Q: What are the pros and cons of carboxytherapy?

Pros Carbon dioxide occurs naturally in the body, and carboxytherapy relies on your body’s own blood circulation to increase oxygen in the treated areas. The treatment is quick and minimally invasive, with no downtime. Carboxytherapy targets some of the most stubborn concerns in dermatology—dark under-eye circles, stretch marks, and cellulite. Cons A series of treatments (often 10 or more, once or twice a week) are recommended for significant results; this can be inconvenient and expensive. Results aren't permanent; expect to return for maintenance treatments every six months. Study of carboxytherapy in the U.S. has been limited, with few clinical trials attesting to its effectiveness, or even fully explaining how the treatment works. Contrary to some information online, it hasn't yet been FDA approved. RealSelf Tip: While the RealSelf members who have reviewed carboxytherapy give it a high Worth It Rating, results may be more subtle and temporary than what you'd get with other treatment options, particularly for fat reduction and cellulite removal .

Question 1

What is carboxytherapy?

Accepted Answer

A carboxytherapy treatment infuses carbon dioxide gas under the skin to increase blood circulation and stimulate new collagen production.

It can be performed anywhere on the body, including the face, neck, arms, stomach, buttocks, and legs. The treatment is usually intended to reduce fatty deposits, as well as the appearance of cellulite, stretch marks, acne scars, fine lines and wrinkles.

Carbon dioxide gas can even be injected into delicate or thin-skinned areas; carboxytherapy under the eyes is often performed, to treat dark under-eye circles.

It’s believed to have skin rejuvenation benefits, stimulating an increase in collagen production that improves skin elasticity and firmness. It's also used to treat alopecia (hair loss) and erectile disfunction.

This procedure originated in France in 1932 and is popular internationally, but carbon dioxide therapy is still relatively new to the U.S. Because clinical studies remain limited, it’s not yet FDA-approved.

Doctors on RealSelf recommend an initial series of 10 or more treatments for optimal results, with follow-ups every six months after that.

Question 2

What are the pros and cons of carboxytherapy?

Accepted Answer

Pros

Carbon dioxide occurs naturally in the body, and carboxytherapy relies on your body’s own blood circulation to increase oxygen in the treated areas.
The treatment is quick and minimally invasive, with no downtime.
Carboxytherapy targets some of the most stubborn concerns in dermatology—dark under-eye circles, stretch marks, and cellulite.

Cons

A series of treatments (often 10 or more, once or twice a week) are recommended for significant results; this can be inconvenient and expensive.
Results aren't permanent; expect to return for maintenance treatments every six months.
Study of carboxytherapy in the U.S. has been limited, with few clinical trials attesting to its effectiveness, or even fully explaining how the treatment works.
Contrary to some information online, it hasn't yet been FDA approved.

RealSelf Tip: While the RealSelf members who have reviewed carboxytherapy give it a high Worth It Rating, results may be more subtle and temporary than what you'd get with other treatment options, particularly for fat reduction and cellulite removal.

Question 3

How much does carboxytherapy cost?

Accepted Answer

Your cost will depend on your provider’s level of experience and training, their practice location, and the number of treatments you receive.

Plan to have a series of treatment sessions and keep in mind that you’ll need follow-up visits to maintain your results. Some providers may offer a discount if you pay for a series up-front.

Question 4

How does carboxytherapy work?

Accepted Answer

When carbon dioxide gas is injected into the subcutaneous tissue below the skin, it dilates blood vessels, which increases circulation and oxygen flow to the tissues.

The treatment is sometimes touted as a nonsurgical alternative to liposuction for fat reduction. It’s believed that the treatment shrinks fat cells (possibly by damaging the cell wall, which may release the triglycerides inside) but doesn’t kill and eliminate them, so they can expand again with time. The first randomized clinical trial, performed in 2018, found that fat reduction results were no longer visible after 28 weeks.

A small pilot study that consisted of eight weekly carboxytherapy sessions for cellulite reduction found it helpful. However, Dr. Mark Youssef, a physician in Santa Monica, California, says in a RealSelf Q&A that “many patients require more than eight treatments, especially for stubborn cellulite,” along with regular follow-up treatments to maintain results. Other cellulite treatments, such as the newly FDA-approved injectable Qwo, have more solid science to back up claims of results.

Minimizing dark under-eye circles is one of the most common applications of carboxytherapy, especially since poor circulation (which creates vascular pooling) is one of their main contributors.

“The lack of appropriate oxygenation to the lower eyelid skin allows the bluish cast to show through the thin skin,” creating the look of dark circles, explains Dr. Ajaya Kashyap, a plastic surgeon in New Delhi. “By injecting a small amount of carbon dioxide gas into the affected areas, blood flow is increased and improved capillary networks are formed, for longer-lasting circulatory benefit.”

However, if your dark circles are due to fat loss that creates hollows, carbon dioxide therapy won't be nearly as effective as dermal fillers or fat transfer.

Carboxytherapy for stretch marks and scars works by encouraging healing. “It restarts the healing process and restores the circulation to the scarred tissue to give it the best chance at healing,” says New York City physician Dr. Jamé Heskett in a RealSelf Q&A.

Some doctors say that combining carboxytherapy with platelet-rich plasma (PRP) injections and microneedling (also known as collagen induction therapy) can improve results.

Question 5

What happens during a carboxytherapy treatment?

Accepted Answer

The treatment usually takes just 15–30 minutes. Your provider will have a carbon dioxide tank that runs gas to a small needle, via a sterile tube.

If you’re anxious about needles or sensitive to pain, your provider can apply a numbing cream to your skin so you won’t feel the injections as much.

They’ll then insert the needle beneath the skin, into the subcutaneous tissue, and inject a small amount of carbon dioxide gas. You may feel a bit of pressure as it expands under your skin, and some RealSelf members report discomfort during the injection; and one even found the treatment "intensely painful."

Only minor side effects have been reported: some bruising, swelling, and discomfort at the injection sites that lasts from one to five days.

But there’s no downtime, and you should be able to return to your normal activities immediately.

Question 6

How long does carboxy treatment last?

Accepted Answer

Carboxytherapy results last for about six months before you'll need to return for maintenance treatments.

Question 7

Is carboxytherapy safe?

Accepted Answer

Providers who offer carboxytherapy say that it's safe, with only minor side effects and no downtime. That said, there aren't enough clinical studies examining its safety and efficacy to definitively determine how safe it is over time.

To ensure you're being properly cared for, find a board-certified doctor who has years of experience performing the procedure safely.

CARBOXYTHERAPY

Kali Swenson

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Kali Swenson

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