Uses and Side Effects of CO2 Lasers

A CO2 laser is a tool that is used in the treatment of skin conditions. ⁽¹⁾ It is used by dermatologists and plastic surgeons in skin resurfacing treatments. CO2 laser help in removing the superficial layers of skin and promote the formation of new cells. People seek CO2 treatment for acne, scars, fine line, wrinkles, and aging.

CO2 laser plays a role in resurfacing process. The rays emitted by the laser are of a certain wavelength that is absorbed by the water within the skin cells. This leads to the ablation of the superficial layer.

The treatment produces heat injury that stimulates the skin underneath and leads to the formation of collagen, a protein in the body that contributes to skin elasticity. ⁽²⁾

After the treatment, as the skin starts healing, new skin starts forming that is more elastic, tighter, and smoother. ⁽¹⁾

The time taken for the treatment depends on the person’s skin type, skin concern, and the laser instructions by the manufacturer.

Ablative CO2 treatment involves vaporizing the skin tissue. It is a more aggressive procedure than the nonablative laser, therefore, it leads to more dramatic changes and visible skin improvements. ⁽³⁾

In fractional CO2 laser treatment, a large number of microbeams are applied that create columns of ablation through the skin preventing damage to the surrounding skin. Due to its targeted nature, the risk of adverse effects is less.

CO2 ablative lasers work best in Fitzpatrick type 1 and type 2 skin, which is due to the lower amount of melanocytes in paler skin. This reduces the risk of hypopigmentation and hyperpigmentation after the procedure.

Nonablative CO2 lasers are more suited to people with darker skin. Fractional lasers are known to work best on those with Fitzpatrick type 4-6 skin and the following skin conditions:

• Acne and acne scars
• Scarring
• Melasma
• Stretch marks

The CO2 laser can be beneficial in the treatment of the following skin conditions:

• Chickenpox scars
• Actinic keratosis
• Sun-damaged skin
• Skin wrinkling
• Seborrheic keratosis
• Uneven skin tone
• Liver spots

A 2018 review of 30 studies found ablative fractional lasers to be effective in treating acne scars. ⁽³⁾ In combination with other therapies, it can be effective for ice pick acne scars.

A study done in 2015 found that fractional CO2 lasers provided results with post-burn scars. The participant reported very less side effects that lasted for a few months. ⁽⁴⁾

A few side effects may be experienced by people after CO2 laser treatment, which include:

• Redness of skin
• Scarring
• Infection
• Milia
• Changes in skin tone
• Skin peeling

It is therefore important to discuss the treatment and its related benefit and side effects with the doctor.

The skin requires 2-4 weeks to heal completely from the CO2 laser treatment. New skin starts growing 2 weeks after the laser treatment.

Initially, the skin is quite raw and may have drainage. It may look as if it is severely sunburned and would be covered with a bandage. A few precautions are given to help the skin recover faster. These include:

• Stay home and avoid strenuous activity
• Avoid picking and scratching the skin while it’s recovering
• Minimizing the exposure to direct sunlight
• Attending follow-up appointments
• Regularly taking any prescription medication given by the doctor

CO2 laser helps in minimizing the appearance of certain skin conditions such as acne, wrinkles, and scars. There are a few side effects and the recovery takes 2-4 weeks. A few precautions should be taken to help the skin heal properly. There are a few other alternatives as well which include dermabrasion, botox, and chemical peels that may have a quicker recovery time. It is best to speak with the doctor and go ahead with what suits you the best.