What is fractional laser and how does it work?
Fractional laser delivers light energy to the skin as many tiny, separate columns instead of one continuous area. The intact tissue between the columns speeds healing, and new collagen formation is stimulated in the treated zones. The aim is a shorter recovery than with traditional full-surface laser.
Laser light turns into heat in tissue. In the fractional technique this heat is delivered to hundreds or thousands of tiny points under a millimetre wide; the surroundings of each point stay intact and repair cells migrate in from neighbouring tissue. This approach aims to cut recovery time and some risks compared with methods that treat the whole surface.
The depth and intensity of the effect depend on the device type, the energy and the dot density. Renewal appears gradually over weeks and months. This page is general information; the device and settings used are chosen by the doctor for each person.
What is the difference between ablative and non-ablative fractional laser?
Ablative fractional laser vaporises tissue at microscopic points; the effect is stronger but recovery and risks are greater. Non-ablative fractional laser heats tissue without vaporising it, giving a milder effect and shorter recovery, and often needs more sessions. The choice depends on the goal and skin type.
Because ablative types remove the upper layers of skin in columns, they can give marked renewal and come up for deeper scars and wrinkles. Redness, crusting and oozing are expected afterwards and healing generally takes one to two weeks, with redness sometimes lasting longer. Given the strength of the effect, aftercare has to be followed much more carefully.
With non-ablative types the surface is largely preserved; redness and mild swelling usually ease within a few days. The effect is gentler, so they are often used in several sessions for fine lines, mild texture problems and superficial scars. Which type suits you is decided by the doctor together with the recovery time available and your expectations.
Which concerns is fractional laser considered for?
Fractional laser is considered for acne scars, surgical or injury scars, fine lines, sun damage and rough skin texture. It is also assessed for some stretch marks. It may not be a suitable first option for deep sagging, volume loss or melasma.
On depressed acne scars, fractional laser may help soften the surface by stimulating remodelling; depending on scar type and depth it can be planned with methods such as RF needling, microneedling or subcision. See the acne scar page for scar types. In sun-damaged skin with fine lines, texture and tone irregularity can also be targeted. The stretch marks page compares the options for those.
Sagging and volume loss are not corrected by laser. In melasma, heat-producing procedures can worsen the spots, so they are approached with caution, and as the pigmentation page explains, priority usually lies with other methods. It is also worth remembering that laser is not needed for every concern; sometimes a gentler method is enough.
How does recovery go after fractional laser?
Recovery depends on the laser type and energy. After non-ablative laser, redness and mild swelling can last a few days; after ablative laser, crusting, oozing and longer-lasting redness can occur. Wound care, moisturising and strict sun protection are carried out under the doctor's instructions during this time.
A topical anaesthetic cream may be applied beforehand; for deeper ablative procedures the doctor plans additional comfort measures. In the first days burning, warmth and swelling can occur. After ablative treatments the skin can be covered in fine crusts, and healing ranges from a few days to two weeks, with redness possibly lasting weeks beyond that.
Picking at crusts, irritating the skin with other products without the doctor's approval and going out in the sun raise the risk of pigmentation, infection and scarring. Newly formed thin skin is more sensitive to sun, so regular sun protection is needed. If fever, increasing pain, spreading redness or yellow discharge appears, contact the treating doctor without delay.
What are the risks of fractional laser and who may not be suitable?
The main risks are pigmentation changes (especially in darker skin), prolonged redness, infection, cold-sore flare-ups, burns and, rarely, scarring. Pregnancy, active infection, recent sunburn, a tendency to keloids and some medicines may mean postponing or changing the treatment. The eye area needs extra care.
In darker skin, brown discolouration after the heat response is more likely, so the device type, energy and preparation are chosen accordingly, and in some cases a non-ablative or gentler approach is preferred. For people with a history of cold sores, preparation to prevent a flare-up is assessed by the doctor. Use of oral isotretinoin and any recent resurfacing or heating procedure must also be reported.
Laser procedures always carry some risk even when done correctly, and light energy should be used in a licensed setting by a trained doctor. Results cannot be promised; marked softening of scars and lines may be expected, but complete disappearance is not. Suitability is determined at the first consultation by considering skin type, history and expectations together.
Frequently asked questions
How many sessions does fractional laser need?
Non-ablative types are usually planned as a few sessions a few weeks apart; ablative types may need fewer sessions but a longer recovery period. The number varies with the goal, scar depth and skin response.
Does fractional laser hurt?
Discomfort varies with the energy, the area and the laser type; most people describe warmth and prickling. Anaesthetic cream and cooling can be used. For deeper ablative procedures the doctor plans additional comfort measures.
When can I go in the sun after fractional laser?
Direct sun and sunbeds are avoided during recovery; when going out is unavoidable, broad-spectrum sunscreen and measures such as a hat are used. Sun exposure raises the risk of pigmentation. The doctor will say how long to avoid it according to the skin's response.
How does fractional laser differ from microneedling?
Fractional laser heats or vaporises skin at microscopic points with light energy, whereas microneedling opens mechanical channels with fine needles. Laser is generally stronger but may involve more recovery and risk. Which suits you depends on the goal and skin type.
Can people with dark skin have fractional laser?
Yes, but because pigmentation risk is higher in darker skin, device choice, energy, preparation and aftercare are planned more carefully. In some cases a gentler method may be suggested instead of laser. The doctor decides after assessing skin type and history.
This content is for general information and does not replace a personal medical assessment.