Multifrax Fractional Laser

Fractional ablative laser resurfacing of the full face using the Multifrax system — creating a grid of micro-ablative channels in the skin to stimulate intense collagen remodelling, improve skin texture, reduce pigmentation, and diminish acne scarring and wrinkles.

Fractional laser resurfacing operates on the principle of fractional photothermolysis — directing laser energy into the skin in a precise grid pattern of micro-columns, creating ablative treatment zones (microthermal treatment zones, or MTZs) while leaving the tissue between columns completely intact. The Multifrax system at Perfect Skin Berlin combines this fractional ablative delivery with the option for non-ablative coagulation at controlled depths, allowing the clinician to tailor the treatment's intensity and recovery profile to the patient's needs and available downtime. In the ablative zones, the laser energy vaporises the tissue within each micro-column from the epidermis down into the papillary dermis. This controlled micro-injury triggers an immediate inflammatory response that progresses into the proliferative phase: keratinocytes at the column margins re-epithelialise the ablated zones within 24–72 hours, while fibroblasts in the surrounding intact tissue are activated by the thermal stimulus to synthesise new collagen and elastin. The resulting skin remodelling produces improvements in texture irregularity, photodamage and pigmentation, fine lines and wrinkles, enlarged pores, and the depressed scar architecture of atrophic acne scarring. The 45-minute session begins with topical anaesthetic application (approximately 20 minutes before treatment), after which the laser is passed across the full face in a systematic, overlapping grid. The treatment depth, density (percentage of skin surface treated), and energy are adjusted by the clinician based on skin type, target condition, and the patient's tolerance for downtime. A standard full-face session produces 3–5 days of social downtime with redness, micro-crusting at the treatment columns, and mild swelling, after which the skin surface appears smoother and more even. For optimal results in moderate photodamage or acne scarring, a course of 2–4 sessions spaced 6–8 weeks apart is recommended. Between sessions, strict sun protection with SPF 50 is essential to prevent post-inflammatory hyperpigmentation, particularly in Fitzpatrick skin types III–IV. Patients with darker skin types should be assessed individually, as ablative fractional laser requires careful parameter selection to minimise dyspigmentation risk.