What It's Really Like To Get Fraxel
By Cheryl Wischhover
PHOTOGRAPHED BY NICHOLAS BLOISE.
I have an outsized fear of lasers coming anywhere near my skin, and not for a theoretical reason (lasers do sound horrifying, right?) but because I’ve actually been damaged by one. Back when I was 18 and dating a bad influence, I decided it would be really edgy to get tattoos on my arms. I realized several years later, when I became a respectable working adult, that sleeveless garments were pretty much off the table in my professional life. So, I sought out laser removal a few years later, in the late ’90s, when laser therapy for aesthetics was still in its infancy. After several treatments, I ended up with wounds that healed into raised keloid scars. Most of the ink is gone, but now it looks like my arms have been branded. I still never wear sleeveless tops.
Now, as I’ve become older and more willing to experiment with Botox and prescription topicals, it’s impossible to ignore the glow-inducing benefits of laser treatments like Fraxel. I started meeting many women, including my trusted dermatologist, who had been getting Fraxel treatments for years. Eventually, vanity won out. My dull complexion, creeping fine lines that I could no longer keep in check with Retin-A, and some new dark spots were real; third-degree burns and permanent facial disfigurement were just a part of my nightmares and unlikely to happen in real life. Right? RIGHT?!
I decided to go for it, and was referred to David Colbert, MD’s New York Dermatology practice, where his colleague, the very calming and exceptionally professional Jessica Weiser, MD, talked me through it. Spoiler alert: I ended up getting three treatments.
Read on to learn what it’s really like to get Fraxel, as well as all the products I discovered, used, and swore by along the way.
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How It Works
Fraxel is nothing like the laser treatment that tore up my arms, nor even like the laser facial-resurfacing treatments of yesteryear, which required three to four weeks of downtime hiding from your friends. Fraxel works by causing controlled micro-injury to the skin, and the magic happens during the repair process. “Instead of completely destroying the surface of the skin [like older laser therapy did], it’s a pixelated-type destruction,” Dr. Weiser explains. “You’re making tiny micro-thermal zones. Those areas are then stimulating new collagen production.” The result of poking a bunch of hot, tiny holes in your skin? Think real-life Instagram filter. The Fraxel Re:store, which Dr. Weiser used for two of my three treatments, targets fine lines and enlarged pores, and can address some pigmentation issues, though there are lasers that are better at eradicating more stubborn dark spots.
My main concerns were the fine lines around my lips that have made wearing dark lipstick a challenge, some sunspots around my eyes, and the enormous crater-like pores on my nose. Dr. Weiser recommended three to four treatments spaced one month apart, and she said that collagen remodeling continues for several months post-treatment. I could expect one or two days of redness or swelling after each treatment, but she assured me I wouldn’t scare small children with my post-Fraxel appearance. Let’s see how that worked out.
The First Treatment
I showed up one hour before my appointment to have numbing cream applied. Dr. Weiser’s medical assistant Leland — who would become my rock, my island, my cold-air-blowing savior in this process — applied the gooey cream. I holed up in the secret waiting room, away from the main waiting area, and spent the hour googling “bad Fraxel side effects.”
Dr. Weiser went conservative on the Fraxel Re:store setting, and only planned to do six passes rather than the full eight, to see how I tolerated and reacted to it. It burned. A lot. Lasering the area around my mouth was particularly excruciating, but I just thought about being able to wear plum lipstick without any liner and breathed through it. Leland stood over me blowing a hose of cold air on the areas that Dr. Weiser treated, and if not for that ministering, I’m not sure I could have made it through. After about 10 minutes and six passes, alternating horizontally and vertically on my whole face, it was over.
Dr. Weiser told me to use simple skin care and cleansers over the next few days, and advised against Aquaphor for the first 24 hours because it can clog pores and cause millia, which are little, hard white bumps. After icing my face with cold packs for a few minutes, Leland smeared on a not-chic prescription healing emulsion called Biafine, and then sent me on my way.
My face was pink and throbbing so badly that I was sure everyone could actually see it moving. I went straight home and stayed on the couch for the rest of the day, layering cold packs all over my face. The next day, I woke up with slight redness and puffy eyes — my face looked like I’d gone to sleep after having a good cry. The throbbing had improved. Over the next few days, a fine sandpaper-like, brown-dotted pattern of dry skin showed up on my face, which I was very tempted to Clarisonic off. Dr. Weiser said to let nature take its course, which I did. After five days, the rough skin had disappeared (without disgusting large flakes), the redness was gone, and I was beginning to see that Fraxel glow everyone talks about. Pfft. This is easy! Or, is it?
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Key Products, Treatment 1
Neutrogena Ultra Gentle Hydrating Cleanser: I gave up my elaborate Korean-inspired double-cleansing regimen to go old-school with this cleanser for the first week of healing, per Dr. Weiser’s recommendation.
Indie Lee Squalane Cream: During this process, I found myself drawn to gentle products touting safe ingredients. Indie Lee’s are fantastic, and this simple cream was my go-to day cream pre-makeup.
Colbert MD Soothe Night: I played around with many recovery creams during this process, but I kept coming back to this one, which Dr. Colbert developed specifically to combat redness and help healing post-treatment.
Drunk Elephant Umbra Sheer Physical Defense SPF 30: To add insult to injury, in the immediate post-Fraxel period your skin is more susceptible to dark spots, according to Dr. Weiser, so I was extra vigilant with sunscreen. This physical blocker, which only features safe ingredients, is light, fluffy, and doesn’t leave a white sheen.
Beautycounter Tint Skin Complexion Coverage: With red, dry skin, regular foundation was too heavy and my usual CC creams weren’t providing enough coverage. This tinted moisturizer was creamy enough to combat the sandpaper skin and covered up the redness.
The Second & Third Treatments
Since I recovered so quickly with relatively few issues, Dr. Weiser decided to “up the power” and also increase me to the full eight passes. For treatment two, she used the Fraxel Dual, rather than the Re:store, which can target pigmentation a bit better. For the third treatment, she went back to the Re:store. With the increased power, I had to stop her more times than during my first treatment because it hurt so much my eyes were tearing.
There is a well-known phenomenon among chemo patients (I used to be an oncology nurse) called anticipatory nausea, in which they start feeling nauseous right when they enter the clinic where they receive chemotherapy. By treatment three, I had anticipatory flinching. Every time Dr. Weiser came near me — and, let me just reiterate what a kind and gentle person she is — my inclination was to move away in horror, because of that hot wand she wielded.
But, thanks again to Leland giving me ice packs and the cold-air blower, I made it through two more treatments. With the laser up to full power, I experienced a few more days of redness and burning compared to the first treatment. For at least four days after both treatments two and three, it felt like someone had dipped my skin in sriracha. I longed for another polar vortex to give my face some relief. The rough patches were also more pronounced, and I experienced a side effect after both the second and third treatments that Dr. Weiser said is rare: a raging case of acne all over my chin and jawline. Let’s just say it was not an attractive week for me. A course of the antibiotic minocycline cleared it up in a few days, both times.
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Key Products, Treatments 2 & 3
Beautycounter Rosewater Uplifting Spray: I’ve heard too many makeup artists rave about the soothing properties of rosewater spray to discount it. I popped this in my fridge to keep it cold and used it liberally during recovery.
SkinCool Ice Roller: Robin Black dropped the intel on this little gem just in time for my third treatment. I know it costs $30. Just buy it. As a person who has tried ice cubes, ice packs, frozen peas, and cold soy sauce packets, this beat them all as a post-Fraxel skin soother. I now use it for undereye bags and even to roll over sore muscles after a workout.
Ling Dual Moisture Emulsion: I needed an extra moisture layer in light of the more intense side effects after the last two treatments. This hyaluronic acid and squalane oil was a savior, and continues to be while I navigate the frozen tundra that my home city has become this winter.
Atelier Cologne Pomélo Paradis: This perfume brand specializes in citrus scents, and this new one in its lineup became a calming potion for me, which I spritzed liberally before I went in for my third treatment. I still use it constantly, when I need a pick-me-up or am feeling stressed.
The Takeaways
You should plan on looking 10 years older for about five days after each treatment — so if that scares you, make plans accordingly.
It’s been about a month since my last treatment, and the pores on my nose seem smaller and less congested, and the fine lines around my lips are considerably softened. I still have a few dark spots around my eyes, but two of the three that were bugging me are considerably faded. Best of all, my skin looks more even, less ruddy, and less rough. According to Dr. Weiser, I will still see improvement over the next few weeks.
Fraxel is not cheap. Dr. Colbert’s office charges $1,500 for one treatment, or $3,600 for three treatments. But, this is a high-end Manhattan-based dermatology practice; prices will vary depending on where you live and your treatment plan.
As with all anti-aging procedures, Fraxel is not a fountain of youth. Dr. Weiser recommends yearly touch-ups as needed. “Fraxel doesn’t stop aging,” she clarifies. “It just slows it down.” I’ll take it, though. Slower aging? That’s worth conquering my fear of being burned to a crisp.
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