Fraxel Laser for Actinic Keratoses

Fraxel is a fractional laser system that delivers thousands of microscopic laser beams to the skin, creating a pattern of micro-injuries while leaving surrounding tissue intact. This stimulates the skin’s natural repair process, thereby removing damaged cells and promoting new collagen growth.

The version of Fraxel often used for AK treatment is the nonablative 1927 nm wavelength thulium laser. Importantly, in 2010, the FDA cleared this laser procedure for the treatment of actinic keratosis.

A landmark multicenter study evaluated non-ablative 1927 nm fractional resurfacing for facial AKs. Patients received up to four treatments and were followed for six months. The study demonstrated good safety, tolerance, and significant clinical clearance of AK lesions, suggesting 1927 nm Fraxel as a promising option for face-based AKs and photodamage.

Beyond clearing existing AKs, newer research has explored whether fractional laser resurfacing can reduce the future risk of developing new AKs or non-melanoma skin cancers. A randomized controlled trial demonstrated that resurfacing of aged, sun-damaged skin restores dermal expression of insulin-like growth factor 1 (IGF-1) — a factor believed to play a role in UV-induced carcinogenesis — and may thus help “reset” skin’s cancer risk.

A single session of ablative fractional resurfacing has been shown to reduce AK lesions at 6 months post-treatment compared to untreated skin. This supports the concept that laser field therapy may both treat and partially prevent AKs.

In a retrospective cohort study of patients with prior facial nonmelanoma skin cancers, those treated with non-ablative fractional laser therapy had a substantially lower rate of subsequent facial skin cancer compared to those who did not receive such treatment. When adjusting for age, gender, and skin type, untreated controls were over two times more likely to develop new skin cancers.

Fraxel is especially attractive for patients who:

• Have multiple AKs or widespread sun-damaged skin (“field cancerization”)
• Value cosmetic improvement in skin tone, texture, or pigmentation
• Wish to proactively reduce future AK risk beyond just clearing visible lesions

During your consultation, we’ll evaluate skin type, extent of sun damage, prior treatments, and overall skin health to design a personalized treatment plan — sometimes combining Fraxel with other therapies (cryotherapy, photodynamic therapy, etc) to maximize benefit.

Using Fraxel as part of a comprehensive skin care approach allows you to:

1. Remove existing precancerous lesions (AKs)
2. Improve overall skin quality by reducing sun spots, discoloration, fine lines, and uneven texture
3. Potentially reduce the risk of new AKs and non-melanoma skin cancers over time
4. Maintain healthier skin through periodic maintenance treatments and diligent sun protection

It’s important to continue lifelong sun protection — daily broad-spectrum sunscreen, sun-protective clothing, and routine skin exams — to preserve your results and reduce future UV damage risk.