Fractional Laser Skin Resurfacing

Fractional Er:YAG laser resurfacing uses the FOTONA 4D system to create thousands of microscopic laser channels in the skin surface, triggering a controlled wound-healing response and intensive collagen and elastin renewal. Unlike fully ablative lasers, the fractional approach treats only a fraction of the skin surface per pass, leaving surrounding tissue intact for faster healing. At AE Derm this modality is used to address acne scarring, fine lines, photoaging and skin texture irregularities.

Fractional laser resurfacing is based on the concept of fractional photothermolysis: the laser beam is split into thousands of narrow micro-beams, each creating a microscopic thermal injury column called a micro-treatment zone (MTZ) while sparing the tissue between the columns. The undamaged surrounding tissue serves as a reservoir of cells for rapid healing, and the local inflammatory cascade initiated by the MTZs drives fibroblast activation and new collagen synthesis over the following weeks and months. At AE Derm MUDr. Helena Závodská applies fractional mode via the Fotona Er:YAG laser. Er:YAG at 2940 nm has the highest water absorption of any medical laser wavelength, meaning its energy is deposited very precisely in the superficial epidermal and dermal layers with minimal thermal spread to surrounding tissue. By adjusting pulse parameters, the depth of ablation and the density of coverage can be calibrated to the patient's skin concerns and tolerance: lighter settings for first-pass treatments or sensitive areas, deeper settings for moderate acne scarring or pronounced textural irregularity. Before the session topical anaesthetic cream is applied for thirty minutes to minimise discomfort. During treatment patients typically experience warmth, a mild stinging sensation and a gritty surface texture. Immediately after, the skin appears red and may feel rough — the surface of the treated micro-columns sloughs in the following four to seven days as new epithelium migrates in from the surrounding intact zones. Social downtime is typically four to seven days. Post-treatment care focuses on moisturisation, strict sun avoidance and SPF 50+ to protect the newly formed skin. The regenerative process continues over two to six months as collagen remodelling matures; a course of two to four sessions achieves cumulative improvement for established scarring or moderate photoaging.