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After doing A LOT of research for months and...

After doing A LOT of research for months and looking over reviews, different types of lasers, doctors etc. I finally made the decision to get this done (today!). Luckily, I have a friend who is in the skincare business who knows pretty much everything about every different type of procedure, product, etc. for skin, and she guided me on who to choose.

I decided (after consultations) to go with the UltraPulse™ Fractional C02 Laser full face procedure that combined Deep FX and Active FX settings.

I went with Dr. Paul Ruff's office (which is very nice, upscale, clean and friendly). Their Nurse Practitioner, Lori Ward (who also does all of my friend's injections), did my consultation and procedure - she is absolutely lovely, educated and awesome, I highly recommend her (as well as the rest of the staff at this office, everyone is competent, caring and top notch). I was given prescriptions to pick up at my pharmacy to start taking 2 days before the procedure and to continue until 5-7 days after; the various meds were: Valacyclovir, an anti-nausea drug, an anti-biotic and a pain killer (hydrocodan). The actual procedure was uncomfortable, but didn't hurt necessarily, it was more like a much more intense IPL session (and felt better and worse depending on which part of the face).

Well, I am now resting and waiting for the next week to unfold so I can see how my skin is behaving and recovering. So far, so good! Side Note: the hydrocodan made me so nauseous that I ended up vomitting all afternoon and just until I started writing this review. Besides that, I would say everything went off without a hitch. I also got an IPL session on my chest after the CO2 face procedure.

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Day 1 after procedure (the day after)

Still red, and my eyes feel swollen and the most sensitive. There's less of a burning feeling all over (unlike right after the procedure), but skin is starting to tighten and raw skin is turning into skin that feels like its healing (not a scab but definitely no longer a raw skin feeling).

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Day 2 after procedure

I have been religious about my vinegar soaks and cleansing regimen (since day 1): I wash with Bio2 Azulene cleanser at 9am, 1pm, 5pm, 9pm and do vinegar soaks after each wash. Then I apply Bio2 recovery ointment.


Thank you sharing your review - look forward to seeing your results! You are brave to have had the IPL the same day!
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Haha thanks! The chest IPL was the easy part :)

Day 3 after procedure

The dead skin becomes so soft during cleansing/vinegar soaks, and I do see that I am peeling much more around my nose and mouth today. During cleansing, I gently rub the cleanser on and some skin came off. I look very uneven (red patches of new skin with the whiteish dead skin lingering). I will say that I am getting a little discouraged as the skin that did peel reveals shiny red skin but with a bumpy texture (which I didn't have before) - not sure if this the laser lines left over that will heal (hopefully soon) or pimples ready to sprout (dreading this if that is the case). I have been drinking at least 80 oz. of water a day with coconut water and I have also been juicing and not drinking any alcohol (I usually like a glass of red wine nightly), and I have been loading up on veggies. I have also been taking Hyaluronic Acid pills daily. My procedure total cost included 2 aestitichian visits where she basically gives me some time of oxygenated facial (the person who did my CO2 said it would speed up recovery and felt really nice to get cleaned up). I meet her tomorrow and then 1 week after my procedure (this coming Thursday).


Thanks for sharing I'm considering this and Iive in DC too so I'll be following your progress. Happy Healing.
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Awesome! I will keep this updated until I am healed all the way! I went to Dr. Paul Ruff's office where Lori Ward does the CO2, she is their Nurse Practitioner who is absolutely amazing.
hi happygolucky can u tell about ur result.is there any side effect frm the laser that u use?

Day 4 after procedure

Skin is itching and peeling off, but I look less red :) Definitely not good enough to go back to work or have a social life, I still look like a swamp monster haha, I see the aesthetician today, hooray!

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1st visit with aesthetician & Day 5

The price of my CO2 included 2 visits (1 on the 4th day after the procedure, the 2nd on the 7th day after) and she was absolutely amazing! She cleaned my skin up (removed a lot of the lingering dead skin) then applied oxygen all over my face in a mist form for about 5-10 minutes, then sealed it with a coat of Bio2 ointment (the same stuff I've been using all this time). She gave me a new skin routine to follow until Thursday (my next visit with her), where I wash with a foamy anti-redness cleanser (the Plastic Surgeon's brand), then spray with Avene thermal water spray, then this blue gel, the a layer of the Bio2 ointment - I do this am/pm and every hour spray the Avene thermal water spray all over my face. I must say my skin is looking so much better since I saw her yesterday!! I am pink, but that's to be expected especially since I have a lot of pink undertones naturally in my skin. Both the aesthetician and Lori, the Nurse Practitioner who did my procedure said I couldn't look any better at this point and my skin is healing perfectly (what a big relief)! Lori also said I can most likely start wearing makeup around Thursday/Friday (this means my social life will be back, hooray)!! Also, on Thursday they said I will switch to using Avene ciculfate and no longer the Bio2 ointment. So far I haven't seen any bumps or break outs but was warned that they could creep up a week or so after the procedure, so fingers are crossed!

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Day 6

I left the house for the first time (to go to CVS) and I only got a couple of weird stares haha, my face is healing still and the skin is still slightly peeling, and I am definitely still pink. My skin feels almost normal again and not super dry, I feel like I could put on regular moisturizer and be ok, can't wait to see how powder and makeup will feel...I'm hoping I can start wearing some Friday so I can go out and do things this weekend :) I definitely notice redness on my neck where the CO2 was done which is being a bit more stubborn to fade (it looks like red bumps).


thanks for the write up and photos, very helpful.
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Glad I could help! When I was researching all I wanted to see were thorough reviews with pics about the process and healing after but didn't find many that helped, so I hope I could fill that void a little and documented all I could :)
Looks awesome! I hope my healing is like yours;) I have mine scheduled for the 11th!
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Day 7 - the holy grail

I feel and look so much better, I'd say today is really the first day you feel like yourself again, I even put a little makeup on (eyebrows and eye makeup, no face makeup). I had my 2nd aesthetician appointment today, she said my skin looked really great and was responding beautifully to the laser and post-op care. Definitely do everything they tell you to to the T post-op its very important. For the 1st 4-5 days, I drank at least 80 oz of water, and some coconut water, juiced (carrots, celery, cucumbers, apples, ginger, kale etc.) and ate pretty good, I didn't have any alcohol or caffeine and the aesthetician said that makes a big difference. If you're going to do this procedure and take the time out needed to heal and spend the $ it cost, then do everything right :) I included my skin regimens for Days 1-4 above, and attached 2 screenshots of my care for Days 5-7, Days 8-14 (or for the rest of April). I have an appointment to go back to the Dr. office on 4/17 to get LED light therapy.


happygolucky123, your daily journal here - with the photos - was EXTREMELY helpful to me! It looks like you got a beautiful outcome - and even in natural lighting, I'm not seeing the acne scars you wanted to get rid of. That is all GOOD! Are you still "not sure" about having done this? That's what your review says. I wondered, cuz I am 58 and contemplating CO2 laser to get rid of crepey skin on the sides of my mouth. I'd had MixTo microfractional laser in 2010 that ended in DISASTER (so much so, that I posted my pix and story here, too!). I nearly died of a staph infection, and at one point about 10 days post, the surgeon talked about skin grafts cuz I was so fried and infected under my eyes. I am SO very leery and utterly shellshocked from that experience that I had a REALLY hard time seeing your pix days one through four post. YE GODS. It looks super painful and just a lot of cleaning, treating ... and for me, that haunting potential for infection again. You seem to have gotten a fabulous treatment and superb after-care. More power to ya! Wash D.C. is too far for me, so I would have to find someone on the west coast to replicate that success! Thanks SO much for sharing your story.
Why thank you! This was my 30th birthday gift to myself, the scarring and bad skin I grew up with has done a number on my confidence, so I hope this procedure helps with that. I left it at 'not sure' because I want to wait for the full healing time to determine if it was worth it (I mostly did it for the acne scars which are like tiny holes in my chin/cheeks area but its hard to get the right lighting to show) and it takes anywhere from 3-9 months to see the collagen rebuild and fill the scars, so only time will tell but so far I do it was worth it. I'm also a huge fan of IPLs, if I didn't have the scars I would've done a series of IPLs with perhaps a few chemical peels instead of this instense procedure. I originally had an appointment to get the MixTo done but was told the Dr was subpar and the laser was not right for me, so I gambled and chose this (which so far, everything in my experience has been lovely)! I'm so sorry to hear about that experience, that sounds like literally the worst case scenario :( I really think that no matter who is performing the laser procedure, that you need good word of mouth from others about the person, that you feel comfortable with their answers to your questions and that you feel they're being honest about what it can do for your particular skin. After care is also suuuuuupppper important as well as choosing the right laser (which is very tough). Yeah days 1-4 were what I call my "swamp monster days" hahaha, but it looked worse than it hurt, as the pain was really only during the procedure and a few hours later, but my skin felt tender (like a sunburn) but it was tolerable, so much that taking 1 Tylenol sufficed. This procedure is a lot to deal with after, you HAVE to be vigilant with the meds, the cleaning, vinegar soaks, water intake, nutrition, sleep...everything! I hope you find if you try lasers again to have more of a similar experience to my own. I'm originally from southern CA so I can only imagine there are some fabulous Doctors, Nurse Practitioners and offices that offer a laser that can certainly help and enhance your skin. My good thoughts/vibes are with you :)
Sorry if I missed it, but did you get shots to numb your face prior? I was wondering if the shots numbed you enough to be comfortable? My take on things is I'll have 3 separate injections to numb my face, on of them is inside my lip:/

Products list I've been using

The entire Bio2 line (I used 4 of these products):

Avene products I use:


happygolucky123, I've also had EXCELLENT results from IPL! I only get the treatments about once a year to eliminate freckles and age spots. At 30, you are also blessed with youth to recover from CO2 lasering. At my age, I simply don't know what the outcome would be. Maybe loss of facial fat, pigment issues or god forbid, staph. The surgeon who did the MixTo on my face, neck and chest was a surgeon I'd gotten excellent results from on a midface lift, neck lift and upper eyelid bleph. I'd also been going to him for Juvey and botox injections for a few years. In retrospect, I think I should've found a highly skilled derm doc to do the face lasering. It's just a different skill set altogether. When I have my annual derm doc app't in May, I will ask about some kind of topical peel for the crepey skin. Sending you positive vibes for that perfect outcome yourself!
Thanks! Well luckily it looks like you have recovered fully and your skin looks like snow white so you're doing something right :)

Day 8 - Makeup!! :)

I finally put on makeup (I used Physician's Formula Talc free green powder after my AM skin care regimen, it doesn't look cakey or bad, it actually looks quite dewey. I still have some pink and blotchiness but you can't really notice if I put some powder on. Oh, and I got some breakouts on either side of the corners of my mouth, boooo! Oh well, I'm sure those will go away in a few days if I can resist the urge to pick. So far, so good I think my skin is healing nicely and the laser lines are almost all gone except for forehead. I tried to capture my skin in different lighting so you can see the skin's texture with a light dusting of powder.


Hi dear happy to see your improvement i also have acne scars and i want to do laser treatment but i m scared for side effects . Is your scar gone from this treatment ? And i live in chicago . Can u tell Me your update pls thank u ..
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Hi Ankita! My scar(s) is not gone yet, and I'm almost at month 3, I go in for a check-up/follow-up next week, so I'll be asking their opinion on that. My skin looks refreshed and nice regardless so that's always a plus! I'll post more pics in the next week and then once month to keep progress on the collagen repair (for scars) since it takes a least 3 months to start that process and should be complete by month 9.
Ok thank u so much for rply and will wait for your good improvement best of luck dear

3 Month Mark

I went for my 3 month follow up last week and they said my skin looks great. They took "after" photos to compare with my "before" visia photos and you can see quite a difference in oil glands, freckles/dark spots, and redness in my skin has diminished (since before getting this even), so that is amazing. They were shocked when they could see a lift in my lips from the before/after pictures. I use the same cleanser still and then use the Bio2 Amino plex spray, then the Phyto-C Icy blue serum (http://www.phyto-c.com/Moisturize_Icy_Blue/#) then followed with the Phyto-C O-Live Serum (http://www.phyto-c.com/new/O_Live_Serum/) and then my moisturizer. My one scar on my right lower chin area hasn't changed really at all and the Dr. said they could go back over that spot to get more results when Fall comes, but I'm not sure I'll do it. My marionnette lines look a lot better as well!


Wow your skin looks beautiful .. You get your result now so congrats i will also go for laser but still i m thinking but thanks for update enjoyy
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5 Month Mark

My skin looks great! I do see an improvement in the scarring (except for the largest scar I had, which the person who did my CO2 said I could get just that spot done and it would reduce in severity much quicker). Overall, my skin looks like velvet and is very smooth and even toned. You just have to stick with your skin regimen, not pick your skin and give it at least 4-6 months before you really start to see the benefits of the CO2.

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My Daily Skin Regimen (at 5 months post)

In case any of you are wondering, here's my daily regimen...

In the morning:

1. I cleanse with Vivant's 3-1 Mandelic Acid Face Wash.
2. Then I apply Phyto-C Superheal O Live Serum (and let it dry/absorb).
3. Then I apply Elta MD UV Clear SPF 46 moisturizer.

In the evening (before bed):

1. I cleanse with the same Vivant face wash (as above).

* Every 2-3 days I'll use Vivant's Buffing Grains after the face wash.
* If your skin is breaking out, try this after the face wash:
Use Himalya pink salt - mix it with a little bit of water and put it all over my face (like a thick salt mask) for about 10 mins. then wash off and moisturize.

2. Then I apply either the Phyto-C Superheal O Live Serum (if my skin is breaking out, but this stuff should keep that at bay most of the time), or I'll use Vivant's Mandelic Acid 8% Serum.

3. Then apply a moisturizer, I use Phyto-C SuperHeal O Live Cream.

*For pesky blemishes, I dab Calamine lotion on them at night after the above steps (I use a cotton swab) and make sure the Calamine has zinc in it.


Thank you for your informative update :)
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Lori Ward

Lori Ward is the Nurse Practitioner at Dr. Paul Ruff's office in DC (2440 M Street NW). Everyone who works there is absolutely the best! Top-notch front desk (Cody), medical assistants (Sharanda), aesthetician (Renee) and of course my favorite person, the Nurse Practitioner Lori :)

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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