Fractional Resurfacing Treatments

Our world is excessively focused on youth and beauty, otherwise there would not be millions upon millions of creams, peels, lotions, potions, serums, advanced technology or injectables! For majority, it is all too confusing, but how could it not be? We have many manufacturers quickly spit out treatments, put a slightly different tweak on it and try to convince you, it is brand new, the best, the greatest! When in fact, they are using already discovered treatments and are attempting to refurbish them to convince the end user, there is nothing else out there like it.

I will focus my attention on Fractional Resurfacing treatments. On tv, on social media, in clinics it’s all the rage, and over the last decade, the variety and tweaks to good old-fashioned fractional treatments has exploded.

What is then a fractional treatment? Think of it like aerating your lawn. The purpose is to cause small areas of damage, to allow the healthy surrounding area an increase in oxygen and nutrients and to jumpstart the healing, which at the end of the healing cycle improves the look of your lawn, or as is the case for your skin using fractional resurfacing. The analogy isn’t perfect but it’s dang near close.

Now that we have established the benefits of using fractionated treatments for the treatment of aging, fine lines, wrinkles, hyperpigmentation, scarring, the list goes on… let’s figure out what equipment is best for the job.

You have more than likely heard about the Fraxel, the Pixel, the Clear Lift, the CO2, the Venus Viva, the Fractora, eMatrix, and many more, yet what no one takes the time to clear up is the fact that all these technologies take a form of energy, supplied by the electromagnetic spectrum, and apply it to the skin in small “dots” in a matrix (or a grid pattern for the purpose of injuring a tiny portion of skin and relying on your own skin’s injury healing mechanism to take care of the rest. (The Wound Healing Cascade) Same concept applies to all forms of microneedling as well!

So, what exactly sets these numerous machines apart? First, the spectrum of energy it uses and what is powering it? The electromagnetic spectrum is simply a range of frequencies of electromagnetic radiation, as well as their respective wavelengths and photon energies. We are surrounded by this spectrum; we live and depend on it for many things. The science has discovered a multitude of applications, when a specific spectrum is selected to produce different effects, in our case, for therapeutic and medical purposes.

Now, getting to the second part, the power supply, the excitation portion. In the case of true light therapy (IPL and Laser) plugging in to the outlet to get electrical power will not make you the type of light that can accomplish the job, this is when we need the help of a medium, this can be gas, liquids or solids. (More on this in my first article, Laser vs I.P.L., you should check it out)

So, you have a C02 Fractional, that means you are getting a laser treatment, or maybe it’s an erbium yag (er:Yag) in which case it is still a laser treatment using a solid medium… and so forth (do you see the pattern?)

Let’s work our way though the electromagnetic spectrum and pick up a radio frequency out of the line up. Still rather a simple concept of using form of energy to “burn” a dot into the skin, or a grid of dots. Therefore, the treatment is still fractionated but is using a different kind of energy to accomplish the job.

Usually, around this part of the lesson, the confusion arises over when to use which energy. Questions of who is a good candidate? What are contraindications for each? When would you use one over the other? Etc…

The short answer: you usually can’t afford more than one technology and those that do, have large clinics with more equipment than capable technicians. In my humble opinion, all these previously mentioned technologies are very lovely, they deliver the promised result but only when used to its potential correctly. Downfall to our industry, are uneducated technicians operating equipment far superior to their limited knowledge. It is not as simple as plugging it in and hitting a few buttons before we blast holes into your skin.

Expert knowledge of skin components and how they work is paramount, as is the understanding of lifestyle and contraindications so we can determine which treatment, how often, how many and what pre and post care protocols will be involved before you can ever bring the technology to the patient’s face. All technology has limitations and that is acceptable in the hands of a technician who isn’t afraid of admitting, the equipment they invested in, may not be the very best option for everyone. In their pursuit to make a sale, there is no winners or benefits to you, the consumer.


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