Fractional Laser
What Is It?
It helps if I first explain what a laser is. A laser is a very intense beam of light, and it creates high heat wherever it hits. If you gave that energy to the skin in one piece, over one big spot, it would burn the area away. The cure would be worse than the disease. So fractional laser splits the energy and sends it into the skin as microscopic columns. Picture a square: the shots are spread across it dot by dot, one hit, one gap. Beside every treated dot, an island of untouched, healthy tissue is left.
Healing starts from these islands. While the healthy cells repair the tiny burns next to them, they also give the surrounding skin a kind of overhaul. We call this controlled trauma. As the skin repairs these micro-injuries it produces new collagen and the tissue reorganises. Recovery is markedly shorter than with methods that peel away the whole surface. The effect appears over weeks, so don’t expect anything on the day. We use it most often for acne and other scars, sun and age spots, fine lines and stretch marks.
How Is It Done?
First I look at your skin. Skin type, any tan, whether there is active acne and the type of scarring decide the energy and density. In darker skin the risk of darkening after treatment (post-inflammatory hyperpigmentation) is higher. So we set the device more cautiously, and we never skip this assessment.
Before treatment a topical anaesthetic cream stays on for 30-45 minutes. You feel heat and stinging during the treatment; a session takes 20-30 minutes on average. Afterwards we apply cooling and repair care. The protocol is usually one session a month, 3-4 sessions on average. The season is part of the plan too. In the summer months we are much more careful because of the sun; it isn’t a matter of life and death, so we usually build the calendar around autumn and winter. I decide the right time for you from your skin type and your relationship with the sun.
Who Is It For?
It suits people who want their skin renewed because of acne scars, other scars, sun and age spots, fine lines or stretch marks. The two things that most decide both the result and the safety are skin type and season.
Active acne infection, an active cold sore, tanned skin and recent use of isotretinoin (an acne medication) change the timing and the settings; in these cases we rebuild the plan. We also assess pregnancy and breastfeeding, a history of keloid or excessive scarring, uncontrolled diabetes and medication that makes the skin sensitive to light. Darker skin types can be treated too, but the settings and aftercare need more attention.
Process & Recovery
Skin analysis and seasonal planning
We look at skin type, tan, active acne and scar type and set the energy from there. We usually build the session calendar around the months when the sun is weak. We take photographs.
Session day
A topical anaesthetic cream stays on for 30-45 minutes. You feel heat and stinging during treatment, and the session takes 20-30 minutes. Afterwards we apply cooling and repair care.
First 3 days
There is redness, a feeling of heat and swelling; we expect it to look like sunburn. During these days repair cream and high-factor sunscreen are used without missing a single day.
Days 4-7
Fine crusting and flaking begin, then the crusts come away on their own. Don’t pick them; picking raises the risk of scarring and pigmentation. The skin may look a little rough during this time.
Weeks 2-8 and between sessions
The collagen response comes into play and the tissue improves little by little. We plan the next session about a month later and do the main assessment 2-3 months after the series ends.
Results & Duration
The effect appears over weeks. During the crusting phase the skin can look worse for a while. The real improvement comes with the collagen response at weeks 2-8 and builds up with each session.
We make the final assessment 2-3 months after the 3-4 session series ends, comparing photographs. The result varies markedly with the type of scar, the starting condition of the skin and age. Keeping the improvement depends on sun protection; without it, the pigmentation comes back.
What Is Not Promised
Scars are not wiped out completely. Whether it is a surgical scar or an acne scar, everyone wants it to look as if it had never been there, and with what we know today that isn’t possible. Our aim is to make them less visible. On deep, pitted scars it may not be enough on its own and may need to be planned alongside other treatments. It doesn’t lift sagging skin and doesn’t replace a face lift.
No one can promise a particular percentage of improvement, number of sessions or duration. In the summer months and on tanned skin the risk of pigmentation goes up, so we re-plan the timing and settings around that.
Key Benefits
- Deep renewal
- Reduced scar appearance
- Rapid healing
“Among the device treatments I do, fractional laser is one of the ones I do most often. It has a season, though; we start once the sun has lost its strength. The same treatment gives a completely different result depending on the skin’s relationship with the sun.”
— Dr. Sinan Akyürek
Frequently Asked Questions
Can I have it in the summer?
We usually leave it for winter. In the summer months the sun raises the risk of pigmentation, and in that heat nobody can protect their skin well enough. We usually build the calendar around autumn and winter; I decide the right time for you from your skin type and your relationship with the sun.
Is it painful?
Most people tolerate it comfortably. A topical anaesthetic cream stays on for 30-45 minutes beforehand. During treatment you feel heat and stinging.
How many days of downtime?
About a week. There is redness and swelling for the first 3 days, then fine crusting and flaking on days 4-7. Most people look like themselves again by the end of the week.
Can I peel the crusts off?
No. The crusts should come away on their own; picking them raises the risk of scarring and lasting pigmentation.
How many sessions are needed?
Usually one a month, 3-4 sessions on average. We set the exact number by the type of scarring and how your skin responds.
Will my scars disappear completely?
Not completely; they get smaller. Once scar tissue has formed, with what we know today we can’t remove it entirely. Deep, pitted scars may need a plan that brings in other treatments.
When will I see the result?
Over weeks. The collagen response comes into play at weeks 2-8 and builds up with each session. We do the final assessment 2-3 months after the series ends.
Which situations need separate assessment?
Active acne infection, an active cold sore, tanned skin, recent isotretinoin use, pregnancy and breastfeeding, a history of keloid, uncontrolled diabetes and medication that makes the skin sensitive to light change the plan. We go through them one by one at the examination.