Fractional Laser equipment operates on the core principle of fractional photothermolysis, a technique that balances high-energy treatment with rapid recovery. The device emits pulses of light to create microscopic columns of thermal injury, known as Micro-Thermal Zones (MTZ) or Micro-Ablative Zones (MAZ), deep within the skin. Crucially, it leaves "islands" of healthy, untreated tissue surrounding each injury column, which act as a biological reservoir to speed up healing and stimulate the regeneration of collagen and elastic fibers essential for repairing striae distensae.
The central mechanism is the creation of controlled, microscopic damage patterns interspersed with healthy tissue. This stimulates the body's natural wound-healing response to rebuild the dermal matrix without the prolonged recovery associated with treating the entire skin surface at once.
The Mechanics of Fractional Photothermolysis
Creating Micro-Thermal Zones (MTZs)
The laser delivers energy in a pixelated pattern rather than a solid beam. This creates thousands of microscopic vertical channels of thermal damage or ablation (vaporization) in the epidermis and dermis.
The Role of Untreated Tissue
The defining feature of this technology is that it targets only a fraction of the skin surface (typically 20% to 90%). The distinct "islands" of healthy, intact tissue between the MTZs are vital for recovery.
These healthy areas provide the viable cells needed to bridge the microscopic wounds. This facilitates rapid re-epithelialization and significantly reduces the risk of side effects compared to fully ablative lasers.
Biological Response and Tissue Remodeling
Triggering the Healing Cascade
The heat generated within the MTZs causes immediate tissue coagulation or ablation. This acute, controlled injury signals the body to activate its natural repair mechanisms.
Rebuilding Collagen and Elastin
Striae distensae (stretch marks) are characterized by thinned skin and damaged elastic fibers. The laser-induced injury stimulates fibroblasts to synthesize new collagen and elastin.
This process, known as dermal remodeling, reconstructs the extracellular matrix. Over time, this thickens the thinned epidermis associated with stretch marks and improves the overall texture and tensile strength of the skin.
Understanding the Trade-offs
Ablative vs. Non-Ablative Approaches
Not all fractional lasers effect the skin in the same way. It is important to distinguish between ablative (e.g., CO2 lasers at 10,600 nm) and non-ablative (e.g., 1565 nm lasers) systems.
Ablative Precision and Intensity
Ablative systems physically vaporize tissue to create empty columns (MAZs). This offers more dramatic remodeling and skin tightening for severe striae but entails a longer recovery period due to the breach of the skin barrier.
Non-Ablative Subtlety
Non-ablative systems heat the dermis to create MTZs without breaking the skin's surface. This results in minimal downtime and faster healing, but may require more sessions to achieve the desired level of remodeling for deep stretch marks.
Making the Right Choice for Your Goal
The effectiveness of fractional laser therapy depends on matching the intensity of the mechanism to the severity of the striae distensae.
- If your primary focus is deep structural repair: You likely require an ablative fractional laser (CO2) to physically vaporize damaged tissue and induce maximum collagen synthesis, accepting a longer recovery time.
- If your primary focus is texture improvement with minimal downtime: A non-ablative fractional laser is preferable, as it stimulates dermal remodeling and epidermal renewal without damaging the surface layer of the skin.
By precisely controlling the depth and density of thermal injury, fractional lasers force the skin to structurally reinvent itself from the inside out.
Summary Table:
| Feature | Ablative Fractional Laser (CO2) | Non-Ablative Fractional Laser |
|---|---|---|
| Mechanism | Tissue vaporization (MAZs) | Thermal coagulation (MTZs) |
| Skin Barrier | Breached/Ablated | Intact |
| Primary Benefit | Deep structural repair & tightening | Texture improvement & fast healing |
| Downtime | Longer (5-7 days) | Minimal (1-2 days) |
| Target | Severe stretch marks & scars | Early-stage striae & fine lines |
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References
- Magdalena Jastrzębska‐Więsek, Anna Wesołowska. Modern capabilities of streach marks treatment. DOI: 10.32383/farmpol/118765
This article is also based on technical information from Belislaser Knowledge Base .
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