Clear + Brilliant vs Fraxel vs Tetra Pro:
light non-ablative, deeper non-ablative, or ablative CO2

What is the difference between Clear + Brilliant, Fraxel and the Tetra Pro?

All three descend from the same idea. In 2004 Manstein and colleagues described fractional photothermolysis: deliver heat in an array of microscopic treatment zones separated by untreated skin, so that healing proceeds from the bridges in between. Every fractional laser since, ablative or not, uses that grid. What differs is what happens inside each column.

The brand names cause confusion because the same company sells all the non-ablative options and, at one time, an ablative CO2 model under the Fraxel name too. When a clinic says Fraxel, the useful questions are which wavelength and whether the surface is removed; the answers tell you more than the badge. The fractional laser glossary entry sets out the vocabulary.

What does Clear + Brilliant do, and who does it suit?

Clear + Brilliant is the light end of the ladder. The original handpiece is a 1440 nm diode run at low energy through a rolling tip, and the Permea handpiece is 1927 nm, absorbed even more superficially. The Touch system treats with both in one visit. Columns are shallow and the surface stays intact, so the skin looks pink and feels like fine sandpaper for a short time, with the micro-channels briefly making the skin more permeable to topicals.

The published record describes improvement in tone, texture, fine lines and the number of detectable pores after a series of low-energy treatments, and the 1927 nm handpiece has been studied in hyperpigmentation, melasma and post-inflammatory marks. A 2025 literature review of the 1440 and 1927 nm diode system found the expected reactions, redness, swelling and crusting, to be mild and self-limited, with safety demonstrated in skin of colour. It is well suited to a patient in their twenties or thirties with early sun damage, dullness and enlarged pores who wants a treatment with little to settle, and it is the wrong tool for a pitted scar, because it cannot reach the edge of one.

Clear + Brilliant is not used here. The equivalent rung at this practice is the FSX Laser, which pairs 1540 nm erbium glass with 1927 nm thulium and is calibrated zone by zone for fine lines, pores, superficial scars, post-acne redness and early laxity, with the 1927 nm pass doing the superficial pigment and texture work that Permea is sold for.

“Heating a column and removing a column are different treatments that happen to share a grid. I match the rung to the scar, not the scar to the laser the clinic owns.”

Dr Sin YongOn choosing between non-ablative and ablative fractional lasers

Where does Fraxel sit between the two?

Fraxel is the deeper non-ablative option. Its 1550 nm erbium fibre wavelength is absorbed less avidly by water than 1927 nm, so the energy travels further and the columns of coagulation reach the mid dermis, where collagen can be remodelled around them. The Dual model adds a 1927 nm thulium handpiece for the epidermal layer. Recovery is longer than after Clear + Brilliant, with swelling and a bronzed, flaking phase, but there is still no open wound.

In acne scars, non-ablative 1550 nm treatment improves shallow rolling and boxcar scars over a series, and the Hong Kong series in Chinese patients found it could be used in Fitzpatrick III and IV skin with a post-inflammatory hyperpigmentation rate that rose with density. It is a reasonable middle choice for diffuse, shallow texture change in a patient who cannot take the downtime of CO2. Its limit is the same as the lighter laser's: it softens a scar edge rather than reshapes it, and it does not release a tether.

Fraxel is not used here either. The non-ablative 1540 nm wavelength on the Secret DUO occupies the same place in a plan, creating columns of heating through intact skin, and can be combined with RF microneedling in the same visit where that suits the scar pattern. The Fraxel, CO2 and Tetra Pro article goes further into the brand, its history and why the name alone can mislead.

What does the Tetra Pro do that the other two cannot?

The Tetra Pro removes tissue. At 10,600 nm, CO2 light is absorbed so strongly by water that each pulse vaporises a column of skin, leaving a microscopic open channel surrounded by a rim of coagulated tissue. The channel reaches the edge of a scar, and the rim drives contraction and a strong collagen response. That is what a sharp-walled boxcar scar or a deep rolling scar needs, and it is why fractional CO2 remains the reference for atrophic scar resurfacing.

On the DEKA SmartXide Tetra Pro, Pulse Shape Design lets Dr Sin Yong set how each pulse rises, dwells and tails off, which changes the balance between vaporisation and the heat left behind. In his S3 Resurfacing Lift, point shots are placed into individual pits first and fractional passes then treat the surrounding skin. The laser is sequenced within the SCAR3 protocol: tethered scars are released by subcision first, ice-pick tracts are collapsed with TCA CROSS, and only then is skin that is free to remodel resurfaced. Depth decides: the FSX Laser for superficial scars, the S3 for deeper ones.

The cost of that reach is recovery and risk. There is an open, weeping phase, then a sandpaper phase, then a pink phase, and in Asian skin a real chance of darkening that is managed by density, preparation, moist healing and sun avoidance; the fractional CO2 in Asian skin guide sets out the logic. Resurfacing parameters validated on lighter skin are a starting point here, not an answer.

Which suits texture, which pigment, and which scars?

Put the concern on the ladder and the laser follows.

• Dullness, early texture, pores, fine pigment: the light non-ablative rung. Clear + Brilliant elsewhere; the FSX Laser here, or R2T2 where the problem is tone rather than texture.
• Fine lines, sun damage, shallow diffuse scarring: the deeper non-ablative rung. Fraxel 1550 nm elsewhere; the 1540 nm fractional laser on the Secret DUO here, often with RF microneedling.
• Pitted acne scars, deep boxcar or rolling scars, a scar edge that must be reshaped: the ablative rung. The Tetra Pro, run as the S3 Resurfacing Lift after subcision and TCA CROSS where needed.
• Melasma or a reactive, darkening-prone skin: none of the three first. Diagnosis, photoprotection and an anti-inflammatory approach come before any fractional heat; see melasma treatment in Singapore.

What decides the plan at assessment is the scar type and depth found on mapping, the Fitzpatrick type and any history of darkening, whether tethers or ice-pick tracts need release first, how much recovery is realistic in the patient's life, and what has already been done to the skin. A patient who has been quoted Clear + Brilliant or Fraxel elsewhere is not being offered a lesser treatment; they are being offered a different rung, and the question is whether their scar needs the one above it.