NEW ORLEANS - There's a new weapon to get rid of sun damage that makes your skin look old.

Laser technology has been around for a while, but now there's a laser that promises to gives you two treatments for the price of one.

Rebecca Dufrene, 37, has a lot of sun damage from her job back in her teen years.

'I chose to do it because I was a lifeguard in high school and in college and I have a lot of sun damage and I would like it to be gone,' said Dufrene.

She was recently in for her second treatment with the latest updated technology.

It's called the Dual Fraxel because in recent months it was updated to give two treatments in one. The original Fraxel had a wavelength that went deep into the skin, heating up the deeper layers so over time the healing stimulated your body to grow new collagen. You were puffy and swollen for a few days but the top layer of the skin was never burned, crusty and oozing.

'The old wave length of 1550 was primarily a deeper penetration that was used primarily for skin texture, for wrinkles and for fine lines and for acne scars. It also is effective for striae or stretch marks,' said New Orleans Dermatologist Dr. Mary Lupo.

But the older Fraxel did not target the upper layer of the skin, so it did not get rid of surface damage from the sun, those brown spots, freckles, blotchy discoloration and even melasma. Now this new Dual Fraxel hits both layers.

'The new Fraxel is called Dual because you have that same wavelength that has incredible peer reviewed studies on its efficacy for acne scars and for photo aging, but in addition to that, there's a new 1927 nanometer wave length that does more on a superficial level to help with that mottled dyschromia from sun damage, blotchy brown pigment, freckling, that overall sort of smudged look to the skin. In addition, it is one of the few things that seems to help melasma and has been studied for it,' said Dr. Lupo.

'You just have redness and more peeling, but results are much more drastic,' said LSUHSC and Metairie Plastic Surgeon Dr. Kamran Khoobehi.

He recommends two treatments for Dufrene. Before the laser was started, she had a numbing cream put on her skin for 30 minutes or so, but because the Fraxel can be very uncomfortable when the laser fires, he also offered her a nerve block like you get in the dentist's office. Those few quick injections made this her second experience with the Dual Fraxel painless.

'Huge, huge,' said Dufrene, describing the difference with and without the nerve block injections. 'It's no pain, none whatsoever.'

So what happens when you have this new Fraxel? Well, that's what patients seem to like, a dramatic difference with only a little down time. Dufrene says she stays out of the public for only a few days.

'(Days) two and three are bad and it (her top layer of skin) comes off in patches, it, I don't know how to describe it. It's like a lizard. It comes off and in segments,' said Dufrene. 'It will feel like sand paper and my entire face will turn brown and then it will continue to come off and when it comes off, the skin is very smooth and it feels great.'

When it comes to treating melasma with the Dual Fraxel, some doctors say this helps, but some patients may also require some extra effort.

'In general to speak about facial pigmentation, I always tell patients that's one of the hardest things for us to treat and unfortunately I think it usually takes multiple treatments to get facial pigment better,' said Metairie Dermatologist Dr. Patricia Farris, who is also the spokeswoman for the American Society for Dermatologic Surgery. 'You can use your lasers in combination with good topical treatments and also good chemical peels which, I find in my hands, are sometimes my best weapon against facial pigmentation.'

'Any laser that helps is used adjunctively with sunscreens and hydroquinone because melasma is not just from episodic sun, it really is a hereditary and ethnic thing that you don't ever, it doesn't really ever go away. Doctors can control it, doctors can improve it, but it's very ridged as to how disciplined you have to be to keep it from coming back,' added Dr. Lupo.

But some doctors believe patients should use their time and money to get a more dramatic result with the stronger CO2 fractionated laser.

'Actually I'm not really impressed with this device because the device it's based on is an erbium laser, and those lasers have not been particularly effective in removing wrinkles around the eyes and the upper lip, which is the main places that we're really trying to remove them,' said Metairie Dermatologic Surgeon Dr. William Coleman, III.

'Quite honestly, I think we're getting closer (to the dramatic results with the CO2 laser) but we're not there yet. But this (the Dual Fraxel laser) gives us another alternative. Now, is it going to achieve as much as the CO2? No, it's not and they need to know that going in,' said LSUHSC and Tulane Dermatologist Dr. Elizabeth McBurney, who is also in private practice in Slidell.

But the stronger CO2 laser requires much more burn wound care and longer down time.

For Dufrene, the Dual Fraxel, with less down time, was a better fit.

Dufrene said she only had to 'hide out' for 2-3 days.

'It's definitely worth it,' she adds.

The Dual Fraxel can run from $900-$1,500 per treatment. Doctors say you get the best result with two or three treatments.

You'll see a change in pigment in a week. The tightening and smoothing of wrinkles takes about six months.

Editor's note: Dr. Patricia Farris is no relation to Medical Reporter Meg Farris.

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