Fractional CO2 Laser Therapy - A New Era in Cosmetic Enhancement

Introduction:

Fractional carbon dioxide lasers are the most commonly used among all types of lasers. These lasers can treat acne scars, cancerous and noncancerous overgrowth, and signs of aging like wrinkles, fine lines, etc. This treatment is generally considered safe, and it is minimally invasive. This article will emphasize how fractional carbon dioxide lasers work to treat skin lesions, where they should not be used, and the possible side effects that these lasers might have.

What Are Fractional Carbon dioxide (CO2) Lasers?

Fractional carbon dioxide lasers (CO2 lasers) are the minimally invasive cosmetic treatment used to treat several skin conditions in cosmetic dermatology. The goal of fractional carbon dioxide lasers is to achieve desirable results with the least thermal trauma to the skin and to keep the topmost layer of skin (epidermis) undamaged.

What Are the Uses of Fractional CO2 Lasers?

Carbon dioxide fractional lasers can be used to treat various skin conditions such as:

• Treatment of acne scars.

• Removal of noncancerous overgrowth such as seborrheic keratosis.

• Removal of skin lesions such as syringomas and xanthelasmas.

• These lasers can remove some cancerous tumors, such as basal cell epithelioma.

• Removal of warts.

• Removal of nail lesions such as onychodystrophy, which occurs on the toenail.

• For skin rejuvenation as a part of anti-aging treatment.

• Reduction of wrinkles and signs of aging.

How Does Fractional CO2 Laser Work?

The carbon dioxide beam is directed at the target area for the treatment. Fractional CO2 lasers work by implanting thousands of minute but deeply penetrating columns of laser beams into the skin to penetrate both layers of skin (epidermis and dermis). These are known as microthermal treatment zones (MTZ).

Old pigmented cells of the epidermis are expelled within each MTZ, and the penetration of collagen into the dermis layer results in a reaction that leads to new collagen production. By utilizing MTZs, the laser targets and treats intensely within the zone while surrounding healthy tissue stays intact and unaffected, aiding in wound healing. This process promotes wound healing and faster recovery.

What Are the Advantages of Carbon Dioxide Lasers?

Carbon dioxide lasers are considered better than conventional surgeries. The advantages of carbon dioxide lasers are listed below:

• They cause less tissue damage.

• They result in less postoperative swelling.

• Less recovery time.

• Faster wound healing.

What Are the Contraindications of Fractional CO2 Lasers?

Fractional CO2 lasers can not be done in every patient. There are some conditions where these lasers can not be applied. These conditions are listed below:

• Patients who have taken medications like oral retinoids a year before can not go for CO2 laser treatment.

• A patient who had active herpes viral infection previously can not go for laser treatment as laser treatment can reactivate the viral infection. Active herpes viral infection should not be present at least six months before the treatment.

• Patients having thickened scars like keloid or hypertrophic scars can not go for this laser treatment.

• Darker skin tone is more likely to get hyperpigmentation than lighter skin tone with these lasers.

What are eCO2 lasers?

eCO2 lasers are the newest type of carbon dioxide fractional lasers combining fractional technology with the deep ablative properties of carbon dioxide lasers. In this type of laser, the micro ablative fractions or the columns of lasers enter deeply into the skin with a depth of 2.5 mm.

These lasers have a wavelength of 10600 nm, absorbing a lot of water. As a result, higher epidermal (outermost skin layer) damage is prevented, and lateral thermal damage (LTD) is decreased, which is caused by carbon dioxide fractional lasers. It results in less damage than CO2 lasers and also influences the remodeling of collagen fibers in the reticular dermis (inner layer of skin).

Side Effects of Fractional CO2 Lasers

The side effects of fractional CO2 lasers are as follows:

• Scarring.

• Prolonged redness.

• Hyperpigmentation.

• Infections (bacterial, fungal, and herpetic)

• Acne.

• Millia.

• The occurrence of new skin lesions like vertigo and psoriasis (called koebner phenomenon or koebnerization).

What Are the Precautions Taken Before Fractional CO2 Laser Works?

The precautions taken before fractional CO2 lasers are as follows:

• Patients who are undergoing CO2 laser treatment should avoid sun tanning or excessive sun exposure at least four weeks before the treatment. To avoid sun exposure, sunscreen should be used.

• Medicines like Doxycycline or Minocycline should be avoided for three days before the laser treatment because these medicines can lead to sun sensitivity.

• The patient should inform the operating doctor about any history of herpes infection in the target area. In such cases, antiviral drugs would be given two days prior to the treatment and continued three days after the CO2 laser treatment.

• The body should be adequately hydrated before treatment. It is advisable to eat and drink prior to the procedure.

What Are the Steps Taken After Fractional CO2 Laser Works?

The recovery time of fractional CO2 lasers is usually one to two weeks. Skin becomes sensitive during this recovery period and the chances of getting infections and other complications increase. Therefore cautionary steps should be taken for better recovery. The steps taken after the treatment are as follows:

• Application of ice packs on the treatment area to decrease swelling.

• The treated area is covered with petroleum jelly or antibacterial cream and a bandage.

• Application of ice packs to the targeted area is advised for the first two to three days after the treatment. This should be done one to five times a day.

• Patients are instructed not to shave over the treated area for one to two weeks after the treatment. In addition, hot baths, hot tubs, saunas, and swimming pools should be avoided.

• Makeup should be avoided in the treatment area till the completion of the healing process.

• Applying sunscreen with SPF 50 for strict sun protection is essential after this laser treatment.

• Generally, it takes many weeks to observe complete healing in the treatment area. In that period, the treatment area may become red or black in color. In addition, a crust can also form, which fades away after one to two weeks of treatment. Patients are advised not to pick or remove the crust as it falls on its own.

• Patients are advised to take painkillers prescribed by the operating doctor to reduce pain after the treatment.

Conclusion:

Fractional CO2 laser treatment can treat several skin-related conditions with minimal injury to the skin. Various skin lesions like cancerous and noncancerous overgrowth can be removed with this treatment. In addition, skin rejuvenation and acne scars can also be treated by this procedure. Complications can occur in some cases, which include infection, scarring, hyperpigmentation, etc. Recovery time is less, and sun protection is a must during recovery.