Cutera Fraxis Pro

With Ashish Bhatia, MD, FAAD

In each issue, Practical Dermatology® magazine spotlights a new device or cosmeceutical that dermatologists are recommending to patients. This month, Ashish C. Bhatia, MD, FAAD of Oak Dermatology in Itasca, IL, discusses Cutera’s Fraxis Pro, which launched in July 2020.

What is the Fraxis PRO, and how are you using it in practice?  

Dr. Bhatia: Fraxis Pro combines fractional CO2 for skin resurfacing and radiofrequency microneedling for dermal remodeling in a single device. We are able to use the Fraxis PRO system for nearly all of our patients. The microneedle RF system allows safe treatment of all skin types for remodeling and rejuvenation. The fractional CO2 is my go-to for micro peels as well as fractional resurfacing. I have performed more than 100 procedures to date with this device with successful outcomes. The greatest thing about the system is that it delivers the best of both worlds for skin remodeling. Whether you’re treating deep acne scars or burn scars, just looking for a little firming or a micropeel, Fraxis Pro gives the flexibility to treat all kinds of patient needs.

What are the treatment protocols?

Dr. Bhatia: Combination therapy with the fractional CO2 and microneedling RF is very efficient for the patient and the practitioner. With this system, we can dial it up or dial it down for each patient. All skin types are candidates, even darker skin types can be treated on lower settings. My recommendations are treating dark skin just with rejuvenation, and treating lighter skin types with rejuvenation plus resurfacing, if needed. We also can do a micro laser peel with minimal downtime to freshen the skin and even the skin tone for superficial pigmentation issues. For laser micro peels, typically we can treat once per month or even every other week for a total of two to four sessions or more as needed. The typical protocol is three or four treatments, or five or six for lower settings. With microneeding RF we typically treat at four-week intervals. For patients who don’t have severe textural changes, they can have a single CO2 with RF microneedling treatment on the same day followed by three or four microneedling RF sessions, or we can wait two or three months if we are using repeated combination therapy.

How does this device stand out from other skin rejuvenation devices?

Dr. Bhatia: Having two modalities (ablative laser and RF microneedling) in one system is a valuable point of difference for dermatologists. The Fraxis Pro is addresses issues from the inside (RF microneedling) and out (fractional CO2) in the same device, which makes it uniquely versatile for the practice. Having two modalities in one box is an efficient use of space and time for the doctor and allows treatments to be done sequentially. We don’t have to switch rooms or move the device into another room to do the second treatment at the same visit. This device is both time saving and space saving. We can do something for everyone. If you don’t have a lot of lasers, this ticks a lot of boxes. It is a fast device so we can cover a larger area very quickly. You can do more in one session for the patient, which is especially helpful post-Covid-19. For example, perioral or periorbital areas take less than 20 minutes each for combination treatment and full face can be done in an hour. We can also treat the neck on lower setting in about 35 minutes. Cheeks and foreheads also go very fast.

How are you marketing or introducing the device to patients?

Dr. Bhatia: It is important to let your current patients know that you offer this new device and what the benefits are. We tend to market mainly to our existing patients via eblasts and our website. We are also active on social media channels, including Instagram, Facebook, and YouTube.

Get more. Visit to access “New in My Practice” features from past issues, covering both devices and topical products. You can also get product updates and news anytime at