Both are fractional lasers. Both improve skin. But they work at different depths, treat different concerns, and ask for very different amounts of downtime. Here's how to know which one is right for you.
The difference comes down to depth. ReVive Thulium's 1927nm wavelength is absorbed almost entirely by water in the epidermis, staying confined to the top 200 to 300 microns of skin. Erbium/FraX penetrates deeper into the upper dermis. That single difference in depth is what determines everything else — what each laser can treat, how much downtime it requires, and who each one is actually right for.
Skin concerns live at different depths. Surface pigment, sun spots, and dullness sit close to the top layer of skin — exactly where ReVive Thulium concentrates its energy. Texture, fine lines, and more significant photodamage sit deeper, in the dermis, where collagen remodeling actually happens — territory that requires Erbium/FraX's greater penetration to meaningfully address.
This is also why the recovery timelines differ so much. Thulium's shallow, water-targeted mechanism produces light bronzing and shedding that resolves in a few days. Erbium/FraX creates more significant tissue disruption at a deeper level, which takes longer to heal but also produces more substantial, longer-lasting improvement in texture and fine lines.
If brightness and sun damage are the concern, Thulium gets there faster and with far less recovery. If texture, fine lines, or more significant resurfacing are the goal, Erbium/FraX has the depth to actually make a difference. Many patients use both over time — Thulium as a low-downtime maintenance option between periodic Erbium sessions. The right starting point depends on your skin, which is why this gets assessed at consultation.
It's common to have both surface pigment and deeper texture concerns at once. In these cases, Dr. Mortazavi often sequences treatments — addressing one depth, then the other — rather than asking a single laser to do more than it's designed for. For pigment specifically, the Pigment Protocol combines ReVive Thulium with PicoLazer for comprehensive correction across both surface and deeper pigment.
Patients often ask which laser is "better" — but they're not competing with each other, they're built for different jobs. I assess what's actually driving the concern before recommending either one. Every treatment is performed personally.
What is the main difference between ReVive Thulium and Erbium/FraX?
ReVive Thulium's 1927nm wavelength stays confined to the epidermis, roughly 200 to 300 microns deep, and is absorbed almost entirely by water. Erbium/FraX penetrates deeper into the upper dermis, allowing it to address texture and fine lines that Thulium cannot reach as effectively.
Which laser has less downtime?
ReVive Thulium has significantly less downtime, typically 1 to 3 days of mild redness and light bronzing. Erbium/FraX requires a moderate recovery period as it works deeper into the skin.
Which laser is better for sun spots and pigmentation?
ReVive Thulium is well suited to surface pigment, sun spots, and dullness because that is where its wavelength is absorbed most effectively. Erbium/FraX can also improve pigment but is generally chosen when texture correction is the primary goal.
Which laser is better for texture and fine lines?
Erbium/FraX is the better choice for texture, fine lines, and more substantial resurfacing because it reaches deeper into the dermis where collagen remodeling for texture actually occurs. ReVive Thulium produces only mild texture improvement as a secondary effect.
Can ReVive Thulium and Erbium/FraX be used together?
Yes. Some patients benefit from combining both, using ReVive Thulium as a lower-downtime maintenance treatment between periodic Erbium/FraX sessions that address deeper resurfacing needs.
Dr. Mortazavi will assess your skin and recommend the treatment — or combination — that actually fits your goals.