Skin ageing is a process influenced by both internal and external factors. Most skin ageing is related to the effects of UV rays from the sun and tanning beds, which cause wrinkles, uneven skin pigmentation, loss of elasticity, thinning of the skin, the appearance of redness and capillaries, some skin growths, enlarged pores and many other skin diseases.

The ablative fractional laser is an established method of reducing the signs of ageing by removing part of the skin’s surface (the epidermis and the upper part of the dermis), while leaving the surrounding skin untreated, allowing it to heal quickly and without visible effects. The surface-acting laser removes some types of brown spots, thin growths, fine lines, tightens pores and smooths uneven and rough to the touch skin surface.

The non-ablative fractional laser works deeper in the dermis, where it causes many microscopic areas of overheating, with no visible signs of the device on the skin surface after the procedure. The procedure stimulates skin cells to replenish collagen, elastin and hyaluronic acid, which reduces the depth of wrinkles, helps eliminate damage and the effects of skin ageing and sun-induced changes in connective tissue and uneven skin pigmentation.

Hybrid fractional laser uses both technologies simultaneously and therefore has many advantages:

• predictable and favourable effect after only 1 to 2 treatments,
• the procedure can also be performed on the neck, chest and the backs of the arms and legs,
• suitable for all skin types, the procedure can also be performed on tanned skin,
• a less intensive and less painful procedure than fractional ablative laser,
• the application of an anaesthetic cream before the procedure is sufficient,
• shorter healing period than after fractional ablative laser treatment,
• the appearance of a noticeable effect after just a few weeks.

 Who do we recommend the hybrid fractional laser for?

The hybrid fractional laser procedure is recommended when the following skin imperfections are to be addressed:

• fine lines and wrinkles,
• enlarged pores on the face,
• brown spots: sun spots (Lentigo solaris) and age spots (Lentigo senilis), thin seborrheic keratoses,
• rough and uneven skin surface, loss of shine,
• shallow scars from acne, water pox, burns, surgery,
• sun (and or tanning bed) discoloured skin with uneven pigmentation, growths, loss of tone, enlarged pores,
• a precursor of skin cancer – thin actinic keratosis.

Procedure

The hybrid fractional laser treatment starts with skin preparation. An anaesthetic cream is applied, as anaesthesia by injection of an anaesthetic is not necessary. During the procedure, which takes 20 to 30 minutes, there is a stinging or moderate burning pain, which can be relieved with cool air and, if necessary, a short-acting anaesthetic. The maximum area of skin that can be treated in a single procedure is equal to the area of the face, neck and chest.

After the treatment

After the procedure, the skin may be slightly red and swollen. The sensation is quite similar to sunburn. After a few hours, the skin calms down.

The redness lasts from one to two days, rarely longer. The duration of the redness depends on the patient’s characteristics (tendency to redness), the thickness of the skin and the settings of the device. Redness lasts for a shorter time (a few hours to 12 hours) in lower energy treatments and up to 7 days in higher energy treatments. We will advise you on an ointment and gel for washing the skin after the treatment that suits your skin type.

In the following days, a light to dark brown epidermis appears which is dry to the touch, but it peels off mostly by the fifth day after the procedure. During this period, we advise against social activities (home visits, going to work, etc.). After the dry epidermis has peeled off, a tinted cream can be applied. The start of its application depends on the low or high energy settings of the device. At low energy, the cream can be used 3 to 4 days after the procedure, and at high energy, about seven days after the procedure.

Furthermore, sun exposure without sunscreen and cover-up is discouraged for at least 3 to 4 weeks after the procedure.

Effects

All patients show a noticeable improvement in skin appearance after fractional hybrid laser treatment. Improvement of the skin surface can be observed within a few weeks after the procedure, with the final effect expected to be seen 3 to 6 months after the procedure. Repetitions of the treatment increase the effect.

Duration of effects

The durability of the hybrid fractional laser effect is influenced by the same factors as any other procedure in aesthetic dermatology. The latter is related to many factors, such as skin type, the degree of damage caused by UV exposure before the procedure, the influence of medications and other diseases, lifestyle, sun exposure and the degree of controlled damage to the skin during the procedure, which triggers healing and repair. Ideally, the effect of hybrid fractional laser is visible for several years, maintained by sun protection measures and a healthy lifestyle.

How many repetitions of the procedure are needed?

The number of repetitions depends on the degree of skin damage, your expectations and the time you have to recover from the procedure. An extremely noticeable effect can be seen after just 1 or 2 repetitions. In the case of former skin rejuvenation techniques using non-ablative fractional lasers, about 5 repetitions were needed to achieve a comparable effect.

How often can the hybrid fractional laser be repeated?

People who have a more severe degree of sun ageing and thicker skin need more repetitions to get the best effect. The fastest time to repeat the procedure is after three weeks for the lower-energy version or after two months for the higher-energy version. After each treatment, a further improvement is observed, which then lasts for many years if the skin is properly protected and cared for.

What are the potential side effects?

Expected after-effects are sunburn-like pain, redness, mild swelling and small brown scabs.

Unexpected side effects include more severe swelling, more severe burning pain, an outbreak of herpes on the lips, itching and allergy to the cream used after the procedure, infection with bacteria, viruses or fungi, or excessive pigmentation of the skin after the inflammation (PIH). With basic post-procedure therapy, which will be advised according to your skin type, the possibility of unexpected side effects can be reduced or prevented.

With proper aftercare, scarring and changes in skin pigmentation are not possible. The latter can happen if the skin is damaged during the healing process due to rubbing, bumping, etc., sun exposure, soaking in water (sea, swimming pools, etc.), which is why these activities are not recommended during the healing period.