I Tried Fraxel Laser at 34—Here’s What No One Tells You About the Pain, Downtime, and Results

Let me guess: You’re currently thinking about getting a Fraxel laser treatment. Yeah, I'm not surprised. Everyone I know seems to be talking about Fraxel lately, and I get the allure: Nothing sounds better than waving a magical (laser) wand over your face and getting smoother, brighter skin after just one treatment. But it's not necessarily as simple as that. As a long-time beauty editor, I've tried countless lasers and non-invasive cosmetic procedures like microneedling, radiofrequency, chemical peels, and, most recently, Fraxel. Fraxel is definitely one of the more intense treatments I've tried, which means that before you make an appointment, we need to discuss a few things first.

Keep reading for my full Fraxel review (including pics of the healing process) and key info on the laser treatment from two board-certified dermatologists.

Fraxel is a professional non-ablative laser treatment that can help smooth skin texture and acne scars, minimize lines and wrinkles, and fade dark spots, whether they're from the sun or old breakouts. Fraxel only targets a fraction (fraction, Fraxel—get it?) of the skin at a time, which is why it's also known as a fractional skin resurfacing treatment. The device has two wavelengths—one that's used for resurfacing the top layer of the skin and one that can go deeper into the epidermal and dermal layers of the skin. Your provider will decide which wavelengths are appropriate for your skin tone and skin issues.

As I mentioned before, Fraxel reduces the appearance of wrinkles and scars, fades brown spots and hyperpigmentation, and basically resurfaces your entire skin for smoother, brighter skin. Fraxel is one of the more aggressive lasers offered at most dermatologist offices (more on these other lasers below), which is how it's able to get rid of things like pockmarks (aka those pitted, indented acne scars known as ice pick, boxcar, and rolling scars).

I’ve done twice-yearly Clear + Brilliant (often referred to as “baby Fraxel”) since my mid-20s to help keep my skin glowy. But now, as a 34-year-old, I finally felt ready for the real thing. My skin tone had become uneven, and my texture looked dull and a bit wrinkly in spots. So I booked my Fraxel appointment for early November—once I knew I’d be out of the sun for the coming months—with two goals in mind: 1. fade stubborn post-inflammatory hyperpigmentation from old breakouts on my cheeks and chin, and 2. smooth fine lines and rough texture on my cheeks and forehead.

Per dermatologist Rishi Chopra, MD, who performed my Fraxel treatment, I stopped using all actives for about a week leading up to my appointment. That included my prescription retinol and benzoyl peroxide cream. I stuck to gentle, barrier-repairing skincare only during that week.

On the day of my appointment, I arrived at Dr. Chopra’s office and had numbing cream applied to my face for a full hour. Because I still had some active acne on my chin and my skin is melasma and rosacea-prone, Dr. Chopra decided to focus on using the Fraxel wavelength best suited for superficial exfoliation to improve tone and texture. The deeper wavelength used for collagen production could have triggered breakouts or caused my melasma or rosacea to flare.

He then did three passes with the laser. The first pass was totally fine—I was chatty and asking questions. The second pass was significantly more painful but still manageable. The third pass was brutal. There was no chatting—just jaw-clenching and involuntary tears streaming down my face. Thankfully, it was quick. Each pass took about three minutes, with the entire treatment lasting under ten minutes from start to finish.

Dr. Chopra told me he used about 35 percent of the laser’s power on me, which seemed insane given how red and hot my face looked immediately afterward—like the worst sunburn of my life. But he assured me that Fraxel at 35 percent is no joke—it’s nearly ten times more powerful than Clear + Brilliant for context.

I left my appointment with a topical steroid cream to apply that night. I also took a Claritin to help reduce redness and swelling, as well as Valtrex to prevent any cold sores (the heat from the laser can trigger them around the nose and mouth). To my surprise, when I got on the bus to head home about an hour later, my face already looked light-years better. The redness had calmed down, and my skin just felt sensitive to the touch.

Now for the healing process. Everyone (aka Reddit) told me days two through five would suck, and then on day six I’d magically wake up with fresh, baby-smooth skin. That’s honestly exactly what happened. On days two and three, my face mostly looked pink and slightly puffy—like the tail end of a sunburn. But on days four and five, especially around my chin and the sides of my cheeks where I had the most sun damage, my skin looked like it was covered in coffee grounds. This is called MENDS, and while it looks unsettling and feels like sandpaper, it’s completely normal.

MENDS (microscopic epidermal necrotic debris) are tiny bits of dead skin tissue that surface and eventually flake off during the healing process after fractional laser treatments like Fraxel. By the evening of day six, the MENDS had mostly disappeared, the redness was gone, and my skin felt smooth.

Although my skin was mostly healed by day six, it didn’t look flawless. I was slightly disappointed but had to remind myself that there is no such thing as a quick fix when it comes to skincare and that collagen takes time to build. It’s not an overnight thing. It wasn’t until about three weeks later, when I was sitting on the couch with my son watching a movie, that I caught a glimpse of myself and thought, holy shit, my skin looks good. I wasn’t wearing any makeup, but my dark marks were faint—as if I had on a layer of tinted moisturizer—and my skin texture looked smoother and more glass-like. I had the same feeling on Christmas Eve—exactly eight weeks after my treatment—while getting ready before family came over. I remember thinking, wow, I barely need makeup right now.

Three weeks post-Fraxel with no makeup.

Eight weeks post-Fraxel, wearing a thin layer of tinted moisturizer and blush

All in all, I would absolutely do Fraxel again—despite it being one of the more painful treatments I’ve tried. Compared to microneedling and other lasers like Clear + Brilliant or Moxi, Fraxel was noticeably more effective at improving my skin tone and texture. I also love that you can see visible results after just one treatment rather than committing to a series of three or more. It’s not a magic wand—no treatment is—but as far as lasers go, Fraxel is by far the best I’ve tried.

FAQ

Fraxel and microneedling are similar in that both treatments use the idea of creating micro-injuries on your skin to help rebuild collagen, but the main difference is that Fraxel penetrates the skin more deeply than microneedling. For this reason, dermatologist Ellen Marmur, MD, says Fraxel laser is better suited for patients with major skin issues (think: big scarring, hyperpigmentation, and texture issues), while microneedling would suffice for more mild concerns (some light acne scarring, discoloration, dark spots, etc.).

Luckily, this treatment is a pretty low-maintenance—at least, beforehand (more on the after care later). According to Dr. Marmur, you'll need to stop using any active product that can cause skin sensitivities for a full 10 days before your treatment, along with 10 days after (that includes retinol, exfoliants, and acids, like glycolic acid or salicylic acid).

Note: If you're breaking out, your dermatologist may want to postpone until your acne has calmed down, so let the office know ahead of time if you find yourself dealing with zits of any kind ahead of your treatment.

The cost of Fraxel varies largely depending on where you live, but dermatologist Marnie Nussbaum, MD, says most often, Fraxel costs around $1,500 per treatment for just the face, and up to $2,000 if you add on the neck and chest.

Pain tolerance is subjective, and many people consider Fraxel to be quite intense and painful (some describe it as being stung by bees or feeling like your face is straight-up burning), even with the numbing cream.

The downtime for Fraxel is typically a week. During the first two days, you can expect redness and swelling (like a sunburn), then between days three and five, your skin will start to roughen up and peel. As tempting as it is to pick at the flakes, resist the urge and allow your skin to heal on its own or you'll risk scarring. And, as a note, the chest usually takes a little bit longer to recover, so don't be alarmed if the process seems slow.

According to Dr. Nussbaum, how long the results last depends on the patient’s hair color, eye color, and complexion (discoloration tends to return sooner on patients with blonde or red hair than on someone with darker hair). Generally, though, Dr. Marmur recommends yearly Fraxel treatments for continued results and regular touch-ups with its gentler counterpart, Clear + Brilliant.

One treatment can decrease 80 percent of the discoloration. Dr. Nussbaum says you might need a touch-up with a Clear + Brilliant laser four to six months later, but usually one Fraxel session is enough to last you the year.

Dr. Marmur stresses that your doctor will determine how many treatments are best for your particular skin type and concerns, but for treating skin laxity and deep wrinkles, most patients wind up needing around two to six treatments to achieve their goals.

For the first few days after treatment, wash your face twice a day with a gentle cleanser (that means absolutely no face scrubs!). In the morning, Dr. Nussbaum suggests applying a vitamin C serum, which will penetrate the skin even better after a treatment and following it up with a lightweight moisturizer three to four times a day. Dr. Marmur even suggests applying a very thin layer of petrolatum ointment, but note that the doctors used words like lightweight and thin. You don't want to load up on a thick, emollient cream, which can clog your vulnerable skin and cause milia. Instead, stick with light layers of non-irritating, non-clogging products for sensitive skin.

Fraxel is a great treatment for your skin and a great excuse not to go to the gym for that first week, because working out will only worsen your hot, inflamed skin. If redness, peeling, and dark flakes are something you'd rather not deal with publicly, plan your appointment during a week when you can afford to take some time off, because makeup is also a no-go. Dr. Nussbaum says during those few days of healing, avoid putting any products on your face except for what we mentioned above.

Once you get a Fraxel treatment, it's SPF 30, a hat, and the shade for you. Dr. Marmur stresses how vital it is that you stay out of the sun for a few days after treatment and always apply sunscreen with broad-spectrum protection. Not only will your new skin be more vulnerable to the sun, but you'll also want to stay covered to prevent the pigment from coming right back. Two grand is way too much $$ just to waste on a day outside, unless you are literally made of money.

• Marnie Nussbaum, MD, is a board-certified dermatologist based in New York, NY. Dr. Nussbaum specializes in non-invasive aesthetic rejuvenation and is the founder of Dr. Marnie Skincare.
• Ellen Marmur, MD, is a board-certified dermatologist based in New York, NY. She is the founder of MMSkincare. Dr. Marmur's expertise includes skin cancer diagnosis and surgery, Mohs surgery, reconstructive surgery, women’s health dermatology, and cosmetic surgery
  

Lauren Balsamo is the beauty director at Cosmopolitan with more than 13 years of experience researching, writing, and editing beauty stories that range from the best skincare routine for your 30s to a comprehensive roundup of the best drugstore skincare brands. She regularly tests and analyzes new skincare products and treatments while working with the industry’s top experts to assess new brands, trends, and technologies.

Lauren Balsamo

Beauty Director

Lauren Balsamo is the beauty director at Cosmopolitan where she writes, edits, and produces all types of beauty content—from product reviews to personal essays and trend reports. She has covered beauty for more than a decade at Cosmopolitan. Follow her on Instagram. 

Brooke Shunatona

Brooke Shunatona is a contributing writer for Cosmopolitan.com.