CO2 Laser Fractional Resurfacing


What is CO2 Laser Fractional Resurfacing?

The CO2 laser gently vaporizes the outer layer of sun-damaged, wrinkled, or acne-scarred skin to reveal smooth, fresh skin underneath. It is designed to remove superficial wrinkles around the eyes, lips, forehead and cheeks seen in aging skin. Facial scars and sun-damaged skin are also excellent candidates for this treatment. Generally, the results demonstrate improvement in the texture of the skin.

Why CO2 Laser?

  • Invented in 1964, CO2 lasers have a long history of use and plenty of evidence to attest to their effectiveness and safety on fair to light skin tones.
  • Doctors can customize CO2 laser skin resurfacing treatments to best suit your skin type and concerns. There are several CO2 lasers on the market, and your provider will recommend the device, treatment intensity, and number of sessions that are right for you.
  • Laser resurfacing addresses a wide range of concerns beyond just aging and damaged skin. When it's performed by an experienced provider, a good candidate will see smoother, clearer, brighter skin once they’ve healed.

What happens after treatment?

CO2 laser resurfacing is an outpatient procedure. Appointments last from 30 minutes to two hours, depending on the size of the treatment area and aggressiveness of treatment. Here’s what to expect:

  • If you’re having a fractional CO2 laser treatment, your doctor will first numb you with local anesthesia and may also provide an oral sedative to help you relax.
  • For a fully ablative treatment, you’re likely to be put under general anesthesia so that you’re completely asleep. (Arrange for a ride home if you’re going to be sedated for the procedure.)
  • Once you’re numb or unconscious, your provider begins moving the handheld laser device across the treatment area as it emits its powerful light beam. The beam is usually a square, so the provider carefully moves the device section by section, lining up each ablated square in a grid-like pattern until the full area has been treated.
  • You won’t feel or be aware of anything if you’re under general anesthesia. If you have just numbing cream or an injected local anesthetic, the sensation can feel like a snapping rubber band.
  • After your provider has applied the laser beam to the full treatment area, they’ll cover your skin with a thick ointment and dressings.

How long is recovery?

Social downtime (when you won’t want to leave the house) can stretch for several days for fractional treatments to more than two weeks for fully ablative treatments.

During that recovery time, your skin will be swollen and develop scabs or crusting. You’ll first notice that your skin is raw, which can feel itchy and painful. You may also have some pinpoint bleeding, particularly following a more ablative treatment.

“It will feel like an exaggerated sunburn, but ice packs will help take down the sting within one to two hours,” says Dr. Paul Flashner, a physician in Boston. Over-the-counter pain relievers can offer some additional relief, and doctors may prescribe stronger pain medication for aggressive fully ablative treatments.

Swelling can be managed with prescription steroids and ice packs as well as keeping your head elevated while sleeping.

Follow your doctor’s precise instructions for gently cleansing and moisturizing the treated area. They may recommend or even provide specific medical-grade skin-care products for you.

It’s important to keep your skin protected and moist throughout the healing process—initially with ointments and thick creams, then with lighter creams and serums down the line. This encourages healthy cell turnover and prevents the forming of scabs, which can increase the chance of scarring and prolong healing time.

After the initial healing phase, your skin can remain pink for several weeks. You can apply makeup to conceal redness, but only after new skin grows in the entire treated area.

When you go out of the house, be especially mindful of sun exposure. Your fresh, new skin will be sensitive, so a broad-spectrum sunscreen with an SPF of at least 30 is a must.

How soon will you see results?

How soon you’ll see results depends on the intensity of your treatment and how long healing takes. You won’t really see results until after your skin has completely healed and any lingering redness resolves, which can be several weeks for fractional treatments and a couple of months for fully ablative treatments.

Surface skin results will be apparent as soon as healing’s complete, but it takes a few months to see the firming effects of increased collagen as your body naturally produces new cells and structural proteins.

How long do results last?

Results can last years. Their longevity will depend on the intensity of your treatment and how well you take care of your skin afterward. To avoid recurring damage, establish a hydrating, antioxidant-packed skin-care routine and strong sun protection habits with high-SPF sunscreen.

That said, your skin will continue to age with the rest of you.

You can help maintain your results with ongoing laser treatments or other skin rejuvenation treatments. According to Dr. Emer, “Fractional lasers should be done every quarter to maintain results, whereas the fully ablative CO2 laser can be done every one to two years.”


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