Fractionated or "pixilated" carbon dioxide (CO2) lasers are one of the latest advances in non-surgical skin rejuvenation treatments. Fractionated CO2 lasers (with its longest wavelength) is the best laser for treating deeper wrinkles, stretch marks, more severe textural changes from sun damage, open pores , blotchiness, acne scars and surgical or traumatic scars, laser skin resurfacing , laser toning, tightening and rejuvenation till date . It has miraculous results on the delicate eyelid skin and around the mouth (smokers lines). It is quite instrumental in improving texture, wrinkles, and blotchiness on the neck, chest, arms and legs .
The CO2 laser goes slights deeper and has a different way of shrinking collagen than the Fraxel laser. Therefore, it generally gives much better result for deeper wrinkles, acne scars, upper fine lines and crepeyness around the eyes. It also works well on crepey eyelid and neck skin when performed by an expert with the proper settings. But because the CO2 can go deeper, there is more "downtime" than with the Fraxel. If you cannot take any time off from your normal activities, the CO2 laser on the face is not the right choice for you. Some off-face areas can be kept covered and may be fine.
The fractional CO2 laser takes the CO2 laser beam and fractionates, or pixellates that beam into thousands of tiny little shafts of light. These tiny shafts of light penetrate into the deeper layers of the skin. The skin then repairs those tiny shafts by pushing out the old sun damaged skin and replacing it with new skin. The "collateral" heat damage also helps to shrink existing collagen. After you numb for about an hour, the treatment takes about 15 minutes for a full face . A strong stream of cold air (a Zimmer cooler) is blown on the area during the treatment to make it comfortable. Plan 2-3 weeks ahead for a laser session for being "camera ready" for any social meeting. One can reduce the downtime to 3 days if one is undergoing only skin rejuvenation.
The CO2 laser is compatible long term with Botox, Juvederm, Restylane, and other laser based technologies like hair removal, Fraxel Restore, IPL etc.
If you apply sunscreen and wear brimmed hats, you can maintain the good effects of your CO2 laser treatment for several years.
Bear in mind that the fractional CO2 laser can be customized. Treatments can be deeper, with more healing and downtime, or shallower, with less healing time. The deeper the treatment, the better the results generally. But some patients prefer to have two treatments that aren’t as deep so they can avoid a lot of downtime.