The CO2 Laser
CO2 lasers have been used in medicine for over 20 years. A CO2 laser emits invisible light with a wavelength of 10,600nm, which is absorbed by the skin. There are many possible applications in dermatology and aesthetics.
On the one hand, unwanted skin changes can be removed, e.g. age-related warts, infectious warts on the feet or in the genital area. You can see examples below.
On the other hand, the CO2 laser is a popular treatment for skin rejuvenation. A coarse-pored, uneven skin texture on the cheeks or the onset of elastosis with wrinkles on the neck and décolleté are indications for the fractionated laser. The laser energy causes microscopically small injuries to the skin, which start a renewal process as they heal. This makes the structure of the skin firmer and the skin texture more even. The combination with Philart® enhances the effect of the fractional laser.
The CO2 laser can also be used to improve the appearance of various scars. Acne often leaves unwanted reminders in the form of so-called “ice pick scars” on the cheeks. Surgical scars can hypertrophy, i.e. form too much scar tissue. Pregnancy can lead to stretch marks (striae distensae), which are caused by small tears in the tissue. Such tears are caused by increased tensile stress on the skin, including obesity or forced muscle training. Fractional CO2 lasers generally offer good prospects of success, even if the scars are older.
Application possibilities
The Pixel CO2 laser can be used to treat the following skin conditions:
Skin Rejuvenation
Skin rejuvenation through fractional laser therapy on the face, neck, cleavage and hands
Uneven skin texture with enlarged pores and typical “ice pick scars” after previous acne
Unsightly scars
Pregnancy stretch marks (Striae distensae)
Age warts (seborrhoeic keratoses)
on the face or body
Xanthelasma
(Yellowish to reddish fat-like deposits under the eyes)
Sebaceous gland hyperplasia
Syringoma
(Enlarged sweat glands on the face)
Fibrous nasal papules
(Punctiform elevation on the nose)
Actinic keratoses
(Rough, reddened skin after long-term exposure to the sun)
Must not be lasered:
Nevi (moles), melanomas or suspicious cancerous changes. If malignancy (malignant tumour) is suspected, a surgical biopsy or excision should be performed.
Some skin changes can be removed in one session, sometimes a gentler approach with multiple treatments is recommended. Certain efflorescences can form again, e.g. new age-warts or syringomas can develop.
As a rule, 2-3 sessions are necessary for skin rejuvenation. A follow-up treatment may be necessary after 1 year.
Is laser therapy suitable for all patients?
No. Patients with skin types I-II can undergo therapy with the CO2 laser provided that the precautionary measures are observed. A dose reduction is recommended for skin type III. Treatment with the CO2 laser is not recommended for skin types III – VI, i.e. darker skin types. The risk of pigmentation disorders caused by the therapy is significantly increased.
What are the side effects and risks of the CO2 laser?
The vaporisation of tissue creates a wound that becomes inflamed in the following days and must heal. As a rule, crusts form which peel off after several days, sometimes only after 1-2 weeks, depending on the size of the wound.
With skin rejuvenation in particular, you can expect the treatment area to be significantly reddened for around 5 days, which can hardly be concealed even with make-up. Numerous tiny crusts form, which become even more visible with make-up. In addition, no make-up should be used in the first 3 days anyway, as the colour particles can penetrate through the small skin lesions and remain there for a long time!
It is very important to protect the treatment area from sunlight! Exposure to the sun should be kept to a minimum for 2 weeks before treatment and sun cream should be applied several times a day. After treatment, sun protection must be continued for a further 2-4 weeks. A possible side effect of laser therapy is hyperpigmentation, i.e. dark spots on the skin caused by stimulation with sunlight and inflammation after laser therapy. These pigment spots can persist for 1-2 years! The best course of action is to avoid them by taking appropriate precautions. Hypopigmentation, i.e. light-coloured spots caused by the destruction of melanin, occurs less frequently.
Other risks include infection of the treatment area and scarring if the laser dose is too high.
Certain medications can have a negative impact on the healing of the skin. These include vitamin A derivatives, which are used to treat acne or actinic keratosis, and of course cytostatics. Caution is advised with photosensitising medications, e.g. doxycycline.
Examples of vitamin A derivatives are: Roaccutane, Tretinac, Isotretinoin, Neotigason, Curakne, and others, So bring a list of all medications to the consultation. Nicotine consumption also hinders the healing of the skin.
Aftercare and important information
The following information is important in order to achieve a good treatment result:
- No sun exposure in the treatment area for 2 weeks before treatment!
- No sun exposure in the treatment area for 2-4 weeks after treatment!
- systematically apply sun protection for at least 2 weeks after treatment (even in rainy weather!)
- apply the post-laser gel several times a day for the first 3-7 days, if necessary you will receive a prescription for a cream containing cortisone
- No make-up in the treatment area for the first 3 days
- Redness and crusts after Skin Rejuvenation usually subside after 5-7 days. Do not scrape off crusts, but wait until they dissolve on their own
- Skin rejuvenation takes 4-6 weeks, but the skin continues to work for several months
- The combination of skin rejuvenation with CO2 laser and Philart® is recommended
A consultation on laser therapies is possible at all locations and is strongly recommended before treatment. On this occasion, we may also perform a trial on a small skin area, if you wish so.