If brown spots, redness or rougher texture have become more noticeable after years of sun exposure, it can be difficult to know which treatment actually matches what you see in the mirror. These changes do not all develop at the same depth in your skin, which is one reason Fraxel and BBL are used for different concerns.
Fraxel is a fractional laser and may be worth considering when texture, scarring or deeper resurfacing is part of the problem. BBL uses intense pulsed light and can be useful for selected brown and red changes. Your dermatologist can look at whether colour, texture or both are driving your concerns and help you choose an approach that suits your skin tone, goals and preferred downtime.
What Are Fraxel and BBL?
Fraxel DUAL is a non-ablative fractional laser system that creates tiny treatment zones in your skin. Its 1550 nm wavelength reaches deeper for concerns such as texture and scars, while 1927 nm works more superficially for selected sun spots and freckles.
BBL, or BroadBand Light, is a branded form of intense pulsed light (IPL) that uses filtered wavelengths to target melanin and haemoglobin. It may suit certain brown pigmentation and redness, while Fraxel DUAL may be more relevant when texture, scarring or deeper remodelling are also treatment goals.
How Does Fraxel DUAL Work?
Fraxel delivers controlled laser energy into tiny columns within your skin while leaving surrounding tissue untreated to support healing. As these treated areas heal, remodelling can gradually improve tone, texture and the appearance of certain scars.
The 1927 nm wavelength can be used for selected superficial pigmentation, while 1550 nm reaches deeper into your skin for concerns such as scars, wrinkles and uneven texture. The wavelength, energy and treatment coverage can then be adjusted to suit your skin and the changes you want to improve.
How Does BBL Work?
BBL uses filtered intense pulsed light that can be absorbed by melanin in brown pigmentation or haemoglobin in visible blood vessels. Treated pigmented spots may temporarily become darker before gradually fading.
BBL systems also use cooling to protect your skin and make treatment more comfortable. Different filters can be selected depending on whether pigmentation, redness or visible vessels are being targeted, while the treatment settings can be adjusted for your skin.
What Is the Main Difference Between Fraxel and BBL?
Fraxel creates controlled microscopic thermal zones within the skin, while BBL uses filtered light to target melanin or haemoglobin. Fraxel is primarily a resurfacing treatment, whereas BBL is particularly useful for selected pigmentation, redness and visible vessels.
If your skin has brown spots and redness but little texture change, BBL may be more relevant, while Fraxel may suit concerns such as acne scars or uneven texture. Treatment choice should be guided by whether the main issue is colour, texture, scarring or a combination of these.
Fraxel vs BBL at a Glance
| Feature | Fraxel | BBL |
| Technology | Fractional non-ablative laser | Filtered intense pulsed light |
| Main targets | Skin resurfacing, texture, selected scars and pigmentation | Selected brown pigmentation, redness and superficial vessels |
| Energy delivery | Specific laser wavelengths | Broad spectrum of light selected through filters |
| Acne scars | 1550 nm may treat selected atrophic scars | Does not primarily correct scar indentation |
| Redness and vessels | Not its main target | One of its main applications |
| Pigmented lesions | 1927 nm may treat selected superficial pigmented lesions | Filters can target selected melanin-containing lesions |
| Downtime | Usually more visible | Often shorter, depending on settings |
| Skin tone considerations | PIH risk needs assessment | Melanin targeting means skin type and filter choice are particularly important |
Which Treatment Can Help With Brown Pigmentation?
Fraxel DUAL’s 1927 nm wavelength can treat selected age spots, sun spots and freckles, particularly when pigmentation appears alongside wider photodamage. BBL works differently, using filtered intense pulsed light that can be absorbed by melanin within suitable pigmented lesions.
Your choice may depend on whether you also have uneven texture or other resurfacing concerns. Your dermatologist should first confirm the cause of your pigmentation, as not every brown mark should be treated with Fraxel or BBL.
What If Your Pigmentation Is Melasma?
Melasma needs careful treatment because heat, light and inflammation can worsen pigmentation or contribute to recurrence. Brown pigmentation should therefore be correctly diagnosed before either Fraxel or BBL is considered.
Laser or light treatment may be considered in selected cases, but results for melasma are variable and treatment can worsen pigmentation or trigger recurrence. Your dermatologist may therefore prioritise photoprotection and established medical treatments before considering a procedure. If laser or light treatment is being discussed, your skin type, melasma pattern and previous response to pigmentation treatments should all form part of that decision.
Which Treatment Is Better for Sun Damage?
BBL may suit you when your sun damage mainly appears as brown spots, redness or visible vessels. Fraxel DUAL may be considered when uneven texture or resurfacing is also part of what you want to improve, with the 1927 nm wavelength targeting selected superficial pigmentation and 1550 nm working more deeply.
Your dermatologist should assess the type and pattern of your sun damage before treatment. This helps distinguish cosmetic photodamage from skin changes that may need medical assessment before any laser or light procedure.
Clinical Tip
Do not assume that every new brown or rough area is cosmetic sun damage. A persistent, changing, crusting or bleeding lesion should be examined before laser or light treatment so that an actinic keratosis or skin cancer is not missed.
Which Treatment Can Help With Redness and Visible Blood Vessels?
If facial redness or visible blood vessels are your main concern, BBL may be more suitable because its filtered light can target haemoglobin. It may be considered for small facial vessels, diffuse redness and some vascular changes associated with rosacea.
Fraxel is mainly used for pigmentation, texture, wrinkles and scars rather than directly targeting blood vessels. Your dermatologist can first assess what is causing the redness and whether BBL or another vascular treatment would be appropriate for your skin.
Research Insight
A 2017 prospective split-face study included 15 people with bilateral facial erythema. Participants received two BBL treatments on one side of the face and non-purpuric 595 nm pulsed-dye laser treatment on the other, with both approaches reported as similarly effective for reducing redness. The study was small, so it does not establish BBL as the best treatment for every vascular concern.
Which Is Better for Skin Texture?
Fraxel DUAL may be worth considering when rough or uneven texture is one of your main concerns. Its 1550 nm wavelength reaches deeper into the skin and can support remodelling in concerns such as uneven texture and selected acne or surgical scars.
BBL may make your skin appear more even when redness or pigmentation contributes to an uneven appearance, but it does not provide the same fractional resurfacing effect as Fraxel. Your dermatologist can assess what is causing the uneven texture and whether resurfacing or treatment of underlying redness or pigmentation is likely to be more useful for you.
Which Treatment May Help With Acne Scars?
If indented acne scars are what you want to improve, Fraxel may be more relevant because its 1550 nm wavelength can stimulate deeper dermal remodelling. BBL is better suited to colour-related concerns such as redness or pigmentation associated with acne and does not primarily correct the structural indentation of a scar.
Your acne scars may need different treatments depending on whether they are rolling, boxcar or ice-pick scars. Your dermatologist can assess your scar type and discuss whether Fraxel, BBL or another treatment such as subcision is more appropriate.
Evidence Note
Fraxel DUAL 1550 nm has a specific indication for acne scars, whereas BBL is primarily used here for colour-related concerns such as pigmentation and vascular changes. This is why the structure and type of your acne scars should be assessed before deciding which approach is relevant.
What Does BBL Treatment Feel Like?
BBL often involves less visible recovery than Fraxel DUAL, although recovery depends on the filters, energy settings, treatment area and your individual skin response. You may feel brief warmth or a snapping sensation during treatment, while cooling helps keep your skin comfortable.
Your skin may look pink afterwards, and your brown spots can temporarily become darker. The filter and energy level can be adjusted according to your skin, the concern being treated and how you respond during the procedure.
UK Guidance Note
MHRA guidance for lasers and intense pulsed light systems emphasises appropriate equipment, trained users, eye protection, skin cooling where required and treatment procedures designed to reduce avoidable optical and thermal injury. Your consultation should therefore include assessment of the device, settings, skin type and relevant medical history.
What Does Fraxel Treatment Feel Like?
Fraxel usually involves topical anaesthetic before treatment, and you may notice increasing warmth as the laser passes over your skin. Cooling can make the procedure more comfortable, although your skin may feel similar to mild sunburn afterwards.
Your experience will depend on the wavelength, energy and treatment area. Ask your dermatologist what settings are being planned and what those settings are likely to mean for your comfort and recovery.
How Does the Downtime Compare?
Fraxel DUAL often involves more visible recovery than many BBL treatment protocols, although downtime for either procedure depends on treatment intensity and your skin response.
- Fraxel redness and swelling: Your skin may look red, warm or slightly swollen after treatment.
- Dryness and peeling: Fraxel can cause dryness, flaking or temporary darkening as your skin heals.
- BBL recovery: BBL usually causes less downtime, although your skin may look pink or feel warm.
- Temporary pigment darkening: Brown spots treated with BBL can become darker before gradually fading.
You should plan either treatment around important events, particularly if visible redness or peeling would concern you. Your dermatologist can explain what recovery is likely for your chosen settings.
How Should You Look After Your Skin After Treatment?
Follow the aftercare instructions given for your procedure and avoid picking or rubbing your skin while it peels or treated pigment darkens. Keeping your skincare gentle and using an appropriate moisturiser can help your skin feel more comfortable as it recovers.
Sun protection is especially important after treatment because UV exposure can increase unwanted pigmentation. You should use the protection recommended by your dermatologist while your skin heals to reduce this risk.
How Many Treatment Sessions Might You Need?
You may need one or several Fraxel or BBL treatments depending on what you are treating, the intensity used and how your skin responds. Some people notice an improvement after one session, while others may benefit from a course of treatment.
Your dermatologist should review how your skin responds before recommending further sessions. Treatment can then be adjusted according to your response rather than following a fixed package.
Are Fraxel and BBL Suitable for Every Skin Tone?
Your skin tone and pigmentation history are important when planning Fraxel or BBL treatment. A tendency to develop post-inflammatory hyperpigmentation, recent tanning and previous skin reactions should all be considered when choosing treatment settings.
BBL targets melanin, while Fraxel can also require adjusted settings for you if you are prone to dark marks. Your skin type, previous pigment changes and response to earlier treatments should all be considered before deciding whether Fraxel or BBL is appropriate for you.
When Might Treatment Need to Be Postponed?
Treatment may need to be delayed if you have an active skin infection, an active cold sore outbreak, significant inflammation, recent tanning or another condition that could affect healing or increase the risk of pigmentation changes.
Your dermatologist should also review medicines, previous cosmetic procedures, abnormal scarring and previous reactions to laser or light treatments. Do not stop prescribed medication yourself before treatment unless your treating clinician advises you to do so.
What Are the Risks and Side Effects?
Both treatments can cause your skin to become red, warm, dry or sensitive. Less common complications can include burns, infection, unwanted pigment changes or scarring. Tell your dermatologist about your skin history, medicines, recent procedures and any active infection before treatment.
Recent sun exposure and a history of developing dark marks are also important. Your dermatologist can take these factors into account when selecting treatment settings and advising you about sun protection before and after the procedure.
How Can You Choose Between Fraxel and BBL?
Start with what you actually want to change in your skin rather than the name of the device. BBL may be more relevant if brown spots, freckles, redness or visible vessels are bothering you most, while Fraxel may make more sense when rough texture, acne scars or deeper photodamage are also part of the problem.
Think about recovery as well. If visible redness, dryness or peeling would be difficult to fit around work or an important event, discuss that before treatment so the plan reflects both your skin and your lifestyle.
Myth vs Fact
| Myth | Fact |
| BBL is another type of laser | BBL is an intense pulsed light technology, not a laser. |
| Fraxel is always better for pigmentation | Suitability depends on the type and depth of pigmentation and whether texture or scarring is also present. |
| BBL can remove indented acne scars | BBL mainly targets colour-related concerns and does not primarily correct structural scar indentation. |
| Either treatment is suitable for every brown mark | Pigmentation needs to be diagnosed before treatment because melasma, sun spots and PIH behave differently. |
| Darker skin cannot have laser or IPL treatment | Some treatments may be possible, but skin type, pigmentation history and settings require particularly careful assessment. |
Key Takeaways
- Fraxel is a fractional laser treatment, while BBL is filtered intense pulsed light rather than a laser.
- Fraxel is more resurfacing-focused and may be considered for texture and selected acne scars.
- BBL is particularly useful for selected brown pigmentation, redness and visible superficial vessels.
- Neither treatment is universally better for sun damage because photodamage can involve pigment, redness, texture or a combination of concerns.
- Melasma and post-inflammatory pigmentation require particular caution before laser or IPL treatment.
- Skin tone, pigmentation history, treatment settings and acceptable downtime should all be considered before choosing a procedure.
Frequently Asked Questions
1. What should you tell your dermatologist before Fraxel or BBL?
Tell your dermatologist about previous pigment changes, abnormal scarring, cold sores, recent tanning, medicines and any recent cosmetic procedures. These factors can influence whether treatment is suitable and how the settings are selected.
2. Is Fraxel or BBL better for your pigmentation?
Both Fraxel and BBL can treat certain types of pigmentation, but they work differently. Fraxel DUAL’s 1927 nm wavelength can target selected superficial concerns such as sun spots and freckles, while BBL targets excess melanin with selected light wavelengths.
3. Can BBL treat your facial redness and visible blood vessels?
Yes, BBL can target certain forms of facial redness and visible vessels because selected wavelengths are absorbed by haemoglobin. If redness is your main concern, your practitioner can assess whether a vascular or light-based treatment is appropriate for your skin.
4. Can Fraxel or BBL permanently close enlarged pores?
No treatment can permanently close pores. Improving surrounding texture and skin quality may make pores appear less noticeable, but results depend on the underlying cause and the treatment used.
5. Which treatment is better for your acne scars, Fraxel or BBL?
Fraxel DUAL’s 1550 nm wavelength has a specific indication for acne scars and can support controlled dermal remodelling. BBL may be useful for redness or pigmentation associated with acne, but it does not primarily treat the structural indentation of an acne scar.
6. Which treatment has less downtime, Fraxel or BBL?
BBL often involves less visible downtime than Fraxel DUAL, although recovery depends on the treatment settings and your individual skin response. Fraxel DUAL may cause more noticeable redness, warmth, dryness and flaking, with the timing and duration of peeling varying according to treatment intensity and how your skin heals.
7. Can you have Fraxel or BBL if you have darker skin?
Your skin tone and tendency to develop post-inflammatory pigmentation need to be considered before either treatment. Your practitioner should assess your pigmentation history, recent sun exposure, skin type and proposed settings rather than selecting treatment based on skin colour alone.
8. Can you have Fraxel or BBL after recent tanning?
Recent tanning can increase the risk of unwanted pigment changes and may mean treatment needs to be postponed. Your current skin tone and recent sun exposure should be assessed before treatment.
9. When can you restart active skincare after Fraxel or BBL?
This depends on the treatment and how your skin is healing. Follow your aftercare plan and ask when products such as retinoids, acids or exfoliants can safely be restarted.
10. How can you choose between Fraxel and BBL?
Start by thinking about the skin concern you most want to improve. BBL may suit you if pigmentation, redness or visible vessels are your main issues, while Fraxel may be more relevant if rough texture, acne scars or broader structural photodamage are also concerns.
Final Thoughts: Choosing Between Fraxel and BBL
Fraxel and BBL can both improve sun damage and pigmentation, but they work differently and suit different skin concerns. BBL may be more relevant for you if pigmentation, redness or visible vessels are your main concerns, while Fraxel can be useful for you when texture, scarring or broader photodamage also needs attention.
If you’re considering Fraxel laser treatment in London, you can get in touch with our team at London Dermatology Centre.
References:
- Piętowska, Z., Nowicka, D. and Szepietowski, J.C. (2022) ‘Understanding Melasma How Can Pharmacology and Cosmetology Procedures and Prevention Help to Achieve Optimal Treatment Results? A Narrative Review’, International Journal of Environmental Research and Public Health, 19(19), 12084. Available at: https://www.mdpi.com/1660-4601/19/19/12084
- Handler, M.Z., Bloom, B.S. and Goldberg, D.J. (2017) ‘IPL vs PDL in treatment of facial erythema: A split-face study’, Journal of Cosmetic Dermatology, 16(4), pp. 450–453. Available at: https://pubmed.ncbi.nlm.nih.gov/28752575/
- Friedman, P.M. et al. (2022) ‘1,550 nm Erbium-Doped and 1,927 nm Thulium Nonablative Fractional Laser System: Best Practices and Treatment Setting Recommendations’, Dermatologic Surgery, 48(2), pp. 195–200. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC8806037/
- González-RodrÃguez, A.J. and Lorente-Gual, R. (2015) ‘Current Indications and New Applications of Intense Pulsed Light’, Actas Dermo-Sifiliográficas (English Edition), 106(5), pp. 350–364. Available at: https://www.sciencedirect.com/science/article/pii/S157821901500089X
- Hu, S., Atmakuri, M. and Rosenberg, J. (2022) ‘Adverse Events of Nonablative Lasers and Energy-Based Therapies in Subjects with Fitzpatrick Skin Phototypes IV to VI: A Systematic Review and Meta-Analysis’, Aesthetic Surgery Journal, 42(5), pp. 537–547. Available at: https://academic.oup.com/asj/article/42/5/537/6432599