Fraxel
A laser that heats thousands of microscopic columns in the skin and leaves the skin between them untouched. Used for sun damage, acne scars, and rough texture. It takes a course of treatments and a few days of looking sunburned each time.
Key facts
Treats
Acne scars, sun damage or rough texture
Recovery
3–7 days of redness or swelling
Treatment plan
Often 3–5 sessions, 2–4 weeks apart
Typical cost
About $900–1,500 per full-face session
What is it?
It is a nonablative fractional laser.
Fraxel heats microscopic zones while sparing skin in between.
Platforms differ.
Wavelength and device determine the treatment.
It is not CO2 resurfacing.
It is less intensive than ablative lasers.
It is not risk-free.
Burns, redness and pigment changes can occur.
What it treats
Acne Scarring
Improves rolling and boxcar scars.
Sun Spots
Clears sun damage.
Wrinkles and Fine Lines
Smooths texture.
Melasma
Low settings may help some.
Ice Pick Scars
Too deep for most sessions.
Rosacea
Can worsen redness.
Treatment areas
Fraxel
Face and hands.
Fraxel
Face and hands.
Skin tones
Lighter skin
Low risk
Redness and swelling for days.
Medium skin
Some risk
Dark marks possible; lower settings help.
Deeper skin
Some risk
Safer than ablative lasers at lower density with an experienced provider.
How it works
Diagram explanation
Fractional heat zones leave surrounding tissue untreated. Superficial 1927 nm treatment helps fade uneven pigmentation; deeper 1550 nm treatment triggers repair and collagen remodeling.
Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.
Types
Fraxel lasers come in two main wavelengths. One reaches deeper for texture and scars, the other works closer to the surface for pigment.
Before your treatment
2–4 weeks before
4 weeks before: Sun: Avoid tanning, self-tanner and sunburn.
Pigment preparation: For deeper skin tones, providers may prescribe a pigment-lowering cream for 2–4 weeks and test near the ear.
The week before
Cold sores: Tell your provider; preventive antiviral medicine often starts the day before.
Hair removal: Stop waxing, threading and hair-removal creams.
Actives: Stop retinoids, retinol and acids 3–7 days before.
Day of treatment
Before you arrive
Arrive with clean skin and no makeup.
Arrange a ride if you will have strong settings or oral pain medicine.
Arrival & prep
Skin is cleaned and photographed. Numbing cream stays on for 45–60 minutes.
Treatment
The laser passes over the skin while cold air cools it.
Expect prickly heat that builds with each pass, often strongly uncomfortable—especially on the forehead and around the mouth.
Before you leave
Skin feels hot, red and swollen. Ice packs and a bland ointment are usually applied.
After your treatment
First 24 hours
Days 1–2: Redness and swelling, especially around the eyes.
Days 2–7
Days 3–7: Rough, bronzed skin flakes away. Do not scrub or pick.
Beyond 1 month
1–3 months: Time to results.
Scar improvement can last years; sun damage can return with sun exposure.
Risks
Dark patches
Brown or gray patches may appear 2–6 weeks later, especially on deeper skin tones or after sun. Usually temporary, but clearing can take months; early treatment helps.
Worsening redness
Report redness that increases after the first week.
Cold sores
Report tingling or blisters, usually around the mouth, promptly; antiviral treatment works best early.
Acne or white bumps
Usually temporary and treatable.
Lighter patches
Uncommon and harder to correct than dark patches; report early.
Cost
Per session
About $900–1,500 for a full face in the US. Smaller areas cost less.
Full course
Several thousand dollars. Packages may reduce the per-session price.
Insurance
Cosmetic treatment is not covered. Coverage for surgical or injury scars is uncommon.
Alternatives
Microneedling
Aimed at the same acne scar and texture problems, without light or heat, so the pigment risk is lower, which matters on deeper skin tones. Generally cheaper per session and gentler, and generally slower to show the same amount of change.
Radiofrequency microneedling
Needles deliver heat below the surface while sparing the top layer, so it is often chosen for deeper skin tones and for people who also want some tightening. Costs more and stings more than plain microneedling.
Ablative fractional carbon dioxide laser
Removes tissue rather than heating it, so it does more per session for scars and lines. It also means an open wound, one to two weeks of real downtime, higher cost, and considerably more pigment risk on deeper skin tones.
Chemical peel
For surface pigment and clogged pores. Much cheaper and available almost anywhere. It works on the surface, so it does not reach indented scars and does far less for texture.
Clear + Brilliant
From the same manufacturer. A far gentler version of the same idea, with about a day of downtime and a much smaller result per session. A reasonable choice for early texture and dullness, not a substitute for a course of Fraxel on scars.
Topical tretinoin
Works on fine lines, texture, and pigment daily at home over many months, for a small fraction of the cost. Slower and less dramatic, and it is the thing that holds any laser result in place.
A prescription retinoid, or over-the-counter retinol
Improves fine lines, texture, and pigment over months of daily use. It is the closest thing at home to what a laser does, and it is what keeps a laser result. This is the sensible default.
Daily broad-spectrum sunscreen
Not a treatment for texture, but sun is what causes most of the pigment and much of the fine-line change. Without it, a course of laser is being undone as it goes.
Vitamin C serum and pigment-lowering ingredients such as azelaic acid or niacinamide
Useful for brown spots and general brightness. Slower and milder than a laser, and safe to keep using long term between sessions.
Home "fractional laser" handsets
A small number of low-powered devices exist and are cleared for wrinkles around the eyes. They deliver a tiny fraction of the energy of an office device, and results are correspondingly small.
Questions
How many Fraxel sessions will I need?
Three to five, two to four weeks apart. Sun damage sometimes needs fewer, acne scars usually need the full course, and deeper skin tones are treated at lower settings, which means more sessions.
Does Fraxel get rid of acne scars?
It improves them rather than removing them. Studies of nonablative fractional lasers show partial improvement in scar depth and appearance over a course. Deep icepick scars respond least and are often better treated by combining the laser with subcision or filler.
How much downtime is there really?
Plan for a week. Two days of redness and swelling, then a few days of rough, bronzed skin that flakes off. Most people cover it with makeup from day three and look normal by day seven.
Does it hurt?
With an hour of numbing cream and cold air, most people call it hot and strongly uncomfortable rather than unbearable, and it stops as soon as the laser does. The forehead and around the mouth are the worst.
Is it safe for deeper skin tones?
It can be done, but differently. The main risk is temporary dark patches. Lower settings, more sessions, pre-treatment creams and strict sun protection all lower that risk, and the provider experience with your skin tone matters more than the device.
Is Fraxel the same as CO2 laser?
No, though one device sold under the Fraxel brand is a carbon dioxide laser. The Fraxel most people mean is nonablative, heating the skin without removing the surface. A carbon dioxide laser removes tissue, does more per session, and brings one to two weeks of downtime and more pigment risk.
