CO2 laser - Treatment of acne scars by CO2 laser Surgery

The CO2 or carbon dioxide, laser has been used by medical professionals for almost two decades.

The carbon dioxide laser, unlike newer lasers that target a specific color (such as red in blood vessels or brown in pigmented spots), vaporizes and chars anything with water content.

Since all skin contains water, it destroys every bit of skin or tissue it contacts. Without local anesthesia or sedation, treatments using the CO2 laser are extremely painful.

Until recently, the CO2 laser was used primarily for destroying warts, eliminating small benign growths, and smoothing out growths such as "W C. Field's nose," as seen in patients with an advanced skin condition called rosacea.

It was also used in lieu of a scalpel in patients who take blood thinners because blood coagulates immediately after the skin is cut with this laser.

The high degree of charring that occurs with the CO2 laser, however, limits its usefulness for medical procedures, especially those that require a positive cosmetic outcome.

During the past decade, however, the use of the CO2 laser has mushroomed because of the development of "superpulsed" CO2 lasers. The superpulsed laser has high frequency, microsecond pulses that allow for precision performance.

Superpulsed lasers can vaporize microscopic layers of skin cells so that the depth of penetration and hence the risks of scarring or poor cosmetic outcome can be significantly lowered. The super pulsed CO2 lasers are commonly used to restore a more youthful look by resurfacing or dermabrading sun-damaged and wrinkled skin. It is possible to have an entire face resurfaced or just the areas around the eyes or mouth. The lasers can also be used to smooth out deep acne scars. A medical benefit of this laser is to destroy multiple precancerous growths, called solar keratoses.

Although the depth of penetration is controlled, these lasers still abrade deep enough to cause at least the entire top layer of skin to be removed. Thus, patients who undergo a procedure with the super pulsed CO2 lasers have a significantly longer recovery period (several weeks to several months) than those who undergo superficial and medium depth chemical peels (up to ten days). In terms of depth of penetration and recovery time, the CO2 laser is comparable to a deep chemical peel, such as a phenol peel. During the recovery period, a person's face is very raw looking and may be scabbed, because the sun-damaged skin has been removed, and the new skin needs time to regenerate.

After the skin heals, some individuals may have blotchy brown pigmentation, persistent redness, and in rare instances, scarring. Most scientists believe that lighter skinned people obtain more favorable outcomes with fewer side effects than darker-skinned people. This CO2 resurfaced skin does not always stay smooth permanently, and sun-damaged skin may likely recur after several years. Most dermatologists believe that this laser should be reserved for individuals who have a large degree of sun damage and deep wrinkles and who do not mind making a greater commitment to after-laser care and recovery time. Using the antiwrinkle cream Renova for several weeks prior to laser resurfacing may enhance its effectiveness.

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• Chemical peels
• Cellulite
• CO2 laser
• Color wheel
• Collagen