Fractional laser (Refine) for acne scars, enlarged pores and stretch marks
Thousands of microscopic beams per square centimetre reach the dermis, leaving normal skin between each point so healing is fast. The body repairs with new collagen, and the skin becomes progressively smoother and firmer over 4–6 sessions.
The principle of fractional photothermolysis
Instead of resurfacing the whole face like older ablative lasers, which needed a week or more of recovery, a fractional laser splits its energy into a large number of tiny beams. Each creates a column of heat 0.5–1.5 millimetres deep, down to the dermis where collagen lives, while leaving around 70–80 per cent of the skin between the points untouched. Cells from the surrounding normal skin migrate in to repair quickly, while the dermis responds by building new collagen and elastin for 3–6 months. Refine uses non-ablative mid-infrared light, so recovery is shorter than CO2 fractional and it suits Thai skin, which is prone to post-inflammatory darkening. The doctor adjusts the depth and density of the points to the concern and the area.
Which concerns it suits
Rolling and shallow boxcar acne scars
The scar types that respond best. Deep ice-pick scars need TCA cross as well
Enlarged pores, rough skin
New collagen tightens the pore edges and smooths the skin
Scars from injury or surgery
Flat scars, uneven colour and firm scar tissue. Often combined with Perfect Bright if the scar is red
Stretch marks
Thighs, abdomen and hips respond well while the marks are still red or purple. Older white marks improve partially
Fine lines and age-related skin changes
Around the eyes, cheeks, neck and the backs of the hands
Sun-induced dark marks and uneven tone
A secondary benefit from renewing the upper layers of skin
On the day
Recovery and results
Have severe uncontrolled inflamed acne, have taken isotretinoin within 6 months, have a history of keloids or raised scarring, are pregnant, have had strong sun exposure within 2 weeks, or have an active cold sore. For very dark skin the doctor lowers the energy and density and may recommend a 2-week course of topical treatment beforehand to prevent dark marks
Aftercare
- On day one do not wash with water; if necessary, wipe gently with cotton wool soaked in saline
- Apply the repair cream the doctor gives you 3–5 times a day until peeling stops
- Sunscreen SPF 30 or higher, reapplied every 2–3 hours outdoors, for at least 4 weeks
- No retinoids, fruit acids or scrubs for 1–2 weeks, and no swimming or saunas for 3 days
Results from our patients
Prices
| Fractional laser full face, 1 session Numbing cream, laser, cold compress, repair cream | From 1,000 THB |
| Spot area (both cheeks or nose) For acne scars or pores in a specific area | [ ] |
| Stretch marks, per area Priced by the size of the area, confirmed before starting | [ ] |
| Course of 5 sessions Every 2–4 weeks, followed up by the doctor | [ ] |
Frequently Asked Questions
Does fractional laser hurt?
Numbing cream is applied for 45 minutes beforehand. During the session you feel a prickly heat, eased by cold air. Most people rate the discomfort 3–5 out of 10, and afterwards it feels like sunburn for 1–2 days.
Will acne scars disappear completely?
No. Scars generally become 30–60 per cent shallower after a course of 4–6 sessions, depending on the scar type and how you respond. Deep scars need additional methods, and the doctor tells you this before you begin.
How many days off work will I need?
Most people need none. The skin is visibly red for 1–2 days and darker with light peeling for 3–7 days, which can be covered with make-up after 48 hours. If you have an important event, allow 7–10 days.
How is it different from CO2 fractional?
CO2 is ablative, giving a bigger result per session but with 7–14 days of recovery and a higher risk of dark marks in Thai skin. Refine is non-ablative, with short recovery, and can be repeated more often. The doctor chooses according to the depth of the problem.
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