Cutera

A frequent question regarding Pearl and Pearl Fractional for resurfacing is which product is more aggressive? The common misconception is that Pearl Fractional is less aggressive than Pearl. This misconception comes from old technologies like CO₂ traditional resurfacing vs. fractional – where the fractional therapy is less aggressive. 

Pearl (confluent) is not designed to create deep full coverage resurfacing like old CO₂. This is not due to its ability, but rather due to the market desire. There are very few deep full coverage resurfacing procedures performed due to the prolonged downtime and high risk of complications. Pearl (with YSGG) is able to perform a treatment that no other wavelength can accomplish. That is to treat to the D/E junction with a thermally confined pulse to provide full surface improvement and collagen stimulation without weeping, oozing or long downtimes and risk. 

Pearl Fractional is designed to be the aggressive tool. Because it treats fractionally, it is possibly to create deep ablation without high risk and downtime. When performing Pearl Fractional procedures, the energy delivered from the laser is significantly more intense than a Pearl laser shot, resulting in ablation in excess of 1mm. Most treatments are performed at 600 to 800µm, which is 1/3 to ½ of the maximum settings on the device.  . Density is then selected by the user to determine the degree of coverage – and subsequent intensity desired. Pearl Fractional is actually one of the most powerful and potentially aggressive devices available on the market today. The aggressiveness of Pearl Fractional treatments (depth and coverage percentage) is limited by physician choice, not by the device.

So why use both? Pearl performs a treatment no fractional laser can accomplish. It treats the entire surface of the face to the D/E junction. This improves universal skin tone, texture, quality, pigment, etc. Pearl Fractional is aggressive to treat significant damage with minimal downtime, but does so by being fractional. This can be used to create greater dermal injuries in focal regions for greater stimulation – but it, like all fractional lasers, intentionally does not treat the majority of the skin’s surface.