Laser and energy-based: treatment guide
Fraxel laser: what it is, results, side effects and cost
What is Fraxel?
Fraxel is a brand of fractional laser. A fractional laser treats the skin in microscopic columns and leaves the skin around them untouched.[3][5][15] The Fraxel laser described in medical research heats narrow columns of skin to treat sun damage, acne scars and uneven pigment, usually over a series of sessions.[1]
Fraxel quick facts
| What it is | A brand of fractional laser. The FDA 510(k) database lists Fraxel laser systems, including the Fraxel re:store Dual and the Fraxel Dual 1550/1927, as cleared devices[3][4] |
|---|---|
| Laser type | Nonablative fractional resurfacing: the Fraxel laser in the cited studies uses a 1,550 nm erbium fiber laser, and the Fraxel Dual adds a 1,927 nm thulium wavelength[1][2] |
| What it treats | Sun damage on the face and body, atrophic acne scars, light-colored (hypopigmented) scars and uneven pigment[1] |
| Typical sessions | A series, typically 3 to 6 treatments spaced 2 to 4 weeks apart[1] |
| Downtime | A nonablative laser has no downtime, though several treatments are often needed[9] |
| Results timeline | Results can take months to appear, with little improvement at first[9] |
| Where it is done | Laser resurfacing is an outpatient procedure; you go home the same day[15] |
| Cost | Varies by clinic and area. Depends on the provider's expertise, the type of procedure, the time it takes and the location.[14] |
| Insurance | Laser resurfacing for cosmetic reasons is generally not covered[9][15] |
How Fraxel works
Laser resurfacing comes in two broad kinds. Ablative lasers, such as CO2 and erbium lasers, remove the outer layers of skin. Nonablative resurfacing heats the deeper layer of skin to improve wrinkles and sun damage while leaving the surface in place.[6][18]
Fractional resurfacing sits in between. The laser treats microscopic columns of skin in a regular pattern, over only a fraction of the surface, leaving the skin between the columns untreated. Compared with nonablative resurfacing it is more effective, and compared with ablative resurfacing recovery is faster.[6] Both ablative and nonablative lasers can be delivered this way.[5]
Fraxel is a fractional laser. The version studied in the medical literature is a 1,550 nm erbium fiber laser that targets water in the skin and creates narrow, sharply defined columns of heated tissue called microscopic thermal zones. Because only part of the skin is treated in each session, a series of treatments is needed.[1] The Fraxel Dual system has a 1,550 nm and a 1,927 nm wavelength in one handpiece, each with different uses.[2]
Researchers think the controlled, limited heating of fractional resurfacing likely helps normalize the skin's cycle of building and breaking down collagen, and a review of the literature supports nonablative and ablative fractional lasers as safe and effective for sun-damaged skin.[7] The Fraxel name is not the same as an erbium laser: the erbium laser used for ablative resurfacing is a different laser, the Er:YAG.[18] See our erbium laser guide and CO2 laser guide for the ablative options.
What to expect, step by step
- Before your consultation: see what the app offers todayFraxel simulation is coming soon to the SkinSync AI app. Today you can already scan your face, see neurotoxin and filler simulations, find a clinic and book a consultation. A simulation does not predict an outcome, and your provider decides what is appropriate for you.
- ConsultationA medical consultation is essential before any laser treatment. Tell the provider if you get cold sores, have a medical condition such as diabetes, smoke, or take any medicines or supplements, and be honest about what you hope to achieve.[9]
- PreparationYou cannot be treated with a tan or sunburn. Dermatologists also advise quitting smoking for at least 2 weeks before treatment, stopping vitamin E, aspirin and other products that can delay healing, stopping retinoid or glycolic acid skin care for 2 to 4 weeks, and taking medicine to prevent cold sores if you are prone to them.[9]
- Treatment dayThe treated area is numbed before laser resurfacing.[15][17]
- A series of sessionsFraxel is usually given as a series of 3 to 6 treatments, 2 to 4 weeks apart.[1]
- ResultsResults take time to appear, often months, and you may notice little improvement at first.[9]
- MaintenanceThe effects of laser resurfacing can last for years, but normal aging continues, and treatment can be repeated as needed.[13]
Side effects and who should avoid Fraxel
Common side effects
After laser resurfacing, treated skin most often feels like a mild sunburn. How strong the reaction is depends on the treatment.[12]
- Redness and swelling, and itching or stinging for a few days[12]
- Darkening of the treated skin (hyperpigmentation), or more rarely lightening (hypopigmentation)[12]
- Cold sore reactivation, mainly when skin around the mouth is treated[12]
- Bacterial infection[12]
- Milia, small white bumps that can appear during healing[12]
- Redness that takes longer than usual to fade[12]
Scarring can happen after laser resurfacing.[15] Darker skin is more prone to burns and dark marks after laser treatment, so look for a dermatologist experienced in treating darker skin.[10] A review of the evidence found fractional lasers a favorable option for skin types IV to VI, while noting few high-quality studies in the darkest skin types.[8]
A tan means no treatment that day
If you arrive with a tan or sunburn, a dermatologist cannot treat you, because the laser could cause a serious burn or discolor your skin.[9]
Who should avoid Fraxel or talk to a provider first
- A tan or sunburn in the treatment area[9]
- Active acne, which makes someone a poor candidate for laser resurfacing[17]
- A history of cold sores, which calls for preventive medicine[9][12]
- Diabetes or another medical condition, or smoking, which you should discuss first[9]
- Medicines or supplements that can make skin more sensitive to laser light; tell your provider everything you take[10]
- Deep wrinkles or sagging skin, which laser resurfacing is not ideal for
Fraxel aftercare
Follow your provider's at-home instructions; they help healing and help prevent side effects.[9] General laser resurfacing guidance includes:
- Protect your skin from the sun until it heals, because sun on treated skin can cause another scar.[9] After healing, use a broad-spectrum sunscreen of SPF 30 or higher every day.[10][15]
- Do not scratch or pick at any crusts, which can cause scarring.[12]
- Use an ice pack during the first day or two to ease swelling and discomfort.[12]
- Moisturize as your provider directs.[12]
- Do not smoke, because tobacco smoke complicates healing.[12]
- Hold off on retinoid and glycolic acid products until your provider says to restart them.[12]
Fraxel vs CO2 vs erbium laser
All three are laser resurfacing treatments, but they work in different ways. CO2 and erbium lasers are ablative: they remove the outer layers of skin.[18] Fractional delivery, which treats microscopic columns of skin and leaves the skin around them untouched, can be used with ablative or nonablative lasers.[5][6][15]
Swipe sideways to see all three lasers.
| Fraxel | CO2 laser | Erbium laser | |
|---|---|---|---|
| Laser type | Fractional laser. The Fraxel laser studied in the cited research is a nonablative fractional laser[1][2] | Ablative. Can be delivered in a traditional or a fractional form[15][18] | Ablative (Er:YAG). Can be delivered in a traditional or a fractional form[18] |
| Effect on the skin surface | Heats narrow columns of skin while the outer layer stays in place[1][6] | Removes the outer layer and part of the layer beneath it[16][18] | Removes the outer layer and part of the layer beneath it[18] |
| Commonly used for | Sun damage on and off the face, atrophic acne scars, light-colored scars and uneven pigment[1] | Wrinkles, sun damage, scars, warts, birthmarks and enlarged oil glands on the nose[16] | Superficial and moderately deep lines and wrinkles on the face, hands, neck or chest[15][17] |
| Recovery, per the cited source | No downtime with a nonablative laser[9] | Up to two weeks[15]; treated areas heal in 10 to 21 days[16] | One full week[15] |
| Side effects compared | Faster recovery than ablative resurfacing[6] | In a split-face study, more redness at 2 weeks and more lightening of the skin than the erbium side[19] | Fewer side effects than CO2, such as swelling, bruising and redness[15] |
| Darker skin tones | A review found fractional lasers a favorable option for skin types IV to VI, with few high-quality studies in types V and VI[8] | Greater risk of healing with darker pigmentation[16] | May be a good choice for a darker skin tone[15] |
| Strength of results | Nonablative and fractional resurfacing do not produce results comparable to ablative resurfacing[6] | Better overall wrinkle improvement than erbium in one split-face study[19] | With more than 5 passes, wrinkle improvement was not significantly different from 2 to 3 passes of CO2 in that study[19] |
In one review, the authors reported that in their experience a series of Fraxel treatments can give results similar to ablative resurfacing for atrophic scars, but often falls short of ablative resurfacing for wrinkles and laxity around the mouth.[1]
Which laser suits you is a decision to make with a licensed provider.
Frequently asked questions about Fraxel
What does Fraxel treat?
In the cited research, Fraxel resurfacing has been used safely and effectively for sun damage on and off the face, atrophic acne scars, light-colored scars and uneven pigment.[1]
How many Fraxel treatments will I need?
Because each session treats only a fraction of the skin, a series is needed: typically 3 to 6 treatments, spaced 2 to 4 weeks apart.[1] Your provider sets the plan.
Is there downtime after Fraxel?
A nonablative laser has no downtime, though you may need a few treatments to see the desired effect.[9] After laser resurfacing in general, skin often feels like a mild sunburn, with redness and swelling.[12]
Is Fraxel ablative or nonablative?
Fractional delivery can be used with either kind of laser.[5] The Fraxel laser described in the cited studies is a nonablative fractional laser.[1][2]
How long until I see results from Fraxel?
Results from laser treatment take time, often months, and you may notice little improvement at first.[9] After laser resurfacing, skin can keep improving for up to a year.[13]
Is Fraxel as strong as CO2 laser resurfacing?
Not usually. A published review found that neither nonablative nor fractional resurfacing produces results comparable to ablative resurfacing, but both have become more popular because their risks are more limited.[6] See our CO2 laser guide.
Can Fraxel get rid of acne scars?
Laser treatment can make a scar less noticeable, but it cannot get rid of it.[9] Dermatologists use lasers to resurface skin with acne scars, and the skin makes collagen and elastin as it heals.[11]
Is Fraxel safe for darker skin?
A review of the evidence found fractional lasers a favorable option for skin types IV to VI, but few high-quality studies include the darkest skin types.[8] Darker skin is more prone to burns and dark marks after laser treatment, so choose a dermatologist experienced with darker skin.[10]
How much does Fraxel cost?
Varies by clinic and area. Your price depends on the provider's expertise, the type of procedure, the time and effort it takes and the location.[14]
Does insurance cover Fraxel?
Laser resurfacing for cosmetic reasons is generally not covered by insurance.[9][15]
Can I simulate Fraxel in the SkinSync AI app?
Not yet. Fraxel simulation is coming soon to the SkinSync AI app. Today you can already scan your face, see neurotoxin and filler simulations, find a clinic and book. Simulations are illustrative and do not predict outcomes.
SkinSync AI: Aesthetic Care
Coming soon
Fraxel simulation is coming soon.
Fraxel simulation is coming soon to the SkinSync AI app. Today you can already scan your face, see neurotoxin and filler simulations, find a clinic and book. When it arrives, the Fraxel simulation will cover skin resurfacing, texture improvement and smoothing.
- Scan your face and see an illustrative neurotoxin or filler simulation from the front and both sides
- Find participating clinics and providers, with availability and pricing
- Book a consultation, in person or virtual, or a treatment in the app
- Save your scans and get reminders and aftercare guidance
Simulations are illustrative and do not predict results. The app does not give medical advice; a licensed provider determines appropriate treatment.
Sources
Every medical fact on this page is linked to one of these sources. Reviewed October 30, 2026.
- Tanzi EL, Wanitphakdeedecha R, Alster TS. Fraxel laser indications and long-term follow-up. Aesthet Surg J. 2008;28(6):675-678 (PubMed)
- Friedman PM, Dover JS, et al. 1,550 nm erbium-doped and 1,927 nm thulium nonablative fractional laser system: best practices and treatment setting recommendations. Dermatol Surg. 2022;48(2):195-200 (PubMed)
- U.S. Food and Drug Administration 510(k) database: K101490, Fraxel re:store Dual Laser System
- U.S. Food and Drug Administration 510(k) database: K130193, Fraxel Dual 1550/1927 Laser System
- Seminars in Plastic Surgery: Current Laser Resurfacing Technologies: A Review that Delves Beneath the Surface (2012)
- Alexiades-Armenakas MR, Dover JS, Arndt KA. The spectrum of laser skin resurfacing: nonablative, fractional, and ablative laser resurfacing. J Am Acad Dermatol. 2008;58(5):719-737 (PubMed)
- Tierney EP, Eisen RF, Hanke CW. Fractionated CO2 laser skin rejuvenation. Dermatol Ther. 2011;24(1):41-53 (PubMed)
- Kaushik SB, Alexis AF. Nonablative fractional laser resurfacing in skin of color: evidence-based review. J Clin Aesthet Dermatol. 2017;10(6):51-67 (PubMed)
- American Academy of Dermatology: 10 things to know before having laser treatment for your scar
- American Academy of Dermatology: Skin conditions that lasers can treat
- American Academy of Dermatology: Acne scars, diagnosis and treatment
- American Society of Plastic Surgeons: Laser skin resurfacing recovery
- American Society of Plastic Surgeons: Laser skin resurfacing results
- American Society of Plastic Surgeons: Laser skin resurfacing cost
- StatPearls (NCBI Bookshelf): Ablative Laser Resurfacing (2023)
- StatPearls (NCBI Bookshelf): Laser Carbon Dioxide Resurfacing (2023)
- American Society for Dermatologic Surgery: Laser resurfacing
- Verma N, Yumeen S, Raggio BS. Ablative laser resurfacing. StatPearls, National Library of Medicine (PubMed)
- Khatri KA, Ross V, Grevelink JM, Magro CM, Anderson RR. Comparison of erbium:YAG and carbon dioxide lasers in resurfacing of facial rhytides. Arch Dermatol. 1999;135(4):391-397 (PubMed)
Related guides
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