Comparison of the New Fractional CO2 (Dot) Laser with Old CO2 Laser Resurfacing

Published on May 31, 2009

The new CO2 Fractional (Dot) Laser therapy works to restore skin texture and color. It can reduce fine lines and wrinkles, soften mild creases, and fade abnormal pigmentations that occur over time. These skin changes are the signs of “aging” of the skin, and can occur most prominently on the face, the chest and the hands. In other words, they tend to “age” a person’s appearance. They are due to many causes, but primarily due to sun exposure, changes of the skin from the passage of time, and even pregnancy.

Fractional laser therapy is based on using the power of the CO2 laser in a more controlled and refined manner. The Old CO2 laser has been considered to be the “Gold Standard” for over a decade for small creases and pigmentations. In other words, there is virtually no other technology that seems to provide the same or equivalent results as the results that this procedure can provide. Unfortunately, the Old CO2 laser had many problems associated with it, and a need was present to refine this treatment. This is why the Fractional laser technique was developed.

The Fractional CO2 laser is remarkably different from the prior CO2 laser treatments. This new procedure is performed in the office using only local anesthetics with mild to deep sedation as needed. Thus it is performed while the patient is awake. The treatment is very controlled with the use of fractional resurfacing techniques and it is quick; each treatment takes only 15 to 30 minutes. The downtime after the procedure is shortened, with most people resuming normal activities within five to seven days. Most patients appear sun burned for a few weeks, but they do not have the tremendous sloughing of the skin or problems as with the Old CO2 laser.

The Old CO2 laser worked differently. The procedure needed to be performed while the patient was asleep with a general anesthetic due to the tremendous pain of the procedure. This Old procedure created literally a second degree burn all over the surface of the face. This resulted in a very long recovery time which could last for 4 to 6 weeks. The skin would turn irregularly dark, it could bleed, it could get infected, it could depigment areas excessively, and it could scar. The patient would not want to go out in public for weeks due to the tremendous unsightly sloughing of the skin that occurred from this old therapy.

Recovery from the Old CO2 laser treatment would typically be like this: for the first few weeks, the patient’s facial skin would turn red, it could bleed, the skin would pigment irregularly all over the face, and the skin would gradually slough off, peeling the old dead skin off the face. If bleeding occurred from the skin, special care would be needed to prevent infections from occurring. This whole process required a tremendous amount of wound care by the patient to make sure no abnormal scarring would occur.

After the Old CO2 laser procedure, the patient was hidden indoors for a long time. At around one month after the treatment, the patient could go outside in public again, but would continue to have a red face for another six weeks to nine months. Maximum avoidance of any sun exposure was necessary during this time. The results were usually great, but very dependent on the skill of the surgeon. The long downtime, however, was a high cost to pay for these results.

Moreover, the complication rate of the Old CO2 laser were unusually high, including excess depigmentations resulting in patches of white skin next to normal colored skin,  and potential disfiguring scarring that many times required further surgery for correction. Over time, this high downtime, the pain postoperatively which could have been significant, and the many complications that occurred from this prior technique caused it to go into disfavor.

The areas that can be treated are also different. With the Old CO2 laser, only the face could be treated down to the edge of the jawbone. With the new Fractional CO2 laser, almost any skin surface can be treated. Thus, not only can it treat the face, but it can also treat the neck, the chest, the hands, and other areas. It can be used not only for the treatment of aging changes, but can also be used on scars, such as acne scars and surgical scars, and for the treatment of melasma, or the pigmentations from pregnancy.

The Fractional CO2 laser has eliminated most of the problems that occurred from the Old CO2 laser technique. It is performed using local anesthesia while the patient is awake, avoiding the need for a general anesthetic. The system is very controlled through a new technology called “fractional” technology. Instead of the entire surface of the skin healing from inside out (i.e. total sloughing of the outside skin), this fractional technology allows for healing of the skin through a different process.

This new “Dot” technology works by creating thousands of tiny holes in the skin down to a specified depth, set by the digital processor of the laser. This destroys the abnormal skin surfaces in a controlled fashion and allows the normal areas that are left intact to heal from the sides of the tiny holes. The healing process thus occurs, not from the bottom of the destroyed skin up, as with the Old technique, but primarily in a sideways fashion.

The results are thus just as remarkable, but the downtime is significantly reduced. Dot treated patients can go outdoors in public within a few days after Dot laser treatments. The redness that would typically last from 6 to nine months after the old CO2 technique now usually only lasts for around seven to ten days with the Dot laser therapy. This redness can be covered up with makeup within a day or two after the procedure, which is different from the Old technique. One can thus resume normal activities much faster. Plus, the many potential complications that had occurred with the Old CO2 technique are rare.

In conclusion, the Fractional CO2 (Dot) Laser is a new technology that provides the same great results as the old Gold standard CO2 laser but with less downtime and less problems. It can reduce the signs of aging, such as fine lines of the skin, wrinkles, mild creases, and pigmentations with remarkable results comparable with this Gold standard. Thus, this Dot Laser can rejuvenate the skin to help people retain the more youthful appearance of their skin through its new technology and skin resurfacing powers.

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