It used to be that “laser resurfacing” meant one and only one thing. Before 2005 laser resurfacing was always “full field” which meant that 100% of the skin was resurfaced. It was the prevailing method for performing laser resurfacing. But with CO2 lasers dominating the field, the procedure had several drawbacks. The first was that it could not be performed on darker skin types. The second was that it had a substantial amount of downtime – typically 2-4 weeks for recovery. Finally the procedure often left a shiny or waxy appearance to the skin after it was completed.

In 2005, with the introduction of the Fraxel brand, laser resurfacing changed forever. “Fractional laser resurfacing” was born to address several concerns with traditional CO2 resurfacing. First, fractional laser resurfacing could be used on all skin types. Now, darker skin types including African Americans could participate in the benefits of laser resurfacing without the risks of traditional CO2 resurfacing. Downtime with the new method of resurfacing was now limited to 1 week and general anesthesia was no longer needed for the procedure.

Fractional laser resurfacing, just as the name implies, only resurfaces a fraction of the skin. It pokes tiny holes in the surface of the skin. The laser practitioner can decide if 10%, 20% or 40% of the skin should be resurfaced by making more than one pass with the laser. The primary laser beam is subdivided into thousands of smaller beams that create tiny holes in the skin. These holes are created when light from the laser is turned into heat as it penetrates the skin. The heat vaporizes the tissue and small voids are created. The body’s process of repairing these tiny holes in the skin is what creates an improvement to acne scars, fine lines and large pores.

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