When the laser is passed across the skin surface, the superficial layers of the skin are vaporized. Sculpting and collagen synthesis then take place and continue in the months following laser treatment. The depth of ablation in the superficial layers depends on how the machine is configured. Modern machine settings can define the desired effects, varying from pure ablation to a preferential heating effect.
Precautions before a fractional CO2 laser procedure
In the 3 to 4 weeks leading up to laser treatment, the doctor will bring the skin’s melanin production to a rest in order to limit the risk of post-inflammatory pigmentation. This is an important precaution for dark skin and Asian skin. Throughout the preparation period, the patient must avoid any exposure to the sun or UV rays, and must also refrain from using self-tanners. In the week preceding laser treatment, the patient must use a moisturizing cream regularly to prepare the skin. Prescription medication against herpes must also be administered in the 2 to 4 days prior to a CO2 procedure to limit the risk of a cold sore outbreak.
Precautions on the day of the fractional CO2 laser session
On the day of the laser session, patients must not wear makeup but can use their regular moisturizer to prime the skin for treatment. If desired, a homeopathic treatment or mild sedative can be prescribed to relax the patient within the 2 hours prior to laser treatment.
At the same time, the patient must apply a numbing cream to the face. The cream must be applied in a thick layer and sealed off with a bandage. The bandage and numbing cream will be carefully removed and the skin will be cleansed in the doctor’s office.
How many laser treatments are needed?
The treatment involves 2 to 4 sessions spaced 6 to 8 weeks apart. Results are visible in 3 to 4 weeks.
How long should patients wait between laser sessions?
Sessions are spaced 4 to 6 weeks apart.
Possible side effects
Following laser ablation, normal reactions such as redness and swelling are observed. However, even though CO2 lasers are optimized for vastly improved clinical tolerance, your doctor will check for a variety of complications that may occur.
How the skin behaves after a fractional CO2 laser procedure
In the minutes following treatment with a fractional CO2 laser, the skin is coated in a thin, whitish film that reproduces the pattern formed by the fractionated impacts. This mesh-like coating is similar to a very fine cloth, a bit like medical gauze.
This film quickly disappears, leaving the skin looking heavily tanned on the first day with light pigmentation and a warm sensation all over the surface of the laser-treated skin. The sensation of heat can be uncomfortable. Discomfort can be controlled by spraying pressurized spring water on the skin several times a day, by taking oral pain relievers, or by applying moisturizing and healing creams several times a day. Tiny scabs may form. In the 3 to 4 days following fractional laser treatment, the skin peels like it would after a severe sunburn. On the 5th or 6th day, makeup can generally be worn to conceal the final stage of the healing process so patients can go back to work.
Post-treatment results are generally visible in 2 stages. There is an initial, rapid improvement within 2 to 3 weeks after the procedure followed by a more gradual improvement over the course of the 6 months following treatment. The skin tightens and a high percentage of wrinkles and acne scars disappear.
In-home treatment in the days following a fractional CO2 laser procedure. Treatment in the days following a CO2 laser procedure involves continuing the preventive treatment against cold sore flare-ups (generally 2 to 4 days following the medical procedure). A healing cream will be prescribed for 3 to 4 days post-laser treatment, followed by a repairing cream.
Skin must be generously moisturized for the 2 to 4 weeks following the fractional CO2 laser medical procedure. Depending on the skin’s characteristics and the patient’s phototype, a depigmentation cream may be used for a few additional weeks.
Similarly, scrupulous sun protection measures must be taken for a least one month. This involves applying broad-spectrum, high-SPF sunblock and staying completely out of the sun. A follow-up visit on the 7th day and after 1 month is required to check that the skin is responding properly and that no complications are occurring. An evaluation after 6 months with a photo shoot is recommended.
Further reading:How does CO2 fractional laser work on problem skin?
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