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Fractional CO2 Laser Skin Resurfacing

What is fractional carbon dioxide (CO2) laser?

It is one of the latest advances in non-surgical skin rejuvenation treatments.  The CO2 laser has the longest wavelengths of all the lasers on the market and can be used safely on darker skin types. The fractional CO2 laser takes the CO2 laser beam and fractionates, or pixellates that beam into thousands of tiny little shafts of light. These tiny shafts of light penetrate into the deeper layers of the skin. The skin then repairs those tiny shafts by pushing out the old sun damaged skin and replacing it with new skin.

What can the fractional CO2 laser treat?

The fractional CO2 laser is used for treating moderate to deep wrinkles, skin texture changes from sun damage, wrinkles, acne scars and scars.  It can be used on the face, neck, chest, arms, legs, and abdomen.

What does it not treat?

It does not treat dilated blood vessels (telangectasia) or reddish blotchy discoloration on the neck (poikiloderma).  A Yag laser which New Life Cosmetic Surgery Center has is more effective for these lesions.

What is the recovery like after a fractional CO2 laser treatment?

There are different settings that can be used to control the depth of laser penetration.  If the patient has 5-7 days to stay out of the sun and heal from the treatment then only 1 or 2 treatments are usually needed to see a significant improvement.  For minimal recovery downtime, less intense settings can be used to still get the same results but over 3 to 4 treatments.

How long do the effects of a fractional CO2 resurfacing laser treatment last?

The results can last several years as long as you wear sunscreen daily and take other measures to avoid sun damage to your skin.  Other important factors are staying hydrated and using the right skin care products.

When will I see results?

You will see some immediate results but you won’t see the full results for 3-6 months. After your skin heals, which may take up to 3-14 days depending on the settings that are used.  There will be a period of 4 to 6 weeks after that when your skin might be slightly pink. During this period, your skin will feel smoother and looks less blotchy. As the color returns to normal, you will see fewer lines, less blotchiness, and more glow.  Plan on 2-3 weeks for being “camera ready.”

How are fractional CO2 laser treatments performed?

At New Life Cosmetic Surgery and Wellness center we ask our patient to arrive 1 hour prior to their treatment.  We will clean your skin but appreciate if you don’t wear any make-up to the office.  We then apply a topical numbing cream.  Some patients will be given a prescription for an oral medication to take for mild sedation prior to the procedure.  Then you can relax and listen to music or read while the numbing medication takes effect.

After you numb for about an hour, the numbing cream will be removed. The treatment takes about an hour for a full face and feels a little like a “pins and needles” sensation. A strong stream of cold air (a Zimmer cooler) is blown on the area during the treatment to make it comfortable. The discomfort ranges from mild to moderate (2-4/10). Plan on being in the office for 2 ½ hours total.

What will I look like right after the treatment and what is the healing time?

During the first 6 hours after treatment, your skin may feel as though it is sunburned. Ice packs/frozen peas are used 5-10 minutes per hour for the first 5-6 hours after the treatment.

If you had a deeper treatment then your skin will peel for 2-7 days and will be pink for 3 to 6 weeks. This healing all depends on how deep your treatment is. If you had a lighter treatment then your skin may not peel but will be pink for 2-3 days.  After a week or so, you can wear make-up to cover the pink. Rarely, bruising may develop, which can take up to two weeks to resolve. Allow 2-4 weeks for weddings, reunions, family pictures, etc just to be safe. Allow longer for body sites like arms or legs.

Can I go back to work and activities immediately?

No, you will need to take the rest of that day off to ice and care for the treated area. For the lighter fractional CO2 treatments, you will need 2-3 days of downtime. For the deeper treatments, plan on 7 days of healing before you can go out in public.

How many treatments will I need?

The number depends on the extent of your sun damage, scarring or wrinkles, and on how much downtime you can accept. If you can tolerate 7 days of downtime, you would generally need only 1 or 2 fractional CO2 treatment.  If you can only have 2 days of downtime, you would generally need 3 or 4 treatments.

Are there any reasons not to be treated with these lasers?

Reasons not to do a fractional laser treatment may include use of medications that increase photosensitivity, use of anticoagulants (some are fine), use of Accutane in the last year (vs. 6 months), chemotherapy, history of difficulty healing or scarring, history of bleeding disorders, and pregnancy.

Are there any medical or cosmetic side effects?

Side effects are not common in our office however the following symptoms have been documented in the literature.

  • Pain. Most people feel very little pain during treatment due to the measures discussed above. Rarely there is mild discomfort for the first day after surgery, but Tylenol is effective for it.
  • Redness. A pink color may persist for two weeks to two months after the laser surgery. In rare instances, it may last three to six months. This is more common in patients who have a history of flushing and blushing easily or who already have dilated vessels on the surface of the skin.
  • Wound Healing. The CO2 laser causes a superficial wound to the skin that takes approximately 2 to 10 days to heal. The superficial injury of the outer layers of the skin may result in mild to moderate swelling. Crusting is rare but peeling is common. Once the surface is treated, it may be sensitive to the sun for approximately 4-6 weeks.
  • Pigment Changes. The treated area may heal with increased or decreased pigmentation. This is rare and occurs most often in darker skin and 2-6 weeks after treatment. Hyperpigmentation usually fades in three to six months, though rarely pigment changes can be permanent.
  • Excessive Swelling. Immediately after laser surgery, there will be swelling of the skin. This is a temporary condition and will resolve over three to seven days.
  • Scarring. There is a very small chance of scarring. This includes hypertrophic scars or, very rarely, keloid scars. Keloid scars are thick, raised scar formations. To minimize chances of scarring, it is important to follow post-operative instructions carefully. It is important that any prior history of unfavorable healing be reported. Do not pick!
  • Eye Exposure. There is also a risk of harmful eye exposure to laser surgery. It is important to keep your eyes closed and have protective eyewear at all times during the laser treatment.
  • Depressionor emotional difficulties even if the procedure is successful.
  • Infection. Occasional infections can occur. If not treated promptly, these could result in scarring.