Q: What are the pros and cons of UltraPulse CO2 laser treatments?

Pros These noninvasive treatments can create significant improvements for a wide range of skin concerns, from fine lines and wrinkles to keep scars. DeepFX and TotalFX treatments stimulate new collagen production, meaning that your results will continue to improve for six months to a year afterward. Some options, like DeepFX are suitable for dark skin tones (though ActiveFX and TotalFX aren't). Treatment time is fast, taking only about 30 minutes. Cons You may need multiple treatments to see optimal results. As with all laser resurfacing treatments, results aren’t permanent; you’ll need follow-up treatments to maintain them. CO2 laser treatments can be intense, and some require a lengthy downtime of up to two weeks. In rare cases, complications such as scarring and pigmentation issues (hyperpigmentation or hypopigmentation) can occur. This is also more common for people with medium to deep skin tones, so it’s especially important to find a provider with extensive experience treating skin of color.

Question 1

What is the UltraPulse CO2 laser?

Accepted Answer

UltraPulse is a carbon dioxide laser that resurfaces skin with concentrated beams of light. The laser energy is absorbed by skin cells, which are then vaporized. Once this tissue is removed, the body’s healing process kicks in to regenerate fresh skin.

CO2 laser treatments like UltraPulse can treat skin concerns like fine lines and wrinkles, discoloration, and even scars.

UltraPulse CO2 Laser comes in four different modes:

ActiveFX is a fractional CO2 laser that penetrates the skin’s surface in a pixelated pattern, causing a gradual peeling of old surface cells while stimulating new collagen production in the skin’s deeper layers for smoother, tighter skin.

In helping the skin shed old surface cells, ActiveFX helps improve an uneven skin tone over time, helping address age spots, sun spots, and other forms of discoloration.

Keep in mind that ActiveFX isn’t recommended for olive or brown skin, due to risks of hyperpigmentation.

DeepFX is a fractional CO2 laser that penetrates deep into the dermis, to stimulate collagen production. CO2 fractional lasers use short pulses of light to remove damaged portions of the top layer of skin, leaving tiny “columns” of untouched skin that help speed up recovery.

Since the DeepFX laser’s heat also penetrates deep tissue, it tightens collagen and boosts production in the long-term.

DeepFX can be effective for treatment of deep-set lines and wrinkles, severe hyperpigmentation, and acne scarring on the face and neck.

However, doctors advise that DeepFX is not for everyone. One study looking at fractional CO2 resurfacing—specifically, how both DeepFX and ActiveFX performed—concluded that patients can expect noticeably softened eye wrinkles. However, acne scars are more difficult to treat, so those results aren’t as consistently good. Some people with deep acne scarring and uneven skin tone may benefit from this treatment, while others might not see the results they’re looking for.

TotalFX is a laser treatment intended to treat acne scars and sun damage. The procedure combines two fractional CO2 lasers—specifically ActiveFX and DeepFX—that treat only a fraction of the skin’s surface, leaving small areas of skin untouched to speed healing.

Because both the superficial layers of skin and the deeper dermis are targeted with this technology, TotalFX treatment improves skin tone and texture.

SCAAR FX uses ablation (removing the top layer of skin) and coagulation to perform controlled skin resurfacing on patients with hard-to-treat skin lesions and scars. It releases powerful pulses that reach up to a depth of 4mm to minimize deep, contracted scars.

These pulses create a pattern of microscopic channels that break up the stiff tissue in scars and promote the production of restored, regenerated skin with improved elasticity. Not only does this form of resurfacing reduce the appearance of scars, it also provides significant functional improvement, too.

Question 2

​​What are the pros and cons of UltraPulse CO2 laser treatments?

Accepted Answer

Pros

These noninvasive treatments can create significant improvements for a wide range of skin concerns, from fine lines and wrinkles to keep scars.

DeepFX and TotalFX treatments stimulate new collagen production, meaning that your results will continue to improve for six months to a year afterward.

Some options, like DeepFX are suitable for dark skin tones (though ActiveFX and TotalFX aren't).

Treatment time is fast, taking only about 30 minutes.

Cons

You may need multiple treatments to see optimal results.

As with all laser resurfacing treatments, results aren’t permanent; you’ll need follow-up treatments to maintain them.

CO2 laser treatments can be intense, and some require a lengthy downtime of up to two weeks.

In rare cases, complications such as scarring and pigmentation issues (hyperpigmentation or hypopigmentation) can occur. This is also more common for people with medium to deep skin tones, so it’s especially important to find a provider with extensive experience treating skin of color.

Question 3

What happens during a UltraPulse CO2 laser treatment?

Accepted Answer

The way your treatment unfolds will depend on which type of UltraPulse treatment you have and your specific concerns, but you can expect it to go something like this.

When you arrive at your provider’s office, your provider will clean your skin and apply a topical numbing cream, leaving it on for about an hour. While the cream takes effect, you may be given an anti-anxiety pill to help you relax during the procedure. Providers will usually offer a strong sedative, such as Valium or Vicodin, or even IV sedation.

Once the area is numb and you’re feeling calm, your provider may inject pain blockers directly into the treatment area. They will then wipe off the topical anesthetic numbing cream and start the laser procedure.

For ActiveFX, they’ll move the handpiece in a stamping motion, methodically delivering the laser light energy over the entire treatment area.

During a DeepFX treatment, your provider will glide the laser over your skin, focusing on the areas needing treatment. If you’re having the TotalFX treatment, your doctor will do one pass with the DeepFX head and another with the ActiveFX head.

Some patients don’t feel anything except heat, while others experience discomfort or a sensation similar to a rubber band snapping against the skin.

You can expect the procedure to last 20 to 60 minutes.

After treatment is complete, your provider will coat the treated area with a hydrating gel to ensure the resurfaced skin is well-moisturized.

Question 4

How long does recovery take?

Accepted Answer

The length of your recovery will depend on which UltraPulse laser you received, but expect that your skin will look worse before it looks better. Redness that’s similar to a sunburn is common immediately after your treatment, with swelling and peeling occurring as well.

Side effects for ActiveFX typically subside within three days, but can last up to two weeks. After three to five days, you should be able to wear makeup to hide redness, although you may need to wait a few more days, depending on how sensitive your skin feels post-treatment.

The DeepFX laser has a longer recovery time, with social downtime being about four to five days. As the peeling subsides, you'll see a new layer of skin, but it will still be pink or red. Y

You may also notice grid lines or small dots caused by the laser; these will gradually fade over two or three weeks. Some people also notice oozing yellow serum from the small holes created by the laser; these can be gently dabbed off.

The TotalFX option has the longest downtime of the UltraPulse laser modes. “The skin does look horrible for a week, but you should be able to wear makeup within a week on the face and after two weeks on the neck,” says Dr. Lisa Benest, a dermatologist in Burbank, California. Expect swelling, itching, and peeling for up to a week.

Use ice packs to bring down swelling and redness, and apply a moisturizer. Dr. Michael Gold, a dermatologic surgeon in Nashville, explains in a RealSelf Q&A that using Neocutis aftercare cream can shorten recovery. “Keeping the skin moist rather than letting it crust up has been shown to keep the skin healing faster.”

Avoid washing your face for the first few days and sun exposure for four weeks post-procedure. Some doctors recommend mixing vinegar and distilled water to blot on the area to sterilize it, too.

During your downtime, you can manage your discomfort with over-the-counter pain relievers. Resist picking—it will extend your recovery time and may cause permanent scarring.

Question 5

When will you see results from the UltraPulse CO2 laser?

Accepted Answer

You’ll see your skin resurfacing results once your skin has fully healed, which can take several weeks.

The benefits of new collagen formation appear within three months of treatment, though you may not see the full results until six months out.

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