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Fractional Co2 Laser


Fractional Carbon Dioxide (CO2) Laser Resurfacing removes layers of skin tissue in a fractionated method (columns of skin are removed, leaving the skin surrounding each column intact to aid in healing) to help reduce “age-spots” (also called sun freckles, liver spots, and lentigines), fine lines, wrinkles, scarring, uneven coloration, skin laxity, textural irregularities, dull tone, and a thinned collagen layer of the face, neck, and chest.

The principle of the CO2 laser is to heat the target until it vaporises. There are many different brands of co2 laser, and most are equipped with three output modes, including continuous wave mode, superpulse mode and ultrapulse mode.

  1. Continuous Wave mode. The far left picture below. The traditional carbon dioxide laser, due to its low output power, needs to increase the temperature of the target by prolonging the heating time. Although the target is destroyed (the straight rectangle in the middle), it cannot reach the very deep level, and the heating time is too long, so that the heat spreads to a larger area (dark red around the rectangle), and damages the normal skin, which increases the incidence of side effects.
  2. Superpulse mode. The middle picture below. The advancement of laser technology shorten the time of the laser pulse to a very short time, and the output energy is high enough to destroy the target, and can reach a deeper depth. While it still produces unwanted heat damage, many of the side effects have been greatly reduced.
  3. Ultrapulse mode. The far right picture below. The latest generation of technology further shortens the time of the laser pulse, and the energy emitted is compressed to a very short time interval, which can destroy the tissue more efficiently, so that it can reach a much deeper level, resulting in the reduction of unnecessary thermal damage and it associated side effects.

In theory, Ultrapulse mode provides a “flat-top” pulsed beam with higher energy density and shorter pulse duration, while Superpulse mode provides a bunch of ultra-pulse-shaped beams that, at the beginning of the pulse, produce a burst of energy, And gradually diminish the duration of the pulse throughout.

UltraPulse mode produces high-energy pulses of short duration and is especially useful for applications requiring minimal thermal damage and layer-by-layer ablation, such as improving enlarged pores, skin texture and acne scar.

Fractional CO2 Laser is good option if you wish to get the most results with one treatment. Fractional CO2 Laser is an in-office procedure that requires pre and post-treatment medications to ensure proper healing and comfort during the procedure. Discomfort varies on the depth of the treatment. For your comfort during the treatment, we may apply a topical anesthetic or inject local anesthetic and prescribe oral analgesic to reduce discomfort. After the treatment most patients describe the post-procedure feeling as a bad sunburn for about 12 hours to 2 days. Please also follow the instructions for all other prescribed pain medication is needed post treatment. We also recommend pain or relaxation medications prior to treatment therefore you will need to have somebody drive you home after treatment.

Typically multiple treatments with Fractional CO2 Laser separated by every 4-6 weeks is recommended. Occasionally, in an area that cannot be treated aggressively, we may need to have more treatment sessions to optimize results. Maintenance treatments may also be necessary to maintain results, especially if sun is not avoided or proper skin care used. Occasionally, even with the best care, another treatment course may be necessary in a few years (in the area around the eyes, it may only be 1-2 years).

Ultrapulse mode


How does Fractional Co2 treatment work?

The Fractional Co2 beam vaporises water molecules in the skin. This heats up the skin so that the top-most layer is peeled off. As a result, production of new skin is stimulated and the skin defects caused by the laser are healed over, creating a smoother skin surface.

“Fractional” Fractional Co2 means that only a part of the treated skin area is hit by the laser beam, while islands of skin between are left untouched. For this reason, Fractional Co2 treatment is less sore and will heal off quicker than “traditional” Fractional Co2 treatment.

What is the difference between Ultrapulse mode and other mode of fractional co2 laser?

Ultrapulse mode is the latest generation of technology further shortens the time of the laser pulse, and the energy emitted is compressed to a very short time interval, which can destroy the tissue more efficiently, so that it can reach a much deeper level, resulting in the reduction of unnecessary thermal damage and it associated side effects.

What is the treatment used for?

Fractional Co2 can be used to treat a variety of conditions, such as reducing unevenness of the skin caused by scars or to remove or reshape skin changes such as, for example, severely damaged skin or overgrowing skin in facial parts or warts.

How many Fractional Co2 treatment should I get?

As with any medical treatment, every patient reacts differently and there is no guarantee just how well it will work for you. We usually suggest a course of 6 treatments separated by every 6 weeks to achieve the optimal result.

Often, these will need to be spaced at least 6-8 weeks apart in order to see how your skin has reacted after each laser session.

How long should I wait before the next Fractional Co2 treatment?

It is generally recommended to wait for at least 6 weeks before the next treatment.

Can I combine with other treatments to treatment my acne scar?

Yes, you can combine with treatments like subcision and filler injection, TCA CROSS, controlled depth peel for acne scar. In this case, the treatment result for acne scar will be maximized.

Is Fractional Co2 painful?

Fractional Co2 resurfacing does involve some pain. The level of pain you experience will depend on the depth and extent of resurfacing. We will apply numbing cream to the skin area to be treated and you will be asked to let the cream penetrate your skin for at least 30 minutes before the actual laser treatment. We may prescribe pain killer in some cases.

What are the possible side effects for Fractional Co2 treatment?

Rarely, Fractional Co2 treatment can trigger colour changes or even scarring of the treated skin. To minimise the risk of this happening, follow our aftercare instructions carefully and avoid strong sunlight exposure before or after the treatment. If sun-exposed skin such as the face is to be treated, sun exposure must be minimised by applying sun cream for up to four weeks before and after the treatment.

Do I need to do anything to prepare for Fractional Co2 treatment?

•        You should avoid direct sun-exposure to the area to be laser treated for 3-4 weeks before, as well as after the treatment. Skin that is tanned or has been UV-light exposed is more at risk to show colour changes after Fractional Co2 treatment.

•        Let us know if you have frequent cold sore or other skin infection or skin allergy.

•        Do not apply any retinol or AHA/ BHA for at least 3 days before treatment.

Tell us if you have any of the following medical conditions:

•        Taking of blood thinners such as aspirin, warfarin, or clopidogrel.

•        Any allergies to local anaesthetics, antibiotics, or dressings, or other drugs.

•        A known tendency to form keloids or hypertrophic scars in the past.

•        Possible or confirmed pregnancy.

What happens after the Fractional Co2 treatment?

The skin treated by laser will be raw, look red, and be swollen. It will look similar to having been slightly burned. To protect the skin, you will be given an ointment containing an antibiotic and, depending how large the treated area is, anti- inflammatory and/or sun-protective creams. Your skin may have bleeding or oozing for the coming few days. Keep the treatment area clean and dry for the coming 3-5 days.

What should I do for the aftercare?

After Fractional Co2 treatment, it usually takes about 1 to 2 weeks for your skin to heal. Your skin will be very sensitive during this time. Here are some guidelines to help your skin heal and prevent infection:

Apply an ice pack wrapped in a soft cloth to the treated area for 15 to 20 minutes.

Gently wash the treated area by distilled water or normal saline.

Don’t apply any ointment to your skin including over-the-counter or natural products.

Keep the treated area clean.

Always wash your hands before touching your skin.

Never let the skin feel dry or tight. Always keep it moisturized.

Do not pick at your skin.

What is the cost of Fractional co2 laser Treatment?

The cost would depend on the treatment area and the number of sessions you require.