In recent years, the field of dermatology has witnessed a paradigm shift in our understanding of how laser technology can be used not just to treat existing skin conditions, but to actively prevent the development of skin cancer. At the forefront of this revolution is the Fraxel 1940 non ablative fractional laser, a sophisticated technology that harnesses the power of controlled light energy to rejuvenate sun damaged skin and, remarkably, to modify the skin’s immune response in ways that help prevent future cancer development. As a cosmetic physician and candidate for the Master of Skin Cancer Medicine at the University of Queensland, I, Dr. Tina Fang, have devoted considerable research to understanding the mechanisms by which fractional laser technology achieves these outcomes.
This blog post will explore the science behind the Fraxel 1940 laser, explain how it differs from other laser treatments, and discuss the compelling evidence for its role in skin cancer prevention.
Understanding Fractional Laser Technology
Fractional laser technology represents a significant advancement in laser based skin treatments. Unlike traditional laser systems that treat the entire surface of the skin uniformly, fractional lasers deliver energy in a pattern of microscopic treatment zones (MTZs), leaving untreated skin between each zone. This approach allows for controlled, precise treatment that stimulates the skin’s natural healing response without causing the extensive damage and prolonged downtime associated with older laser technologies.
The key advantage of this fractional approach is that it creates a controlled wound healing response. The untreated skin between the treatment zones serves as a reservoir of healthy cells that can migrate into the treated areas, promoting rapid healing and regeneration. This mechanism allows for more aggressive treatment of photodamaged skin without the risk of significant scarring or prolonged recovery times.
The 1940nm Wavelength and Why It Matters
The Fraxel 1940 laser operates at a wavelength of 1940 nanometres, which is specifically chosen because it corresponds to one of the peak absorption wavelengths of water in the mid infrared spectrum. This is significant because water is the primary chromophore (light absorbing molecule) in skin tissue. By targeting this specific wavelength, the Fraxel 1940 laser can deliver energy to the skin in a controlled manner, creating thermal damage at superficial depths without ablating (removing) the epidermis, the outermost layer of the skin.
This non ablative approach is crucial for skin cancer prevention. By preserving the stratum corneum (the outermost layer of the epidermis), the treatment maintains the skin’s barrier function whilst still achieving the desired therapeutic effects. The laser creates focal areas of damage that extend to approximately 200 to 226 micrometres in depth, allowing for the treatment of both epidermal and superficial dermal pathology.
How Fraxel Differs from Other Laser Treatments
There are several types of laser treatments available for photodamaged skin, each with its own advantages and limitations. Ablative lasers, such as CO2 and erbium lasers, remove the entire thickness of the epidermis and portions of the dermis, resulting in more dramatic results but also more significant downtime and risk of complications. Non ablative lasers, such as the 1550nm fractional laser, provide gentler treatment with minimal downtime but may require more sessions to achieve results.
The Fraxel 1940 laser occupies a unique position in this spectrum. As a non ablative fractional laser, it combines the benefits of fractional technology with the safety profile of non ablative treatment. The specific wavelength and fractional delivery system allow for more controlled penetration and more predictable results than some other non ablative systems.
| Laser Type | Depth | Downtime | Results | Skin Cancer Prevention |
| Ablative (CO2/Er:YAG) | Full thickness epidermis and dermis | Weeks | Dramatic | Limited data |
| Non ablative 1550nm | Superficial dermis | Days | Moderate | Emerging evidence |
| Fraxel 1940 (Non ablative) | Epidermal and superficial dermal | 3 7 days | Significant | Strong evidence |
The Science of Controlled Thermal Damage
The Fraxel 1940 laser works by creating controlled thermal damage in the skin. When the laser energy is absorbed by water molecules in the skin, it generates heat that causes coagulation and denaturation of proteins in the targeted tissue. This thermal injury triggers the skin’s natural wound healing response, which involves the production of new collagen and the migration of healthy cells into the damaged areas.
This controlled thermal damage is precisely calibrated to achieve therapeutic benefit without causing excessive injury. The laser parameters, including energy level, pulse duration, and coverage percentage, can be adjusted to tailor the treatment to the individual patient’s needs and skin type. This level of control is essential for achieving optimal results whilst minimising the risk of adverse effects.
How Fractional Laser Changes Skin’s Immune Response
One of the most exciting recent discoveries in laser dermatology is that fractional laser treatment does more than just remove photodamaged tissue. It also triggers changes in the skin’s immune response that may help prevent the development of future skin cancers. Recent research has shown that non ablative fractional laser treatment is associated with a 50% decrease in the risk of developing basal cell carcinoma and squamous cell carcinoma . This remarkable finding suggests that the laser’s effects extend beyond simple tissue removal to include immunological changes that protect the skin from future malignant transformation.
The mechanisms behind this immunological benefit are still being elucidated, but research suggests that fractional laser treatment may enhance the skin’s ability to recognise and eliminate abnormal cells before they develop into cancer. This represents a paradigm shift in how we think about skin cancer prevention, moving from a purely surgical or destructive approach to one that harnesses the body’s own immune system.
Clinical Effectiveness for Skin Cancer Prevention
Clinical studies have demonstrated the effectiveness of the Fraxel 1940 laser for treating photodamaged skin and improving overall skin quality. In a clinical trial involving 18 female subjects with a mean age of 51 years, subjects underwent a series of 2 to 3 skin resurfacing treatments to the face or body with the Fraxel 1940 handpiece. The results showed visible reduction in pigmentation associated with photodamaged skin, with 50% of subjects reporting “Very satisfied” with their treatment outcome and 65% showing improvement on the Global Aesthetic Improvement Scale .
Beyond these cosmetic improvements, the underlying mechanism of action suggests that the treatment is addressing the fundamental pathology that leads to skin cancer. By removing photodamaged tissue and triggering immune modulation, the Fraxel 1940 laser offers a comprehensive approach to skin cancer prevention.
The Role of Collagen Remodelling in Prevention
A key mechanism by which the Fraxel 1940 laser may prevent skin cancer is through its effect on collagen production and remodelling. Photodamaged skin is characterised by disorganised and degraded collagen, which contributes to both the visible signs of ageing and the increased risk of skin cancer. The thermal injury induced by the Fraxel 1940 laser stimulates the production of new, organised collagen, which strengthens the skin’s structure and resilience.
This collagen remodelling process is not instantaneous; it occurs over weeks and months following treatment. Markers of collagen synthesis peak around 30 days post treatment, and the benefits continue to accrue over a longer period. This extended remodelling process contributes to the long term benefits of the treatment, including improved skin texture, reduced wrinkles, and enhanced skin health.
Treatment Considerations and Expectations
The Fraxel 1940 laser is typically administered in a series of 2 to 3 treatments, spaced 2 to 3 weeks apart. Each treatment session lasts approximately 20 to 30 minutes, depending on the size of the area being treated. After treatment, patients typically experience redness and mild swelling, similar to a sunburn, which resolves within 3 to 7 days. Some patients may experience mild peeling or flaking of the skin as the damaged tissue is shed.
It is important to note that sun protection is essential following treatment. The skin is more sensitive to UV radiation in the weeks following laser treatment, and strict sun avoidance and the use of high SPF sunscreen are necessary to protect the healing skin and to maximise the benefits of the treatment.
Conclusion
The Fraxel 1940 laser represents a significant advancement in our ability to prevent skin cancer through non invasive laser technology. By combining fractional delivery with a specific wavelength that targets water in the skin, this laser achieves controlled thermal damage that stimulates collagen remodelling and immune modulation. The clinical evidence for its effectiveness in treating photodamaged skin is compelling, and emerging research suggests that it may play an important role in skin cancer prevention.
At ISO Skin Cancer & Laser Clinic, we are committed to offering our patients the latest, evidence based treatments for skin health and cancer prevention. If you would like to learn more about the Fraxel 1940 laser and how it might benefit your skin, we encourage you to schedule a consultation with one of our experienced cosmetic physicians.
