Fractional Laser

Indications:

	•	Wrinkles (except dynamic wrinkles and wrinkles caused by skin sagging)

	•	Acne scars

	•	Improvement of skin tone and texture

	•	Pigmentation

	•	Melasma

	•	Stretch marks

Over the past few years, a new type of laser became available in dermatology. There are many versions made by different companies.

It uses infrared light to penetrate skin with hundreds of microbeams per cm2 causing microscopic tubular zones of thermal damage, which should stimulate skin remodeling and improve the above-mentioned conditions. This could be compared to a gardening technique where you make little holes in the ground to air the lawn and increase its vitality.

Fractional lasers need approximately three to six monthly treatments.

All those lasers are classified in two categories: Ablative and non-ablative.

Ablative: Thermal ablation of micro-columns of skin leaving little red dots and crusting for approximately one week of healing time.

Non-ablative: Skin collagen is "heated" and damaged in micro-columns but there are no micro-perforations and side-effects are mild redness and swelling that require no down time away from school or work.

Clinical trial program with fractional laser

There are very few clinical studies on fractional lasers and their real efficacy compared to established treatments such as Erbium laser, Chemical peeling or photodynamic therapy. We have no data on success rate percentages for those different devices. I am not aware of any  long term studies on efficacy or side-effects at the time of writing this page (2009). The principal attraction of this technique would be greater safety and a lower percentage of complications and a short healing time of zero to seven days. (because only small fractions of skin are treated during each treatment and the rest of the skin remains intact)

According to one clinical study, the short term complication rate was 7% and they had minor complications (flare up of acne, infection, hyperpigmentation, depigmentation) with one type of fractional laser.

Fractional lasers aim for higher efficacy than IPL (often used in cosmetic beauty centers with disappointing results) and minimal healing time compared to classical techniques for skin resurfacing (which are much more effective than IPL but have more side-effects and a longer healing time). Fractional lasers occupy an intermediate niche with intermediate results and zero or minimal convalescence with the trade off of serial (fractionated) treatments.

I have attended several conferences and read many documents but I am still unable to decide which of those devices would be the most beneficial for my patients. I am under the impression that laser companies are less than candid with doctors and tend to exaggerate claims regarding the performance of their devices in order to boost sales.

I propose to recruit volunteer patients who are ready to serve as guinea pigs for those treatments that I consider experimental (even though they are legally approved by Canadian and US authorities).

This should allow me to compare laser systems from different companies regarding efficacy, side-effects and patient satisfaction.

There is no guarantee of success or absence of side-effects. There is no guarantee as to the number of available treatments or the duration of clinical trials with a given laser system. Treatments will be limited to specific limited times and dates.

In exchange for assuming the risks of participating in a clinical trial, selected patients will be treated at a reduced fee equivalent to the regular dermatologic consultation fee for each treatment. This is less expensive than treatment fees suggested by laser companies.

If you wish to participate in this study, please check that you are part of one of the six categories of above-mentioned indications at the top of this page and contact us at 514-695-9646 mentioning you wish to participate in "the fractional laser clinical trial program"