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  • Writer's pictureBotany Skin Clinic

CO2 Fractional Laser

Updated: Apr 28, 2021

What is a carbon dioxide laser?

Carbon dioxide (CO2) lasers have been used for many years to resurface skin. Typically, they are used to improve skin texture and tone, reduce wrinkles, remove sun damage and pigmentation, and to tighten skin on the face. They work by removing a fine layer of skin as well as heating the skin. This remodels the skin’s collagen, and this leads to significantly smoother, firmer, and more even-toned skin.

Despite the dramatic results, there are many downsides to treatment with traditional carbon dioxide lasers. The risk of traditional carbon dioxide laser treatment includes prolonged recovery periods, gradual loss of skin pigmentation, and a relatively high risk of scarring in comparison to non-ablative lasers.

Am I a candidate for treatment? What can be treated with this laser?

This laser treatment is for those people wanting skin resurfacing for the face, neck or body. Most commonly, the face, neck, decolletage, and hands are treated.

Most people who present for carbon dioxide laser treatment have a degree of concern about the effects of ageing and accumulated UV exposure on their skin.

Laser resurfacing with fractional carbon dioxide lasers can treat a number of skin concerns. It can be used to improve skin texture, reduce wrinkles, improve acne scarsand other scars, reduce sun-induced skin pigmentation, and to reduce skin sallowness. It can also help to tighten skin.

Because the carbon dioxide laser is able to ablate (vapourise) skin tissue, certain skin lumps and bumps can be treated with this laser, including benign naevi (moles).

Rhinophyma, an enlargement of the sebaceous glands on the nose that leads to a bulbous nose, can also be treated with the carbon dioxide laser. Rhinophyma is usually caused by an underlying skin condition called rosacea. The carbon dioxide laser can ablate the excessive sebaceous tissue and return the nose to its normal size and shape.

Finally, we have also been using this laser to treat burn scars and other scars such as surgical scars or traumatic scars. penetrating fractional handpiece), we Laser helps to remodel the scar tissue. Also, topical cortisone (Kenacort) is applied to the skin post-laser, and this infuses into the channels created by the laser. The cortisone helps to reduce scar tissue activity and improve the appearance and flexibility of the scar. The laser therefore also not only remodels the scar, but provides a conduit for the delivery of medication through to the scar tissue. This may be a preferred alternative to injecting cortisone, which can, when delivered this way, cause atrophy of the scar or fat resulting in an indentation in the area. Recovery from this treatment for scars is significantly less than the recovery from skin resurfacing for wrinkles using the same laser.

Who cannot have treatment with this laser?

We recommend those who are pregnant, breast-feeding, are prone to keloid scars, and those who have taken isotretinoin (Accutane, Roaccutane) in the past 6 months to avoid treatment.

The laser can also be used on most skin types from fair to dark, however, darker skin types may not be able to be treated with as aggressive settings as the fairer skin types due to the increased chance of darker skin types to have pigmentary disturbances post-laser.

What does this treatment involve?

The first step of treatment involves preparing the skin for laser treatment. A good skin care regime with medical grade ingredients, especially topical retinoids, before laser can help improve the results achieved from laser as well as reduce the potential side effects. Topical retinoids can help to improve skin turnover and have been shown, if used for at least two weeks prior to laser resurfacing, to reduce the time of re-epithelialisation (regeneration and reformation of skin). For those with darker or olive skin types, preparation with a topical lightening agent such as hydroquinone may help to reduce complications such as post-inflammatory hyperpigmentation (darkening of the skin in the treated areas as a result of treatment).

In some cases, a test patch may be done to help determine the level of energy to be used as well as the possible skin response to the laser. This is usually done in more olive or darker skin types to help predict the possible outcomes. It is also performed in an inconspicuous area if possible.

Especially for heavier treatments, anti-viral medications or antibiotics may need to be taken prior to the procedure to prevent infections.

The anaesthesia for the treatment will depend on the level of treatment and the hand pieces used. For lighter treatments, a topical anaesthetic agent may be used without any other forms of anaesthesia. This will need to be applied at least 30 minutes prior to the onset of the procedure. For stronger treatments, it may be necessary to use topical anaesthetic agents in The treatment with the laser takes approximately 30 minutes (not including anaesthetic) for a full face or neck/decolletage . The area is systematically covered by the laser.conjunction with nerve blocks/injectable anaesthesia. The treatment with the laser takes approximately 30 minutes (not including anaesthetic) for a full face or neck/decolletage . The area is systematically covered by the laser.

During the treatment your eyes will be covered with gauze, and for treatments within the orbital rim (within the bone surrounding the eyes), corneal shields may need to be inserted under the eyelids to protect the eyes.

The treated areas appear red and swollen after the treatment, and the small columns of laser can be seen on the face in a grid-like pattern of dots. The treated areas also feel quite hot after the procedure.

What happens after the treatment?

Full recovery takes from 4 to 14 days approximately depending on the level of energy used in the treatment (this can be tailored to your requirements). Off-face areas usually take longer to heal, and usually only lower energy levels can be used for these areas.

There is a period where the skin appears quite red. Usually this subsides within 1 week in lower energy level treatments, but may take up to one month to fade for more aggressive treatments. Swelling of the face/eyes may occur for a few days, and sleeping on a 45 degree angle or greater can help to reduce this. There may be a mild acne-like break out (small white pustules) on the face after 3 days as the skin regenerates. The skin may scab, peel and flake and this occurs over one week.

Vaseline needs to be applied post treatment until the skin peels, and then a normal moisturiser can be used. Sun avoidance is important post procedure to help reduce the chance of pigmentation changes post treatment, or more specifically, darkening of the treated areas.

Anti-viral medications or antibiotics may need to be taken post-treatment, depending on the depth of your treatment, and we closely monitor you for any signs of infection.

Generally the post-treatment recovery period will depend purely on the level of the treatment, and therefore we are able to tailor the recovery time to match the time you can afford to take off your normal activities.


Pop in for a free consultation with the nurse. Consultation with the Doctor is $150 and must be booked in advance. We are located in the heart of Botany Town Center Next to TSB bank.

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