CO2RE Intima: What You Need to Know

Pros

• The treatments are brief, taking about 15 minutes. If the area needs to be numbed, which is common when CO2RE Intima is used externally, it may take a little longer.
• When used internally, to treat the vagina, it’s virtually pain-free—numbing isn’t needed.
• CO2RE Intima reviews are generally good, with doctors reporting high satisfaction rates among their patients.
• Results are often seen after just one treatment.
• There’s no downtime associated with the treatment, and—with the exception of refraining from intercourse for a week—you’re free to resume your daily activities immediately.

Cons

• When used externally, to improve the appearance of the vulva, the CO2RE Intima Laser can be somewhat painful. “It feels like a slight sting associated with some heat, which subsides within two hours,” says Atlanta facial plastic surgeon Dr. Theresa Jarmuz in a RealSelf Q&A. “Patients state the pain associated with external Intima treatment is three to five on a scale of 0–10.”
• Multiple sessions are recommended for the best results. “Most patients have two to three treatments, separated by one month in between,” says New York City plastic surgeon Dr. David Shafer in a RealSelf Q&A.
• CO2RE Intima treatment is expensive, and annual follow-up sessions are usually needed to maintain the results. It’s not usually covered by insurance.
• The treatment isn’t intended for certain vaginal concerns. “It cannot correct severe stress urinary incontinence or uterine prolapse or severe vaginal laxity,” says Peabody, Massachusetts, plastic surgeon Dr. David Wages in a RealSelf Q&A. “These conditions may need traditional surgery.” Because CO2RE results in limited skin contraction, labial asymmetry may also require surgery to reshape the outer tissues (labiaplasty). 
• If surgical mesh was used to help repair urinary incontinence, you may not be able to be treated with CO2RE Intima.

While lasers and other energy-based devices have been approved by the FDA to treat abnormal or precancerous tissue in the cervix and vagina, they haven’t been approved to treat concerns like impaired sexual function, vaginal atrophy, or urinary incontinence. Because of that, the FDA ordered several companies to stop marketing laser devices for “vaginal rejuvenation” in 2018. However, according to Dr. Lara Devgan, a plastic surgeon in New York City and RealSelf chief medical editor, “While laser and energy vaginal devices have not been FDA-approved for the claims that are frequently made about them, they do work well anecdotally and in clinical practice.”

Common side effects, such as redness and swelling, usually resolve after a day. Complications with CO2RE Intima are rare. 

Skin tone may be a consideration with fractional CO2 laser treatment. “Light-skinned individuals of certain ethnicities, those on certain medications and [those] with underlying medical conditions can experience side effects, such as hypo- or hyperpigmentation, resulting in unevenness or patchiness,” says Peabody, Massachusetts, physician Dr. Shanthala Shivananjappa in a RealSelf Q&A. Be sure to talk to your doctor about whether the treatment is right for you.