Fraxel laser is by no means inexpensive.  It’s touted as the latest and greatest acne scar treatment so it’s bound to draw desperate customers like me.  And from what I have read, the procedure itself only lasts thirty minutes with another hour devoted to prep time with a topical anesthetic.  I’ll be generous and roll it into two hours.  For some places to charge approximately twelve hundred dollars per treatment, that’s six hundred dollars an hour we’re talking about here!  And due to the series of four treatments, that’s forty-eight hundred dollars.  But honestly,  I would be willing to pay twice that… or an even ten thousand dollars to get back the social life that my acne scars have robbed me of.  Again, I would be willing to pay that much if I’m guaranteed a smooth face.  Or to set realistic expectations, a 75% improvement in my acne scars.  I don’t think it will ever be perfect but get it as close to perfect as my condition allows me and I would be happy.

I think it’s important to discuss this with the dermatologist what the realistic expectations are.  If the first treatment does not reach the target expectations, would you go through it a second, third and forth time?  I’ve heard of patients going in for Fraxel laser treatment ten times and still it wasn’t to their satisfaction.  At one point, you have to say either Fraxel doesn’t work for you, or the doctor doesn’t know what he/she is doing and can’t give you the predicted outcome.  In either case, don’t stay with the doctor because something clearly isn’t working.  You won’t know what isn’t working if you don’t set expectations with your doctor and demand to know why they haven’t been met.  I just hope when I come to this situation with my doctor that I won’t cave in and go “just one more time” and have my money just leached from me.

At the place where I’m contemplated to getting the Fraxel laser treatment done, here are the prices:

Face (only) $1250

1/2 Face (only) $750

Perioral $450

Neck $600

Chest $1000

Dorsum Hands $800

Full Hands $1000

Minimum $300

I’m going to get the full face done because I have acne scars on my forehead and on my cheeks and jawline.  I know I can get it at a cheaper price as there are some spas that do it but I’m really not comfortable with those types of places to entrust my face with their hands.  I’d much rather have a medical doctor do it.  And make sure it is going to be the doctor who is doing your treatment and not passed off to some technician.  No offense to technicians in the cosmetic field but if I’m going to be paying that much to have my face done, it better be by a doctor.  If my doctor has 15 years of experience with lasers, she better be using all her expertise on me.

Since Fraxel has different types of laser treaments: Fraxel re: fine, Fraxel re: store, Fraxel: repair, I’m assuming the cost doesn’t change for different treatments.  For instance, if I’m getting Fraxel re:store for acne scars for the full face, it would be the same for someone getting Fraxel re:fine done for a full face melasma treatment as well.

Looking at the prices, I can’t believe how some people would get Fraxel done on their hands and chest.   To me, it seems like an unneeded expense but I guess different people have different types of insecurities so who am I to judge?  If you have the money and if it makes your life better, then go for it.   I just hope everyone gets the results they expect.

My cosmetic dermatologist was recommended by my family doctor who was always reluctant for me to go see a dermatologist.  She always thought it was unnecessary and gave me topical treatments that never really cleared my acne.  I’m in my 30s and I still have mild to moderate acne and I think this is totally unacceptable.  I was tired of being pushed around by doctors who said it was nothing while it has left my face scarred.  In any case, now I have a dermatologist who was reluctantly recommended.  Just great.

I looked up my dermatologist on the Internet to see if she had any patient ratings and it was mixed.  She got good reviews for port wine stains which is her specialty but no reviews on Fraxel laser treatments.  What reviews she did have left her with an average rating.  Some liked her and some didn’t and felt she was cold and only after the money.  That is something that I fear with cosmetic dermatologists – that they always want you to come back for the next treatment as they suck you dry of your money with promises of results that never materialize.

Looking at her very large office suite, you know she has done well for herself.  I don’t know if this is a good or bad sign.  Does this mean that she is doing well because she is gauging or she is doing well because of her reputation involved.  Some patients report that she is a cold doctor.  Personally I didn’t think so but then again, I’m not a chatty person to begin with.  I go in and I come out.  No chit chat.  And frankly, I don’t care if she’s mute.  As long as she does her job and can provide me with an acne scar treament.

In my previous posts about Fraxel laser side effects and Fraxel laser reviews, I pointed out some discrepancies on what I had read and what my doctor answered.  I hope she’s not pushing Fraxel on me to make a quick buck.  On my first consultation visit, I asked her what the side effects were and what is the worse case scenario.  She just shrugged it off and said your acne would come back and that’s it.  It was only during my second follow up appointment to review my acne medication progress that she said that acne might come back with Fraxel due to the aggravation.  Okay, finally what she said matched with what I read on the Internet.  Next, I asked her about the possibilities of hyper and hypopigmentation.  She said no but I wonder if she has any experience with olive skin or if her clientele are purely Caucasian people.  Does she have experience with people of Asian skin, African skin, Latino skin?  In the Fraxel laser literature, they say it is fine and the laser does not affect melanin in the skin.  However, when I read about the reality of Fraxel patient reviews online, I am getting that some darker skinned people have experienced complications.  Discoloration can be easily overcome if the issue is dealt with right away.  However, if my doctor is unaware or is denying the possibility of this then she can’t help me prepare if I am the unfortunate ones who experience this.

I am still torn whether or not if I want this doctor to perform the Fraxel treatment on me.  Hell, I don’t know if I’m going to get Fraxel treatment done at all.  I still have lots to research.  But if I do go through with it, my instincts tell me that I have to develop trust with the doctor.  If I let her go through with it and I have doubts, then it’s as much her fault as it is mine if something goes wrong.  I will say this though.  I would never go to a spa to get this done as I have seen some spas advertise for this and for a cheaper price too.  I don’t know if they have a doctor performing it or a technician/esthetician but I would feel much more comfortable if a doctor performed it.   Maybe it’s on the lightest setting but still, this is your face we’re talking about here.

So, for now, I’m content with my current cosmetic dermatologist treating my acne but later on, I might seek a second opinion about the Fraxel laser from a dermatologist solely so there is no bias to the cosmetic industry.  Just to play it safe.

My dermatologist told me to expect some pimple breakouts after getting Fraxel treatments and this matches what I have read on the subject as well.  I know she’s being honest with me and she has had previous experience with this common side effect at least.  In fact, she’s a cosmetic dermatologist who has fifteen years of experience in lasers so hopefully she can do a good job using Fraxel to get rid of my acne scars.    However, there are other areas of concern for me with this doctor.

I have an olive skin complexion so I had read that non white people might have skin discoloration issues?  Hypopigmentation and hyper pigmentation after Fraxel done.  I had heard to stay out of the sun but what if you follow all the procedures of wearing sunblock/sunscreen and wide brim hats and still get discolored?  I really don’t know why one would get discolored with Fraxel but I don’t doubt what people say.  If they reported it after the laser treatment I want to know if it is a possibility.  I asked my dermatologist and she says as well that people don’t get discolored because the Fraxel laser does not target melanin (which I read on the web as well).   But like I said before, after reading the message boards of some acne sites, a doctor commented that some people do get discolored.  Now is it because they were in the sun, or because the laser did that to them?

I really hate this conflicting information.  I’d rather have the truth being told to me so then I can evaluate the risks.  If my dermatologist says this is not the case, then I have to question this.  If this is something she doesn’t know about, then am I comfortable with her doing my acne scar treatment or will she introduce even more problems?  Or, is this whole thing blown out of proportion with people not following up correctly on their Fraxel after care program?    Still, like I said, my doctor  has fifteen years in the cosmetic laser industry.

Other conflicting reports that I have read about Fraxel side effects are the down time regarding having this procedure done.  People say that Fraxel takes like a week or two weeks to heal while the brochures conveniently say you can go back to work within the afternoon and it’s practically something you can do at lunch time.  What I think is going on here is that it depends on the intensity that the Fraxel laser is set on.

There are three types of Fraxel laser treatments:

Fraxel re:fine, Fraxel re: store, and Fraxel re: pair.  The intensity of the laser is different on each and the FDA has approved different types of skin treatments for each laser.  For instance, Fraxel re: fine is for pigmented lesions, periorbital fine lines, melasma, skin resurfacing, soft tissue coagulation.  Fraxel re: store is for photodamage, mild to moderate periorbital wrinkles, acne scars, surgical scars, melasma, actinic Keratosis.  Fraxel re: pair is for rhytides, pigmented lesions, moderate to severe wrinkles and furrows in lax skin, fine lines, textural irregularities, vascular dyschromia.

Now, I have no idea what all these medical terminology means because I just copied the stuff but clearly for acne laser scar treatment Fraxel re: store is what you are probably going to undergo.  At least, that is the type of  laser treatment you should have.  If you have the Fraxel re: fine, that is not FDA approved for acne scar treatment because it’s too light an intensity (I think) and Fraxel re: pair might be too strong.  However, the last I read, clinical trials are underway for acne scar removal with Fraxel re: pair.  Some patients have reported good results for deep acne pitting.

So my concern with the Fraxel laser marketing brochures reporting short down times might be because they were giving the best case scenario for Fraxel re: fine and not Fraxel re: store.  And for those who are out of commission for several days to reheal after Fraxel might have gotten Fraxel re:pair.

The thing is, you must ask your dermatologist what type of Fraxel laser you are getting and truthfully what type of side effects you are going to undergo and how long it will take you to heal.  There might be discrepancies in what you read and what they tell you for better or for worse.  It is too late to find out later what to expect after you have the Fraxel laser done without knowing the consequences.

The way Fraxel laser is supposed to work is by sending thousands of microscopic beams of light in specific areas of treatment to destroy damaged skin cells while promoting the growth of new ones.  And because the Fraxel laser only targets 5 to 50 percent of the skin’s surface, it leaves the rest of the skin free to help with the healing.  I am not well versed in cosmetic dermatology so it all sounds good to me.  Also, they claim that Fraxel’s recovery time is much shorter than other acne laser scar removal procedures precisely because of this localized healing and the precise nature of the laser.

Okay, so maybe that’s all marketing hype but the Fraxel treatment has been FDA cleared to treat acne scars and skin resurfacing.  One can only hope that they are not in the pockets of the cosmetic companies and they have our best interests at heart.

In any case, maybe I’m cynical but I really, really want to believe in Fraxel for my acne scarring and so I’ve been doing lots of research.  Reading Fraxel reviews, only slightly more than 50% said they would recommend it.  Why so low if the cosmetic industry says it’s the greatest acne scar removal treatment there is?  Are the only reviewers on these forums just negative people?  We all know that people are more likely to give negative comments than give positive comments.  That’s just the way life is.   People just don’t give compliments or say thank you in their daily lives so you can’t expect them to log into a forum.  At least that’s the way I’m justifying it.

However, other things that concern me are the down times advertised.  The Fraxel laser treatment brochures I’ve been given say that the downtime is short (actually, they don’t say specific numbers at all).  The Fraxel side effects I’d expect are redness and swelling much like a sunburn.  And then I can expect some itching and flaking and then a bronzed skin appearance.  Okay, that doesn’t sound bad at all and frankly, I’ve had worse from acne medication that caused the flakiness and drying.  I can live with this.  However, from the reviews I’ve read, the side effects are much more severe and longer lasting.  We’re talking about a week of down time here.  For some people, they might be able to get away with make up but I would probably want to take a week off.  First of all, I don’t want my coworkers to know that I’m getting a cosmetic procedure done and next, I would want to stay away from the sun for as long as possible so I don’t get burned.  I think the treatment makes you more light sensitive.  Finally, I don’t want to wear make up as that might aggravate the acne into coming back.  I’ve already read from people that after Fraxel treatments, it made their acne come back so you better be prepared for that as well and have some medication either oral or topical to combat it.

Maybe the people who are reviewing the Fraxel laser treatment haven’t had the full course yet.  You’re supposed to get a series of four treatments spaced 1 to 3 months apart.  Perhaps they stopped at only one when they didn’t see any results or the results weren’t to their expectations.   Apparently with the Fraxel laser, you see immediate results and then the progressive results that happen later on.  With the immediate results, your face gets fuller I guess because of the swelling so it elevates the pitted acne scars.  But then later on, when the collagen starts to produce you see the more permanent results.  Again, this is what has been advertised by the cosmetics industry.  Is it just because they want you to come back for return visits so it pays them more?  I don’t know.  I think the best scenario is to have realistic expectations before having the laser treatment.  That is what I’m going to ask my dermatologist.  How much can I expect my acne scars to improve after Fraxel?   If it doesn’t work then either she is a bad doctor or she lied.  In either case, I’m not going to go for a second, third and fourth treatment after that.  It would be a waste of money and I’m putting my face in danger by a doctor I cannot trust.

There are many Fraxel acne resources so I suggest that you read up when having this procedure done.  I know I am.

I have suffered from acne for almost half my life and I’m still suffering from it now.  I’m a woman in my early thirties and I just want it to stop.  It was embarrassing to go through it in my teens and it’s embarrassing now.  At least when you were a kid, everyone knows it is because of hormonal changes.  As an adult suffering from acne, you’d think the acne flare ups would have stopped by now.  Unfortunately, it doesn’t and women are more susceptible to adult acne than men.  It’s due to our periods, pregnancy, and all sorts of stresses that can put our hormones out of whack.

I’ve always had mild to moderate acne and my family doctor never thought much of it and always gave me topical acne treatment.  I always told her that I wanted a referral to a dermatologist but she just said they would just prescribe me the same thing.  Now years later, and acne scarring to go with it, I wish I’d been more forceful as this could have saved my face from scarring.

I have a new family doctor now and a cosmetic dermatologist and we’re going to see what we can do.  Like I said, I still suffer from acne so Fraxel laser treatment won’t be right for me right now.  I need to keep it under control first.  For the first time in my life, there is some sort of hope.  I’m on a new cleansing treatment and the relief alone of my face from not having to endure harsh washings helped it immensely.  I have oily skin and I’d wash it three times a day.  I don’t think it is excessive – once in the morning, once when I come home from work and once before I go to bed.  Before, my acne skin care regiment would be that I’d use Cetaphil which is pretty much recommended by everybody and natural acne remedies such as a natural gel with astringent and cooling herbs containing green tea extract.  Well, this just aggravated my face and my dermatologist told me to stop.  I’m on Spectrogel and the first time I used it on my face I felt instant relief.  It wasn’t harsh on my face at all.  My topical acne treatments now include Metrogel gel at night and Clindasol cream in the morning with SPF.    If you’re familiar with rosacea treatments you might be familiar with Metrogel as it is used to treat it.  Now, why would my dermatologist recommend it for my acne?  It seems that I have something called red acne that comes with flushing/stressed/easily embarrassed which is also common with rosacea.   Unfortunately, this hasn’t cleared up my acne totally to begin Fraxel laser treatment but it has helped.  I still have these tiny bumps on my right jaw line and it’s driving me insane.  It’s the only place I always flair up.  I might get some on my chin as well but I think this has to do maybe with clothes,  pillows, or blankets coming in contact with these areas so I always watch where I put my hands or how I sleep.  I’ve also changed from Pantene shampoo to Head and Shoulders because the zinc might help with the acne as well.  Although I don’t want to take any oral medication, I am at a point where I am going to try anything so my dermatologist has me on a six week course of minocycline as well.  I’m pretty small in size so for the first week, I took 100 mg of minocycline and now I’m on 50 mg a day which I take with supper.   I go back to see my dermatologist in six weeks to see if there is any progress in order to even contemplate having Fraxel done to improve my acne scarring.  If I don’t get my acne under control, there would really be no point in getting it done.  By the way, after what I read on the internet and also speaking to the dermatologist, she said that the Fraxel might even aggravate acne at first so you really want to get your acne under control with medication before any acne scar removal procedure can take place.

In any case, we’ll see if the minocycline helps me.  I don’t want to be on it forever because one of the side effects are teeth staining.  I mean, what next?  I don’t want to have acne and bad teeth.  It would just compound the problem.  Minocycline also makes you sensitive to the sun so make sure you wear sunscreen.  Again, you don’t want to compound your acne problem with sun damage either.

There are so many issues when trying to deal with acne that I just want it to go away.  Hopefully, one of these days it will be all over and I will wake up with a face clear of acne scars.  I’m hopeful that my journey in getting ready for my Fraxel laser treatment will be worth it.