CO2 Laser Treatment
CO2 laser skin resurfacing is a procedure involving the use of carbon dioxide (CO2) and a skin surface-removing laser (ablative laser) to remove scars, warts and deep wrinkles.
How does CO2 laser skin resurfacing work?
Ablative lasers, such as a CO2 laser, work by traumatizing the skin. It removes the thin outer layer of skin (epidermis) and heats the underlying skin (dermis). This stimulates the growth of new collagen fibers. As the epidermis heals and regrows, the treated skin appears clearer, smoother and tighter.
Non-ablative lasers, such as pulsed light (IPL) devices, do not traumatize the skin, instead they stimulate collagen growth and improve skin tone and texture. This is less invasive and requires less recovery time, but is less effective.
The surgeon chooses the laser type based on the condition being treated and the patient’s cosmetic goals.
What are the uses of CO2 laser skin resurfacing?
CO2 laser skin resurfacing can be used to treat:
- Fine and deep wrinkles
- Age spots
- Uneven skin tone or texture
- Sun-damaged skin
- Mild to moderate acne scars
- Large pores
- Superficial to deep hyperpigmentation
Other uses for carbon dioxide resurfacing include:
- Seborrheic keratosis
- Verruca vulgaris/plana
- Sebaceous gland hyperplasia
- Angiofibroma (fibrous papule of nose)
- Lentigo simplex
- Small syringomas
When is CO2 laser skin resurfacing not recommended?
CO2 laser skin resurfacing is not recommended with:
- Active bacterial, viral, or fungal infections
- Unrealistic expectations
- Poor general health
- Oral isotretinoin (Accutane) use within previous six months
- Fitzpatrick skin phototypes 5-6 (very dark skin)
Other resurfacing procedures within preceding two to three months:
- Unwillingness to accept possibility of complications
- Collagen vascular disease
- Human immunodeficiency virus (HIV) or systemic infections
- Tendency for keloid or thick scar formation
Is CO2 laser skin resurfacing painful?
CO2 laser skin resurfacing is usually done with anesthesia, so there is minimal discomfort during the procedure.
Topical anesthetics are common
Numbing cream may be applied directly onto the skin or sometimes local infiltration (injection)
Other types of anesthesia are usually performed in individual situations and for skin conditions that need deeper penetration of the laser. These forms of anesthesia include:
- Regional nerve block
- Intravenous (IV) sedation
- Laryngeal mask airway
- Combined techniques
Post-operative pain is minimal and can be managed with oral pain killers
What are the side effects of CO2 laser skin resurfacing?
Transient side effects (resolve spontaneously or with medication):
- Erythema (redness)
- Itching (pruritus)
- Post resurfacing hyperpigmentation
- Infection (bacterial, viral, yeast, fungal)
- Contact dermatitis
- Serious complications
- Hypopigmentation (loss of skin pigment)
- Sharp demarcation lines
- Hypertrophic scars and keloids
- Tooth enamel injury
- Eye abrasion/injury
- Post-inflammatory hyperpigmentation (PIH)
How effective is CO2 laser skin resurfacing?
Results of CO2 laser resurfacing are good to excellent, depending on the indication for which the procedure was performed. Sun damage improves the most with laser resurfacing. Wrinkles may improve by 60% to 80% in some people, while scars improve to a lesser degree.
Most patients are satisfied with the aesthetic improvement, and the surgery results in minimal recovery time and a low incidence of complications.