Fractional CO2

Fractional CO2 laser treatment is one of the most effective options in the treatment of acne scars, especially deep and stubborn scars that don't respond well to other treatments. Generally, this treatment is combined with other treatments like micro needling radio frequency (MnRF) and platelet rich plasma (PRP) .This advanced laser technology resurfaces the skin by targeting microscopic areas, causing micro thermal zones or tiny areas of laser burns , thereby causing tissue injury which leads to production of new collagen and skin remodeling. This treatment significantly improves the appearance of acne scars.

How Fractional CO2 Laser Works

Mechanism: The CO2 laser emits a high-energy beam of laser light that creates tiny, controlled injuries in the skin. This is known as micro thermal zones, which means the laser treats only a fraction of the skin at a time, leaving surrounding tissue intact.
Action: The laser ablates (removes) the outer layers of damaged skin while simultaneously heating deeper layers to stimulate collagen production.
Results: The treatment leads to smoother, firmer skin. It also shows significant reduction in the appearance of acne scars, wrinkles, and other skin irregularities. The results are exceptional in fair skin as higher energy can be used with multiple passes of laser.

Types of Acne Scars Treated

Ice Pick Scar: Deep, narrow scars that resemble small, deep pits. Generally, people confuse this with open pores. These are one of the toughest type of scar to respond to treatment. However, fractional CO2 laser improves these cars as well to some extent.
Boxcar Scars: Broad, depressed scars with well-defined edges. These type of scars create significant alteration in the reflection of light from the surface of skin. These type of scars need special attention with different laser energy in its borders to make the border less apparent.
Rolling Scars: these are wavy, shallow scars that give the skin an uneven appearance. These cars respond very well to treatment.
Hypertrophic Scars: Raised scars above the surface of skin are called hypertrophic scars. Though these may respond better to other treatments like injections, fractional CO2 laser is used to improve the texture of skin above these scars.

Procedure

Preparation: The skin is thoroughly cleansed with alcohol or a disinfectant after washing with the cleanser. A topical anesthetic cream is applied and covered with the sticker. It helps to numb the area and minimizes the discomfort. In some cases, local anesthesia or mild sedation may be used for deeper treatments.
Laser Application: The laser device is passed over the treatment area, after removal of the numbing cream , delivering precise bursts of laser light that create micro-thermal zones in the skin.
Duration: The procedure typically takes 30 minutes to an hour, depending on the size of the area being treated. However, if it is combined with other treatments, it may take a little longer.
Post-Treatment Care: A cooling gel or calming mask may be applied immediately after the treatment to soothe the skin. It also helps to bring down the redness.

Recovery and Aftercare

Downtime: Recovery time varies but generally includes redness, swelling, and peeling for about 5-7 days. Mild pinkness may persist for a few weeks. The initial phase of redness will persist for up to 24 to 48 hours, followed by dark brown dots over the skin, which gave a sand like feeling on touch. These will be shut off by 4 to 5 days.
Sun Protection: Rigorous sun protection is essential to prevent hyperpigmentation. Sunscreen with SPF 50 or higher and protective clothing are recommended. Patients are advised to remain indoors as far as possible.
Moisturizing and Wound Care: Keeping the skin moisturized is very essential to allow the skin barrier to heal . It is required to use certain Recovery creams in case the treatment is done aggressively. The dermatologist at Subodha skin and cosmetic clinic may prescribe you certain Recovery creams and medications to help with the optimal healing of skin.

Benefits of Fractional CO2 Laser for Acne Scars

Significant Improvement: This laser can dramatically reduce the depth and appearance of acne scars, even after just one session. Hence, this treatment is considered to be gold standard in the treatment of acne scars.
Skin Rejuvenation: It gives a great improvement with skin texture, tone, and firmness due to increased collagen production.
Customizable: Settings can be adjusted for different skin types, scar depths, and individual patient needs. You are dermatologist will decide the energy as per the depth and the type of the scars. it also depends on the skin type, as darker skin types are more prone for Post inflammatory hyper pigmentation.

Potential Side Effects and Risks

Redness and Swelling: Common and expected as part of the healing process. However, it is transient, lasts less than 48 hours.
Hyperpigmentation or Hypopigmentation: Changes in skin color, especially in those with darker skin tones. This is called Post inflammatory, hyper pigmentation. Your doctor may prescribe a priming cream before the procedure and Recovery cream after the procedure to minimise or avoid the side-effect.
Infection: Rare but possible; proper wound care can minimize this risk. It is better to avoid the treatment if there is a pre-existing infection like herpes, folliculitis.
Scarring: Rare, but can occur, particularly if post-treatment care is not followed or if the laser parameters are not used appropriately by untrained professionals.

Who is a Good Candidate?

Ideal candidates are those with moderate to severe acne scars who have realistic expectations and are willing to commit to the recovery process.
Not recommended for individuals with active acne, certain skin types prone to pigmentation changes, or those with specific medical conditions that affect healing.

Treatment Frequency

Sessions Required: Most patients need 1-3 sessions spaced 3-6 months apart, depending on scar severity and skin response.
Maintenance: Some may opt for maintenance sessions to continue improving skin texture and prevent aging.

Fractional CO2 laser treatment should be performed by an experienced dermatologist or laser specialist to ensure safety and maximize results. It’s a powerful tool in acne scar management, offering long-lasting improvement in skin appearance and texture.

At Subodha skin and cosmetic clinic, one of the best dermatology clinics in Bangalore, functional treatment is performed by experienced dermatologists And generally combined with other acne scar treatments. Dr Shilpa Bhat, best assistant in Bangalore, says- the selection of candidate for fractional CO2 laser is important, our Indian skin needs special attention in pre-treatment priming and post procedure care. If it is done properly, this fractional CO2 laser treatment can give extremely satisfying results.