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Which is better Fraxel or DOT Therapy?


More often than not, technology is second place to the skills and experience of the person performing the treatment. Both Fraxel re:pair and DOT Therapy are CO2 devices designed to perform fractional surface ablation.

Fractional resurfacing is a very popular procedure for evening skin tone and improving texture. There are many technologies available to perform this treatment and all of them use a different wavelength or method of delivery to treat patients. We spoke to physicians from all over the US to discuss the different fractional resurfacing devices available and specifically the device that they use. Dallas cosmetic surgeon Dr. Bill Johnson spoke to us about SmartXide Dot Therapy from Deka and Dr. Christopher Zachary about the Fraxel re:pair.

Fraxel re:pair

Treatment time doesn't take very long at all. As Dr. Zachary describes, "In terms of doing the full face laser ablation with the fractionated CO2 laser, it probably takes me about 35-40 minutes, but I tend to get patients in about an hour earlier." The speed of healing is also a benefit of the Fraxel re:pair, " I'm impressed with these fractionated systems. How well the skin heals up after the treatment so that after 4 or 5 days it's completely healed up and the patients have very little discomfort." To see full results takes some time as new collagen growth continues. "We get continued improvement at 3, 4, 5, 6 months, up to about a year."
dr. zachary fraxel repair before and after photo
Actual Fraxel re:pair Results, 3 months after treatment

DOT Therapy

"I think the DOT has a couple of advantages, over some of the other devices. It is faster than most of them, which considering that I do all the CO2 resurfacing procedures that's a real advantage. The other thing is it's very versatile... how deep you go, how tight you put your dots, and how the shape of your pattern, and all those things add to a more versatile device," says Dr. Johnson. He is finding the DOT to be very useful on treating acne scars. "The classic use is for facial resurfacing in someone that has a lot of facial wrinkles, facial laxity, and facial creases. It certainly is quite good at that, I think one of the more exciting applications is in old acne scars, because, prior to having fractional CO2 therapy, full CO2 resurfacing was really the only thing available to those folks that made a difference, and it's such a dramatic long recovery time procedure that nobody would ever do it twice, and you really need to do several treatments on acne scars to make a real difference, so this has brought the capability to do several treatments with reasonable recovery times, and I think we're seeing some remarkable results."
dr. johnson smartxide dot therapy before and after photo
Actual SmartXide DOT Therapy Results, After 1 Treatment, 6 months post procedure

Conclusion: "It's the singer, not the song!" - Choose an experienced provider with many technologies!

Dr. Zachary has found Fractional Resurfacing useful in combination with other treatments. He says it's important to make sure to visit a physician with experience in skin resurfacing and who also has a full set of tools. "For the patients to get the best results, they have to see somebody who's had the experience and who can actually use all these things interchangeably. One of the problems about a patient seeing a physician who has one laser is that the likelihood is that they're going to recommend that one particular laser for the treatment, whatever it is. If you go to see somebody who's got 20 different devices then they have a choice and they can optimize the treatment for that particular individual."

It is also important to discuss with your physician which specific device they are using and how aggressive they want to be with it. There are four different models of the Fraxel Laser, each tailored with different power settings and treatment options... so when you are shopping remember that all Fraxel lasers are not the same!