At the De Felipe Dermatology Clinic, we are experts in treatments designed to improve skin quality and structure. Our goal is to achieve healthy, beautiful, and radiant skin, enhancing the unique qualities of each skin type without deviating from the standards of naturalness.The CO2 laser is one of our greatest allies for rejuvenation, treating scars, and improving skin texture, among other treatments.
What is a CO2 Laser?
The CO2 laser is a medical or surgical cutting tool using infrared light. This laser emits a wavelength of 10,640 nm, in the infrared light spectrum. This type of light is absorbed by water, which makes up 70% of our body. When the light from this laser is absorbed by the skin or body tissues, the temperature rises well above 100°C, causing vaporization.We can use this laser to cut skin or tissue, vaporize a lesion on the skin, tongue, or stomach, and we can do so with a precision that outperforms other surgical tools such as metal scalpels or electric scalpels.
Why is the use of the CO2 laser so interesting in medicine?
Around the laser cutting area, a temperature rise occurs, which coagulates the blood and prevents bleeding. This heating zone is very thin, so the damage the CO2 laser causes to the tissues it works on is minimal. For this reason, many dermatologists and surgeons prefer to use the CO2 laser over other cutting tools.
What is ablative resurfacing with CO2 laser?
Ablative resurfacing, or flattening, is a special way of working with the CO2 laser. A scanner moves the CO2 beam, reducing the exposure to each point of the skin to less than 1 MS, allowing a very superficial and controlled penetration or vaporization. This advantage is used to smooth the skin without scarring or to eliminate skin lesions, causing minimal damage to the skin’s surface (Figure 1).
What is a fractional CO2 laser?
The CO2 laser can be used on distant points through healthy skin, facilitating healing. In this way, the laser creates tiny holes that close as they heal, reducing the overall skin surface area. Fractional CO2 lasers are also used to create holes through which drugs can penetrate, facilitating treatments such as creams, medications, or photodynamic therapy (Figure 3).
Figure 1, left
This represents the effect of an ablative CO2 laser, which sweeps or ablates a very superficial area of the skin. This technique is useful for removing warts , flatten lesions, or reducing skin wrinkles.
Figure 3, right
This represents the effect of a fractional ablative CO2 laser, where only small columns of skin are treated, resulting in faster recovery from treatment. This approach can also be used to facilitate the penetration of medications through the skin.
Treatments that can be performed with the CO2 Laser
ACNE SCAR REDUCTION
Acne scar treatment with CO2 laser is very common and has been performed for many years in dermatology, using either collimated resurfacing or fractional CO2 laser. The CO2 laser flattens and reduces the overall skin surface, improving the appearance of scars. If the fractional laser technique is used, several treatment sessions are required, usually between 4 and 8. Post-treatment application of exosomes accelerates recovery and improves results (CO2 7)(CO2 8)(CO2 9).
WRINKLE REDUCTION DUE TO AGING
This is one of the favorite treatments among dermatologists. Fractional or collimated CO2 lasers can be used. The fractional requires several sessions (4 is the most common), while the collimated requires a single session every 10 years. The stronger the laser energy and the treatment, the better the result, but also the longer the recovery time, especially in terms of the duration of redness. The combination with topical Retinol can improve the results (CO2 12) and CO2 13).
REMOVAL OF SEBORRHEIC KERATOSES
The CO2 laser can be used to remove all types of skin lesions. Laser destruction of these lesions appears to be less damaging to the surrounding tissue and leaves fewer marks or scars than traditional procedures.
REMOVAL OF BENIGN SKIN LESIONS
The CO2 laser can be used to remove various types of skin lesions. Removal of these lesions appears to be less damaging to the surrounding tissue and leaves fewer marks or scars than traditional procedures. Surgical lasers are used to cut and excise while simultaneously producing hemostasis to prevent bleeding. The CO2 laser is also used in surgery to cut the skin more effectively and simultaneously produce coagulation of blood vessels. This is a great advantage because it keeps the surgical field clean and reduces errors. It also shortens surgery time.
DRUG DELIVERY IN THE NAIL
The fractional CO2 laser is an excellent tool for delivering drugs to the nail when used fractionally. Due mainly to the fact that the nail is a thick keratinized structure that is difficult to penetrate with topical medication, nail pathologies such as Lichen unguium, Psoriasis or fungal infections do not respond well to topical treatment but do respond better when this drug is administered after performing fractional CO2 laser (CO2 1).
TREATMENT OF ONYCHOMYCOSIS
Treatment of onychomycosis is challenging due to its impact on the nails, the location of the fungus within the nail, and the reported worldwide resistance to antifungals. Light-based technologies and CO2 lasers are treatments that can be used for onychomycosis. The efficacy of photodynamic therapy and fractional CO2 laser, used alone or in combination, has been evaluated for onychomycosis. A prospective, randomized, comparative study of 51 patients with onychomycosis found that treatment with fractional CO2 laser or its combination with photodynamic therapy provided high success rates, good patient satisfaction, and a safety profile (CO2 3).
SKIN REJUVENATION AND SCARS
Fractional CO2 lasers have been reported in numerous published clinical studies to improve dark spots and skin texture associated with photoaging. These treatments are safe and effective for photoaging. The limited and controlled dermal heating of the fractional CO2 laser likely initiates a series of events that result in the normalization of the collagen-genesis/collagenolysis cycle. The introduction of fractional CO2 lasers for photoaging represents a significant advancement over traditional ablative laser resurfacing treatments, which were complicated by prolonged redness, delayed-onset hypopigmentation, and scarring.
IMPROVEMENT OF NORMAL SCARS
The CO2 laser can also improve scars on the body. It does this using the fractional CO2 technique. This is because the skin on the body has far fewer skin appendages than facial skin, making scar repair much more difficult. The purpose of the fractional CO2 laser is to reduce the size of the scar, and several sessions must be repeated (CO2 10) and (CO2 11).
REMOVAL OF VIRAL WARTS
Viral warts are skin infections caused by a virus, the papillomavirus, which recurs very easily despite cryotherapy or electrocautery procedures. It appears that with the CO2 laser, recurrence is less frequent, due to the higher temperatures reached by the laser. On the other hand, laser removal of a viral wart is less damaging to the surrounding tissue and leaves fewer marks or scars than traditional procedures (CO2 14) (CO2 15).
MOLE OR FIBROID REMOVAL
The CO2 laser can be used to remove all types of skin lesions. Laser removal of these lesions appears to be less damaging to the surrounding tissue and leaves fewer marks or scars than traditional procedures.
TRANSCONJUNCTIVAL BLEPHAROPLASTY
One of the best-known surgical applications is blepharoplasty, or eyelid surgery. In this type of surgery, it is important to prevent bleeding. Thanks to the use of the CO2 laser, the surgeon can remove excess fatty tissue while simultaneously coagulating. The procedure is shorter, safer, and more precise thanks to the use of the CO2 laser (CO2 4) (CO2 5).
DRUG DELIVERY TO IMPROVE DRUG PENETRATION INTO THE SKIN
The CO2 laser can be operated to open small holes in the skin’s surface to aid drug penetration. This is known as laser-assisted drug delivery and improves the results of applying topical products for skin conditions such as psoriasis (CO2 6).
VAGINAL TREATMENT
The CO2 laser is especially convenient for lesions on the female genitals due to its high coagulation capacity and precision.
PINCER NAIL TREATMENT
Pincer Nail Deformity (PND) is a common toenail disorder characterized by a transverse overcurvature of the nail plate. It can cause severe pain, chronic inflammation, and recurrent infections. Treatment can be performed with carbon dioxide (CO2) laser matricectomy.The result is successful without intraoperative or postoperative complications. Recurrence sometimes occurs 7 months after treatment.
PSORIATIC NAIL
Another indication for CO2 laser treatment is the treatment of psoriasis or psoriatic nails. In this case, the CO2 laser is used to promote the penetration of the active drug into the psoriasis through fractional mode.In one study, twenty-eight patients with nail psoriasis were assigned to two groups. The first group was treated with a nail matrix injection of methotrexate, while the second group received fractional CO2 laser treatment followed by topical methotrexate application. Treatment was administered 2 weeks apart for 6 sessions. At the end of treatment, both laser-assisted administration and intralesional methotrexate injection resulted in statistically significant improvement in the psoriatic nail. No statistically significant differences were found between the two groups with respect to the overall Nail Psoriasis Severity Index. However, pain and subungual hematoma were significantly less in the laser group than in the injection group (C02 16).
ENDODONTIC TREATMENTS
The CO2 laser is widely used in the stomatological field of dentistry. The absorption of CO2 laser light produces various effects such as coagulation, vaporization, and ablation. The main indications in dentistry are pain relief and prevention of recurrence of canker sores and cold sores (minor canker sores, herpes simplex), removal of excess benign and irritating tissue (stimulus fibroma), correction of bands on the lips and tongue, and soft tissue hemostasis. The great advantage of using a CO2 laser is minimal bleeding in the surgical field, which allows for optimal visibility. Furthermore, the CO2 laser offers great patient comfort as primary wound closure with sutures is not necessary (CO2 2).
What is a CO2 laser treatment like?
What is the recovery process like after CO2 laser treatment?
The skin usually remains red for a few days. If the entire skin surface is treated, as in the collimated mode, the redness lasts longer and can last up to months.
If the treatment is performed with fractional laser, the redness lasts a few days, then it has practically disappeared within a week.
If a dermatological lesion such as a mole, seborrheic keratosis, or fibroma is treated, a wound remains covered with a white, moist layer (fibrin) and takes between one week (on the face) and three weeks (on the legs) to epithelialize.
If a Drug Delivery procedure is performed, the redness is very mild and lasts a few days.
Tips to follow before a CO2 Laser treatment
- To prevent hyperpigmentation after treatment: apply creams containing Retinol, Hydroquinone, Tranexamic Acid, Azelaic Acid, Vitamin C, or Kojic Acid 15 days in advance. You can consult our professionals.
- To avoid pain during resurfacing of large areas, whether COLLIMATED, INTENSE, or SOFT FRACTIONAL, apply a thick layer of anesthetic cream and cover with a plastic dressing to improve penetration at least 45 minutes before the procedure.
- If this thick layer is not possible due to visible areas such as the face, the anesthetic cream can be applied in very thin layers, like a moisturizer, but repeated every 5 minutes for 45 minutes.
- If you have Herpes simplex or zoster in the treatment area or an active infection such as impetigo, cancel the appointment and reschedule it for another day.
- If you have recurrent herpes (more than 4 outbreaks per year), take COPINAL every day for one month before treatment and/or LYSINE (500-650 mg daily) to prevent a new outbreak after treatment.
- Avoid sunburn.
Tips for after CO2 Laser treatment
For the removal of simple lesions: follow the same advice as for the removal of normal lesions using epithelialization accelerators such as liquid silicone or gels with rosehip and borage oils such as CICASES or CICALFATE CREAMS.
For resurfacing larger skin areas:
- Apply Vaseline or silicone gel or liquid to the treated area 5 times a day for 5 days.
- Avoid intense sun exposure.
- To prevent hyperpigmentation after treatment: Apply a low-power red light laser two or three times a week, and after 7 to 15 days, apply creams with retinol, hydroquinone, tranexamic acid, azelaic acid, vitamin C, or kojic acid. You can consult our professionals.
CO2 Laser Price in London
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Frequently Asked Questions from Our Patients
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