My Experience with Fraxel Dual

By Pacific Derm on September 18 2013

One of Pacific Dermaesthetics’ patients, Kate Britt, wrote a blog diary in 2011 about her first experience with a Fraxel laser treatment. While her blog post is no longer online, she has written a second blog diary about her follow-up Fraxel experience. If you’re interested in having a Fraxel treatment, Kate’s post will give you a good idea of what to expect before, during and after treatment. Please note that this is one patient’s experience. Your treatment experience may differ depending on your skin colour, skin type, age and treatment parameters. 

June 11, 2013 – Day 0 – The day before treatment

I’ve decided to get a “Fraxel Dual” treatment on my face.

I had my first Fraxel laser treatment two years ago. My main purpose was to address the many age spots I had on my face. They made me look and feel older. I don’t mind the normal process of aging or my wrinkles or grey hair. However, I don’t believe these spots on my face are within the “normal process of aging”—no, they tell an embarrassing tale of foolish fair-skinned me sitting in the sun too much in my younger years. Let’s call it what it is: Sun damage.

Here’s what I’m talking about – before Fraxel shots from 2011:



For about a decade I had been trying to get rid of those spots. I tried every face-cream there is out there. Taking them in turns, giving each of them a year or more trial to give them time to work, I’ve tried creams containing retinol/retinoids, glycolic acid, Vitamin A, Vitamin E, Vitamin C, hyaluronic acid, ascorbyl glucoside, l-ascorbic acid, lactic acid, citric acid, beta-hydroxy acids. Various brands, all fairly expensive. I have a sunspot on one shoulder, which I left untreated as a “control” for color comparison. From that, I could see that the bigger spots on my face had faded only slightly and were nowhere near gone.

I’m 64 years old and I’m often told I look younger than my years, but my mirror tells me that those brown skin-damaged spots detract from my otherwise youthful look and demeanor.


MyFraxel-2013.2In 2011, Dr. Jason Rivers did my original Fraxel treatment. He explained that the Fraxel Restore Dual laser boosts the skin’s collagen, which stimulates the growth of new skin cells to enable skin healing and promote skin renewal. In doing so, the treatment also repairs the older skin texture and tone, and reduces the fine wrinkle lines. All of this leads to an overall refreshed and rejuvenated look.

As a very important bonus, Fraxel also treats any pre-cancerous skin areas that may exist without our knowing about them.

The results of my 2011 treatment were fantastic! Dr. Rivers said that my face’s age lost 5 to 10 years. I couldn’t see it until I put the ‘before’ and ‘after’ photos side by side:

Now, two years later, I’m comparing my ‘after’ photo from 2011 and this new 2013 photo (taken at Pacific Dermaesthetics before my treatment).


My skin is now looking relatively dull again and I have some new age spots. Once again, my main motivation for getting another Fraxel treatment is to get rid of those brown spots.

Here’s the UV version of the above, showing the new sun damage below the surface, invisible to the eye. Yikes!

Rather than a touch-up maintenance treatment for the spots, Dr. Rivers recommended that I get another full-face treatment, not only to address the new age spots but also to achieve that overall skin rejuvenation. So that’s what we’re doing.

I have done the pre-treatment prep as instructed. For two weeks ahead, I’ve avoided all sun exposure. For one week ahead, I’ve avoided alcohol, aspirin, Vitamin E products, and face creams with retinol or glycolic acid.

June 12, 2013 – Day 1 – Treatment day

As instructed for pre-treatment prep, I went for my treatment with no makeup or face creams on my face and wore comfortable clothing. I took along a little snack, a bottle of water, and my eReader.

I was in the treatment offices for just under 3 hours total.

First I met with Sara, a Clinician, who took some ‘before’ photos of my face. The most dramatic are the UV shots that show the damage we can’t see with the naked eye or in normal photos. Even though I’ve been vigilant since my 2011 treatment about using SPF 60 whenever I’m out in the sun, the UV photos show new damage. Sara said that perhaps those damaged areas of skin had been there before, but in deeper skin layers than the first Fraxel could get to, and now they’re closer to the surface.



Then Sara took me to the treatment room and gave me two Tylenols (1000 mg total) to help me with any discomfort I might feel during the treatment. Dr. Rivers came in to discuss the treatment I’d be getting. He said he was extremely happy with how well the results of the 2011 treatment had lasted and (best comment of all 🙂 he said I still look younger than when he first met me two years ago. We compared the ‘after’ photos from 2011 with today’s ‘before’ photos to discuss the differences. Then he left for a while so that Sara could prepare my face.

Sara got me settled on the comfortable horizontal chair in the treatment room. First she cleaned my face with a gel cleanser; then she applied some numbing gel.

During the one-hour wait for the gel to do its work, I relaxed, read, and enjoyed the snack I’d brought with me. Sara returned about halfway through to apply a little more gel. Then Sara cleaned the gel off my face and I was ready.

Day1_011-Dr.RiversAfter Sara placed some protective covers over my eyes, Dr. Rivers began the Fraxel treatment. He began with the cheek, then the chin, then upper lip, then the nose, and finally the forehead.

As Dr. Rivers worked with the Fraxel laser wand, he frequently asked me how I was doing, how my face was feeling, made sure I was relaxed and comfortable. The total laser time was about 15 to 20 minutes. As he worked, we chatted. I asked him a few details about the process and found out that each area of my face got four passes with the laser wand, two vertical and two horizontal.

This photo shows one cheek complete, and only half of the other cheek.

This photo shows one cheek complete, and only half of the other cheek.

I asked if he could easily tell which parts of the skin were done, that is, did the laser leave a visible “trail” like when we mow a lawn. He thought that was a funny analogy, but yes, he said he can see a red path as he works and he is very careful not to overlap one path with the next.

People ask me, did it hurt? What did it feel like? Well, the feeling on my skin was a mild sensation, somewhat like a couple of fingernails gently gliding across the skin. I can say that it was not painful at all—because of the numbing gel I guess—but there’s a definite sensation that told me where the laser was on my face. I could feel my skin getting kind of hot, the feeling of a bad sunburn but without the pain of a burn, again probably because of the gel. I could also compare it to the heat of feverish skin.Day1_026.right after treatment

Immediately after he was done, Sara draped my face with wet, icy cold cloths, which made the heat calm down and felt very good. The cloths were on for about 10 minutes.

When she took off the cloths, Sara touched my face here and there to make sure the skin heat had gone down. Then she applied a cooling gel, followed by some sunscreen to protect my face for my trip home.

Before I left, Sara gave me a handout about what I should do at home for post-treatment care of my skin during the various stages of the healing process.

I’m at home, about two hours after the treatment, and the numbing effect has begun to go away. My face has gradually gotten redder and redder and it feels glowing hot. The skin feels tight, as if I’ve been in the sun way too long and have a bad sunburn. I’m sure everybody knows what that feels like. There’s also a strong tingling or stinging sensation. hour hour after ……..

It’s the end of the evening, about 9 hours after treatment. After the numbing effect wore off completely (about 4 hours after treatment), my skin actually felt better and I didn’t even notice it as I sat watching TV. I suppose the tingling feeling I had earlier was mostly from the ‘freezing’ (i.e., the effects of the numbing gel) coming out.Day1_032.nine hrs after

Now my skin feels very tight, prickly, crispy, as if I’d applied some raw egg whites and then let it dry. It’s also feeling really hot. My husband said it looks a little puffy and quite red. So I’m going to lie down and use the cold-packs that Sara gave me to bring home. I don’t know whether I’ll sleep comfortably because I’m not sure how my face will feel on the pillow for the night.

I actually I had no problem going to sleep or sleeping through the night. Before bed, I washed my face with a super-gentle cleanser using only my hands (no face cloth) and very little pressure on the skin. It was super-sensitive to the touch. Then I applied some serum that has Vitamin C in it because that’s supposed to boost healing. Then some gentle, rich moisturizer.

(Note: If you’re reading this because you’re considering having a Fraxel treatment, please don’t follow my lead on how to take care of your post-Fraxel skin. Your dermatologist will give you his/her instructions to follow.)

June 13 – Day 2

I woke up to a very prickly feeling all over my face, and some parts of it were itchy. Throughout the morning, I’ve had to focus on not reaching up to scratch it. It’s still very red. The skin feels extremely tight, as if it would crack if I smile. Not true, of course, but that’s the sensation. The inflamed-looking puffiness I saw last night has gone down.IMG_0135

I’ve noticed some fine red pin-spots in the chin area. Surrounding those pin-spots, the skin is lifting slightly in very small flakey bits. A few of the brown spots have darkened and become much more obvious.

Touching my skin, I’d say the texture on the flaky chin and on the darkened brown spots is like very fine sandpaper. I’m using moisturizer frequently. It reduces the itch and relieves the feeling of tightness. Even right after applying moisturizer, the overall texture is like extremely dry, rough skin.

June 14 – Day 3

There’s no significant change in how my face feels today. It’s not sore at all. The dominant skin-feeling is still tight and itchy, although the tightness is less than yesterday and the itch is much greater. It’s all I can do to keep my hands away from it! Frequent moisturizing helps reduce the itch.

Kate Britt Fraxel Day 3Kate Britt Fraxel Day 3.bWhen I apply the moisturizer, it’s like spreading it on rough sandpaper. The roughness isn’t reduced with the moisturizer, but the itch certainly is, at least temporarily.

The formerly bright-red color has toned down to a calmer pink with a few red spots. The dark sunspot areas are even darker, and up close I can see that those spots are breaking up and rough-looking instead of the smooth, solid color they had before.

My lower jaw, especially the chin area, is beginning to get a little flaky now and the flakes look like I could just rub them off. But I won’t because I don’t want to rush the process in case I do some kind of damage to the new skin below the flakes. I’d rather let it just happen in due time.

I’m glad I’m retired, because I can’t imagine going to work looking like this. I guess that’s the ego speaking. 🙂

June 15 – Day 4

Big progress today! When I woke up, my pillowcase had quite a few fine flakes of dead skin on it. I looked in the mirror and saw that my face was covered with flaking skin, like a peeling sunburn.

See the progress of the flakes coming off and the fresh pink skin starting to peek through.

See the progress of the flakes coming off and the fresh pink skin starting to peek through.

A lot of the flakes are loose enough that they drop off if I lightly rub my fingers over my face. I don’t want to rub too much in case of doing damage to the new skin underneath. So I’m just applying moisturizer (about 4 or 5 times a day) and trying to otherwise leave it alone—although the itch is constant, as you can imagine with all that flakey dead skin wanting to come off.

The overall color of my face isn’t as red as it has been the previous days. It’s more of a pink color. And it’s more blotchy-looking, with some areas getting back to a normal skin tone, amid the pinker areas where the new skin is and the dry brownish-red areas where the flakes are falling away. My husband called it “snake skin” today and I can see why—but I prefer to think of it as flaky rather than ‘scaly’, which is what I presume he means.


This shows where the brown sun damage areas are breaking up and the brown skin is starting to flake off.

This shows where the brown sun damage areas are breaking up and the brown skin is starting to flake off.

There’s a light prickly feeling on the surface of my face today—a change from the previous tingling and tightness. Itching is still the dominant sensation.

The new, very pink skin that’s visible where the flakes are completely gone—most notably on my upper cheeks, presumably the places that left the flakes on my pillow during the night—is a little tender to the touch. Today when I apply moisturizer, it just sits on the surface of the dead skin, doesn’t absorb very well. But the new pink skin underneath really likes the soothing feeling of the moisturizer and in those areas the skin is really absorbing it.

It’s great to see this new stage of progress today because I can now start to imagine what my fresh new skin will look like all over my face when all the blotchiness is gone and the healing is done.

June 16 – Day 5

Quite a change today. My clothing has had “face dandruff”—dead skin flakes falling off my face—throughout yesterday and today!

Kate Britt Day 5So now, instead of a face covered with flaky skin that feels like sandpaper, my face is mostly new skin that feels baby-bottom smooth. That’s not to say it looks fabulous yet, because it doesn’t. It’s still looking quite blotchy, as the new skin is still very pink in some areas and obviously needs more time to heal. There are still patches of dead, rough skin, most notably on my chin and lower jaws. Also, even though my forehead skin flakes are all gone, what remains are a couple of the original sun-spots, although they are pink now rather than brownish. I hope they still plan to disappear somehow. 🙂

As for how my skin feels, it’s still sensitive wherever there’s new skin, and it dries out quickly and really drinks up the moisturizer. There’s still a mild overall itchy feeling, which tells me there’s still healing going on.

I think if I were employed, I could have gone to work today without worrying how my face appears. So in terms of days, in my case it took from Wednesday, day of treatment, to being OK to be seen by Sunday. I guess if you’re employed and considering having a Fraxel treatment but you’re worried about how it’s going to look while healing, you could take just Wednesday to Friday off work and be good to go back on Monday without the after-effects being noticed too much.

June 17 – Day 6

Today my face looks ‘normal’ enough that I’m feeling OK about going out to do some shopping. The overall impression is very-slightly pink skin with a few areas of minor flaking.

It’s interesting that some of the areas that I thought had finished flaking and peeling, places where yesterday there was just new very bright pink skin, have now started to get flaky again. So it seems that my skin is going through two layers of peeling on those areas. That’s on my upper left cheek, the left cheek beside my mouth, and on my chin under the lips.

Kate Britt Day 6KAte Britt Day 6b

I’m wondering about the three pink spots on my forehead. My whole forehead has pretty much finished peeling, but those three spots remain, fairly noticeable. I compared today’s front-face photo with the one taken at the doctor’s office before my treatment, and those spots were only slightly visible that day, yet they’re much more noticeable now. I hope this means there will still be more peeling or healing there so the color fades and the spots disappear.

Now when I apply moisturizer, the clean (non-flaky) skin looks shiny and glowing, so I’m starting to really see the progress!

June 18 – Day 7

All the dead skin is gone now, no more flaky patches left. My face still has pinkish areas here and there, and they’re still a bit itchy, which tells me that there’s still healing taking place. I suppose it looks a bit like chapped skin here and there, especially on the upper chin area, but that’s only if one looks really closely. Overall, my skin looks pretty much back to normal. But without those brown spots! Yay!

I know from my previous treatment that it will be a few weeks before the full effect of brand-new-looking skin is complete—it takes time for the collagen boost to complete the healing and do its magic. Dr. Rivers also said that the rejuvenation will carry on throughout the year. He booked my follow-up visit for two months from now. That’s when they will take their “after” photos to go with their “before” shots. So the 8 week time gap between photos tells me that’s how long they think it takes for the full dramatic effect to be seen.

Nevertheless, I’m very happy with the results so far. Happy to have no more “age spots”, happy with the new smooth feeling and the look of fresh skin.

The approximately one week of post-treatment changes and healing (and isolating myself from curious eyes) seemed to go very fast, and the noticeable changes each day helped keep my focus on the healing and progress. I’ll leave you with my ONE WEEK Before and After photos:

b4&a01Kate Britt 1 Wk

They don’t show a very dramatic change from then until now.

Stay tuned: see and read about Kate Britt’s results 8 weeks after her treatment.