Fraxel is safe in all skin types!

Fractional non-ablative laser resurfacing at wavelength of 1550nm has been used for rejuvenation and resurfacing of skin. The 1550nm wavelength does not target melanocytes. Therefore, it is thought of as being safe for patients with darker skin color since risk of post-inflammatory pigmentation should be low. The device also allows the clinician to adjust the settings to each patient’s skin type to control erythema caused by the laser.

A recent review by Alexis and colleagues examined effect of 115 sessions with 1550 nm erbium-doped fractional nonablative laser (Fraxel Re:Store SR 1550; Solta Medical, Hayword, CA) in 45 patients with Fitpatrick skin phototypes IV-VI. These sessions were performed between January 2008 and January 2012. The study specifically examined frequency of treatment-associated postinflammatory hyperpigmentation (PIH) and treatment settings.

Acne scarring was the most common reason for treatment in this study. The authors found that higher mean energy levels were more likely to be associated with PIH than lower level: 60.8 mJ vs. 44.7 mJ, respectively (P=.05). Treatment levels and number of passes did not make a significant difference.

This study confirms what some clinicians have seen in practice. Namely, that fractional non-ablative laser resurfacing is safe in patients with Fitzpatrick skin types IV-VI. However, it is prudent to keep the energy levels down to avoid PIH. This author routinely recommends sunscreen and hydroquinone after treatment.