Samantha Toerge, M.D.LLC

Fraxel Laser


dr. toerge with patient

We would like to introduce the New Fraxel Re: STORE DUAL wavelength system which is the latest technology to treat pigment irregularities and resurface the skin, with minimal discomfort and downtime. Fraxel™ is an FDA approved laser for treatment of wrinkles, age spots, acne scarring and melasma (increased pigmentation of the skin). The innovative Fraxel™ system targets microscopic zones of skin, leaving the surrounding areas of skin unaffected and intact. This fractional treatment allows the skin to heal much faster than if the entire area were treated at once.

Conditions that can be treated with Fraxel™ include:

  • Fine lines and wrinkles
  • Lentigos (age spots)
  • Acne scarring
  • Scars (including surgical scars)
  • Acne scarring
  • Striae (stretch marks)

Fraxel™ treatments usually take 30 minutes. Dr.Toerge recommends that you do not have important events scheduled for 72 hours after treatment. Typically, there is no need for pain medication after the procedure and you will feel fine. 

The best results are seen after 3 to 6 treatments, depending on the condition and location being treated. Dr. Toerge will customize a treatment plan to fit your unique goals.

Before and After Photo

How many Fraxel treatments will I need?

Clinical studies suggest that on average, an effective treatment regimen is 4 to 6 sessions spaced about 2 to 4 weeks apart. Depending on your condition and schedule, you and the physician may choose to space treatment sessions further apart. Results are immediate and progressive, with optimal improvement usually visible in 2 to 3 months. This time frame and treatment structure allow for complete healing and the production of new collagen and elastin to replace damaged tissue.

What precautions should I take after Fraxel re:store treatment?

Wear sunscreen of SPF 30 or higher, avoid direct sun exposure for at least 13 months after your last treatment, and wear a wide-brimmed hat when you're in the sun.

How long do the effects of Fraxel Dual re:store last?

It depends on your particular condition and how you care for your skin. Once your skin is treated, continue to protect it as described above. Your physician will give you specific advice based on your individual needs.

What side effects can I expect after a Fraxel Dual re:store and how long will they last?

Swelling and redness are the most common side effects from a Fraxel DUAL 1550/1927 treatment. Any swelling is typically minimal and subsides within a day or two, and any redness typically fades within a few days. Other temporary side effects may include minor itching, dry skin, peeling or flaking, and a bronzed skin appearance. There is a limited risk of infection, hyperpigmentation, or scarring. The intensity and duration of side effects depend on the aggressiveness of a treatment and on your particular healing characteristics. Dr. Toerge and staff will go over specific post care instructions with you the day of the procedure.

What should I expect after Fraxel Dual treatment?

During the first 24 hours after a treatment, your skin may feel as though it is sunburned, and it will appear pink or red. You can wear make-up to reduce the sunburned appearance. Your skin will naturally bronze over the next week or two, and as you continue treatment, the sunburned-to-bronzed appearance will repeat. As with a sunburn, your skin will flake and exfoliate normally. Use a moisturizer to reduce the appearance of dry flakes.

Does Fraxel Dual treatment hurt?

Most patients describe an increased sensation of heat during the treatment. To minimize discomfort, topical anesthesia is applied before the procedure and cold air is used on the treatment area during the procedure. After the treatment, most patients feel like they have a sunburn, which usually diminishes in 1 to 3 hours.

How many Fraxel Dual treatments will I need and how frequently will they be spaced?

Clinical studies suggest that on average, an effective treatment regimen is 3 to 5 sessions spaced about 2 to 4 weeks apart. Depending on your condition and schedule, you and Dr. Toerge may choose to space treatment sessions further apart. Results are immediate and progressive, with optimal improvement usually visible in 2 to 3 months. This time frame and treatment structure allow for complete healing and the production of new collagen and elastin to replace damaged tissue.

How are Fraxel Dual treatments preformed?

First, your skin will be cleansed. Then, about 60 minutes prior to treatment, a topical anesthetic ointment will be applied to the treatment area. The Fraxel DUAL 1550/1927 procedure takes about 15-20 minutes for a full face.

What FDA clearances has Fraxel Dual received?

  • Wrinkles around the eyes (periorbital wrinkles)
  • Acne scars
  • Surgical scars
  • Age spots/sunspots (pigmented lesions)
  • Melasma (irregular patches of brown skin on the forehead, cheeks,
  • upper lip and nose)
  • Actinic Keratoses (precancerous lesions)
  • Skin resurfacing

Courtesy of Fraxel For more information visit Fraxel

What to expect, Do's (and don'ts) after Fraxel

Taking care of your skin after a Fraxel procedure is as important as the actual treatment itself!

Listed below are instructions on how to make your healing process as comfortable and easy as possible.

immediately after treatment:

  1. Your face will feel very warm. Soothe your hot skin by placing frozen peas on the treated area for 5-10 minutes every 1-2 hours until bed time.
  2. In order to prevent undue swelling, try to keep head elevated when lying down by using an additional pillow or two.
  3. When looking at your skin up-close, you may notice a "grid" texture to your skin. This is completely normal, and each of those microscopic dots represents an area of skin that was treated today. (The criss-cross pattern marks the actual path of the laser beam as it treated your skin.)
  4. Drink plenty of fluids to stay hydrated. (Diuretics such as alcohol or caffeine should be avoided.)
  5. If your skin feels tight or itchy, apply a noncomedogenic moisturizer liberally, as many times as needed. (Leave your moisturizer and sunscreen in the refrigerator! It makes applications feel especially soothing.)
  6. Your skin is especially fragile, and needs to be shielded from the sun. Sunscreen (at least SPF-30) is a must. You will need a purely physical sunscreen like Elta UV Physical.
  7. Start taking Valtrex 1gm each day for 10 days to prevent cold sores.

Next day:

  1. If your skin feels tight, dry, or itchy, continue to apply noncomedogenic moisturizer Neutrogena hydro boost as often as needed. You will likely be applying moisturizer at least 3 times a day.
  2. Make sure to apply ample sunscreen after washing face in the AM. Even if you are not going to be outdoors, you can still be exposed to incremental sunlight from windows, or being in the car, etc. Protect the skin you are trying to perfect!
  3. Although cold compresses will no longer benefit your healing process, the coolness against your skin will still feel good. For comfort's sake, you are welcome to continue to ice your skin for as long as you like.
  4. If you are experiencing uncomfortable swelling, any over-the-counter anti-inflammatory such as Aleve or Motrin can be beneficial in reducing puffiness. The most common areas of swelling are under the eyes and around the mouth. Do not worry, if this happens to you — it will go away!
  5. You may notice that the "grid" texture is more pronounced today, and possibly turning brown, with a rough, sand-papery texture. This is completely normal, and is simply a sign of your skin's healing process — each of those tiny spots represents a treated area that is being pushed out as your skin heals from underneath.
  6. You may notice tiny white bumps all over the skin. These are pockets of solidified oil, and will wash/slough away within a day or two if left alone. Do not try and pick these — your skin is very sensitive right now, and even the most gentle of attempted extractions can greatly complicate a situation that would naturally and quickly resolve itself.

Days 2 through 7 after treatment:

  1. Your swelling should be going down; however it is not uncommon for some puffiness to remain for up to 7-days after treatment.
  2. Continue to apply moisturizer and sunscreen as needed.
  3. You may still be pink/brown. Once peeling starts do everything you can to NOT pick or peel it off. The skin will come off as it heals, and in the meantime any forced peeling can result in scarring or permament discoloration.
  4. If you are noticing any pimple-like breakouts, again do NOT pick or pop! If the Fraxel came into direct contact with any debris lurking in a pore, your body's healing process has expedited the cleansing process and pushing out the clog now. In other words, any pimples you are experiencing now are breakouts that would have occurred in the future. Your skin is still very fragile, so any extractions you attempt can easily go awry. If you leave any break-outs alone, you should notice a quick and easy natural clearance as your skin continues to shed and heal.

During the first week after treatment, you should avoid:

  • Pulling at skin that is not ready to come off.
  • Trying to pick, pop, or scratch anything on your skin.
  • Prolonged exposure to the sun.
  • Any harsh skin care products; do not use any Retinols, exfoliating products, Clarisonic brushes, Benzoyl Peroxide, Glycolic or Salicylic Acid products. If you have questions about a product, please feel free to ask us! 301 951-7905)
  • Waxing hair on treated areas. Gentle shaving or tweezing is fine however.
  • Washing your face with hot water. Hot water will not do any damage to your skin, but when your skin already feels so warm, it won't feel good. Warm water feels much better against the skin.

After one week:

  • You should be able to go back to your original skin care regimen a week after treatment. However, your skin will "speak" to you, and if your regular products cause irritation after a week's time, you should abstain from using for another day or two.

One month:

  • If you are intending to have multiple Fraxel treatments, your skin is ready for a subsequent treatment a month after your first.

Some moisturizers, such as Vaseline or Aquaphor, are "occlusive" and too heavy for your skin. In order to prevent unnecessary clogged pores, please feel free to run your moisturizer of choice by us.

Please keep in mind that healing time varies from person to person - be patient with your healing process.

Our Location

5454 Wisconsin Ave, Ste 1400, Chevy Chase, MD, 2081

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