ULTRAPULSE CO2 LASER

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. 

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.

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.

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.