How does a Fraxel Laser (FL) work?
Fractional (Fraxel) means that the skin is lasered in fractions. With its vertical laser beam the FL sets thermally heated channels in the dermis down to a depth of about 700 nm (0.7 mm). The dermal proteins are “melted” and destroyed that results in a necrotic tissue. This “heated” tissue transforms into an unformatted fibrotic tissue, a micro scar. By setting thermal scars side by side, the scary tissue finally becomes confluent by forming a scar layer underneath the epidermis with an upholstery effect against wrinkles.
Long term investment of Laser vs. microneedling device/roller
The latest Fraxel generations may cost everything between 50,000 and 100,000 EUR. Most of these units are not bought cash, but leased and that results in very high monthly leasing costs. The monthly leasing rates must be recovered. Quite often a FL treatment is associated with terms “soft and easy” but in reality any laser treatment is relatively painful, regardless how much topical anaesthetic cream is applied. The reason for the pain is the thermal injury with its longer healing cycle and the burning of nerves that results in a longer and stronger nerve pain memory effect. Costs of about 600-800 Euros per treatment are at the lower range. 5 treatments will result in at least 3,000 Euros.
The physician/therapist has a very low investment. Statistics from around the world gives clear evidence that only 3 microneedling procedures are sufficient to achieve improvement in acne scars in the range of 70%. A physician/therapist also should take in consideration that microneedling has no reported negative side effects, especially in respect of pigmentation changes (particularly on darker skin types), and that the microneedlng can be repeatedly performed on all skin parts of the body and that there are no long-term investments and extra maintenance charges like a high-tech equipment. The treatment intervals for microneedling treatment should be 3-6 weeks apart.
How long will induced collagen last?
The body reacts to any foreign object by encapsulating it with fibrosis initially. Statistics from those experiences clearly showed, that the fibrotic tissue formation reached its peak after 2 to 3 months and than was slowly downgraded by an average loss of 20% per year. The reason for this degradation is not known but we can assume that the body, by whatever means, detects a surplus of connective tissue and downgrades it over time. This possibly is one of the reasons why a scar degrades and becomes less visible over time.
Despite the fact, if microneedling is performed or not, we always have to take in consideration that the aging process of the body and its skin continues. The collagen grid becomes thinner and fragile and the visible results are wrinkles. This age related or photo-damage induced collagen shrinkage can be compensated by microneedling.
In order to stabilise and maintain this improvement we recommend microneedling sessions every year. During the initial 3-6 microneedling treatments, that should be three to six weeks apart, between treatments and after the last Microneedle Therapy we recommend the use of suitable home care products.
Rule of thumb for skin improvement:
After 1st procedure: 30-40%
After 2nd procedure: about 50% of the 1st treatment
After 3rd procedure: about 50% of the 2nd treatment..............
In total: 50- 70% overall improvement after only 3 treatments. The worst a physician or therapist could do is to give the patient to high and non-realistic improvement expectations. We are all individuals and therefore cannot expect permanently good results. It is a fact that skin of older people and heavily sun damaged tissue especially in combination with nicotine abuse will have a far less response to microneedling as younger persons. In such cases expectations must be reduced dramatically.