months following treatment.
  • Botox may be recommended 2 weeks prior to treatment to relax facial movement in key areas such as crows feet, frown lines, and forehead creases. This will allow for better laser penetration into deeper wrinkles.
  • If you have a history of cold sores/herpes on your lips/face, we will prescribe a preventative medication prior to your treatment. An antibiotic may also be prescribed to prevent infection.

What are the side effects and risks?

1927nm laser treatments may result in bronzing followed by peeling of the skin. Mild redness and swelling are common after the treatment. If a patient is treating pigmentation or has a darker skin type, there is a small risk of developing brown spots. We recommend additional special precautions with this type of skin. Patients seeking improvement with wrinkling utilizing the 1550nm wave length can expect more swelling and redness initially, followed by dryness, fine flaking, and itching. Keep in mind that side effects vary from patient to patient. Significant side effects are uncommon, but may include pigmentation changes, blistering and crusting. Scarring is extremely rare.

How can I maximize and maintain my results?

We strongly encourage all patients to apply a daily sunscreen to protect your skin from the harmful effects of UV exposure. Alastin Recovery Complex applied starting 2 weeks prior to and continuing afterwards has been shown to speed recovery and enhance collagen stimulation following Fraxel treatment. Patients seeking improvement for discoloration with the 1927nm wavelength should start a skin lightening product such as SkinMedica’s Lytera or a prescription strength hydroquinone cream a minimum of four weeks prior to treatment, and continue afterwards to help maintain results. Many factors can contribute to the risk of re-pigmentation including sun exposure, family history, hormonal influences. Periodic treatments can help slow down the aging process and minimize repigmentation.

What to expect after my treatment?

During the first 1 to 3 days after your procedure you will look slightly pink to red and swollen (like a sunburn), and you can experience peeling for up to 10 days. We do not recommend any strenuous exercise during the first 48 hours, and you should avoid the sun for 48 hours, wear a hat, and sunscreen thereafter. The majority of patients are able to return to work within 2 to 3 days. Make up may be worn the next day after treatment if desired.

Post-Treatment Care 

  • Avoid sun exposure for at least 48 hours.
  • Follow the post treatment skin care instructions and prescribed medications.
  • Avoid chemical peels, microneeding or other resurfacing procedures for at least 3 weeks.
  • Wait 2 weeks to resume retinoids such as Retin A (tretinoin)
  • Wait 2 weeks to resume waxing.

Please contact us for specials and most updated pricing.
Pronox (laughing gas) is included in any treatment $600 or more. Additional Pronox tubing is $50 if you do not bring your tubing back for subsequent treatments.

*All prices include a mandatory COVID-19 non-invasive rapid test performed the day of the treatment. Our COVID-19 rapid test is a gentle swab in your nostrils that is self-administered. If you test positive on the day of your treatment, your treatment will be rescheduled.