Fractional scanning technology functions as a high-precision delivery system that divides a continuous CO2 laser beam into an array of microscopic columns. By creating specific Microthermal Zones (MTZ) while deliberately leaving surrounding "bridges" of healthy tissue intact, this technology allows for deep tissue remodeling without the severe trauma associated with traditional full-surface ablation.
The defining advantage of fractional scanning is the creation of a "healing reservoir." By preserving untreated tissue between microscopic wounds, the system dramatically accelerates re-epithelialization and minimizes the risk of post-operative scarring and hyperpigmentation.
The Mechanics of Fractional Scanning
Creation of Microthermal Zones (MTZ)
The system operates by emitting high-energy photons which are absorbed by the skin and converted into thermal energy.
This energy creates vertical columns of thermal damage, known as Microthermal Zones (MTZ) or Microscopic Ablative Zones (MAZs). These zones extend from the surface down into the dermis, effectively vaporizing aged or damaged tissue.
The Role of Tissue Bridges
Crucially, the scanner does not treat 100% of the skin surface area.
It leaves specific intervals of healthy, untreated tissue between the ablated spots. These structures serve as "bridges" that maintain the structural integrity of the skin during the procedure.
Biological Response and Recovery
Accelerated Re-epithelialization
The primary reference highlights that these tissue bridges significantly shorten the recovery period.
Because healthy cells are located immediately next to the wound sites, the skin can heal rapidly from multiple points simultaneously. This is a distinct improvement over non-fractional lasers, which require healing to migrate solely from the edges of the treated area.
Deep Collagen Regeneration
The heat generated within the MTZs triggers a controlled wound healing response.
This thermal stress stimulates the synthesis of new collagen and elastic fibers in the deep dermal layers. The result is comprehensive skin texture remodeling, effectively addressing issues like deep wrinkles and atrophic acne scars.
Understanding the Trade-offs
Risk Mitigation vs. Elimination
While fractional scanning significantly reduces the risk of side effects compared to continuous wave lasers, it does not eliminate them entirely.
The technology is designed to minimize post-operative hyperpigmentation and scar formation, but these remain potential risks if parameters are unmatched to the patient's physiology.
Skin Type Sensitivity
The supplementary data indicates that "fractional" does not mean "universally safe" for all settings.
Patients with darker complexions require conservative treatment spacing (4-6 weeks) and lower intensities. Aggressive settings on high-melanin skin can still result in hyperpigmentation or hypopigmentation, regardless of the fractional delivery.
Making the Right Choice for Your Goal
To maximize the utility of fractional CO2 technology, align the application with the specific clinical objective:
- If your primary focus is rapid recovery: Prioritize lower density scanning patterns to maximize the surface area of the "bridge" tissue, which serves as the healing reservoir.
- If your primary focus is deep scar remodeling: Focus on the depth of the MTZs to stimulate the deep-layer collagen regeneration necessary for repairing atrophic tissue.
Fractional scanning transforms CO2 laser therapy from a destructive resurfacing tool into a regenerative instrument, balancing aggressive treatment with rapid biological repair.
Summary Table:
| Feature | Fractional Scanning Role | Benefit to Patient |
|---|---|---|
| Microthermal Zones (MTZ) | Creates microscopic columns of thermal damage | Stimulates deep collagen & elastin production |
| Tissue Bridges | Preserves untreated skin between ablation spots | Accelerated re-epithelialization & faster recovery |
| Delivery System | High-precision laser beam division | Reduced risk of scarring & hyperpigmentation |
| Energy Control | Vaporizes aged/damaged tissue at precise depths | Effective treatment for deep wrinkles & acne scars |
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References
- Marcos Matias Motta, Paulo Kharmandayan. Effects of the lower energy and pulse stacking in carbon dioxide laser skin treatment: an objective analysis using second harmonic generation. DOI: 10.1590/acb360304
This article is also based on technical information from Belislaser Knowledge Base .
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