Carbon Dioxide laser surgery

Picture of acne scar for carbon dioxide laser surgery

Carbon Dioxide laser surgery

Carbon dioxide (CO2) laser surgery can be used as treatment for wrinkles, scars, growths & more…….

Article by Parneet Gill, Plastic surgeon, Liverpool, UK

What is carbon dioxide laser surgery?

As the name suggests, carbon dioxide laser surgery involves the use of a specific laser machine (the carbon dioxide, or ‘CO2’ laser). This is an increasingly used laser for the treatment of wrinkles, scars and skin growths


How do carbon dioxide lasers work?

Laser machines are often named after the molecule that is used inside the machine to help produce the laser beam. So, carbon dioxide (CO2) is the molecule that is used inside the carbon dioxide laser machine. The release of energy in the form of laser light targets the water in the skin and heats it up to get the desired effect. This can be used to treat a block of skin or only small areas within a section to enable faster wound healing (fractionated carbon dioxide laser). This is performed in a controlled manner, aiming to produce the desired effect whilst reducing risks and side-effects

What can carbon dioxide laser surgery be used for?

A common use is to help improve the visible signs of ageing such as fine lines and wrinkles. ‘Fractionated’ carbon dioxide lasers also allow tiny pin-point holes to be placed in the skin, which can help tighten the skin and give a ‘fresher’ look.

The CO2 laser can also be used for acne scarring, improving the scars and general skin quality, and in the treatment and removal of skin growths

How is carbon dioxide laser surgery performed?

At your initial consultation, your laser specialist should check your aims and expectations of treatment, and go over the risks and possible complications of CO2 laser treatment. A patch test is performed, treating a small and usually discreet area of skin, which is reviewed after a few weeks. This allows the laser specialist to decide upon the settings that produce a good result whilst reducing risks of adverse effects.  If the area has healed without any signs of complications then the rest of the area can be treated at those settings.

The Carbon Dioxide laser treatment is usually performed under local anaesthetic (LA, with you awake), but can occasionally be performed under general anaesthetic (with you asleep). Local anaesthetic in CO2 laser surgery usually involves using topical local anaesthetic gel, which is applied to the area to be treated and left on for at least 45 minutes to get the full effect.  This numbs the area to provide pain relief. The area being treated is usually red immediately following treatment and can weep over the first week.  The laser specialist may use aloe vera gel immediately following treatment, and soft paraffin to keep the area moist for the weeks after treatment 

How long does carbon dioxide laser surgery take?

This is dependent on the size of the area being treated; it can range from 20 – 50 minutes. Usually only 1 treatment is needed for a good result, however top-ups can be done at a later stage if needed


What happens after CO2 laser treatment?

Usually the treated area stays red and may weep during the first week and you may be advised to keep the area washed and clean to avoid any buildup of crusting or infection. The area should be protected from sun exposure, which could otherwise result in darkening/pigmentation of the treated area

What are the risks of CO2 laser surgery?

There are a number of possible risks and complications of carbon dioxide laser surgery including:

• Blistering/burns

• Scarring

• Tenderness/pain

• Infection

• Changes in pigmentation (darkening or lightening)

• Unevenness of the skin surface

• Delayed wound healing

• Sustained redness

• Eye damage

• Cold sores or spread of herpes zoster infection 

• Need for further treatment

Fortunately, most of these risks are uncommon and many people go through treatment very successfully. Be sure to discuss these risks and any other concerns with your laser specialist

This information is for general information only and is not intended as advice for treatment. If you have any concerns about your health or are considering any treatments, you should seek advice from a healthcare specialist

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