Should I get CO2 or Halo for my under eyes area? (Photo)

Question

35 year old female and I recently had a consultation about laser treatment for my under eyes. I was given options of co2 fully ablative on Lumenis Ultrapulse or Sciton Joule X or not fully ablative using Sciton Halo. I’m struggling to decide so any further information would be greatly appreciated. I should say I am smiling in the photo but dynamic wrinkles and creepiness is my major issue.

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Erin Smith, MD · Answer

In our practice, we utilize both CO2 fractionated laser as well as Halo fractionated laser for treatment of fine lines and wrinkles, including under the eyes. When discussing these procedures, I like to discuss the downtime associated with both procedures, recovery, as well as set expectations on degree of improvement that can be seen between both. These are some of the questions to ask your provider.

Nadir Qazi, DO · Answer

Of course, I'd be happy to help! It sounds like you're considering laser treatments to address fine lines, wrinkles, and skin laxity in your under-eye area, and are trying to decide between two popular options: CO2 fully ablative and Sciton Halo not fully ablative. Here's some additional information that may help you make your decision:
CO2 fully ablative laser resurfacing is a powerful and effective treatment that uses high-energy beams of light to remove the outer layer of skin and stimulate collagen production in the deeper layers. This treatment is best suited for patients with significant skin damage or scarring, as it provides more dramatic results than other laser treatments. However, because it is fully ablative, it requires a longer recovery time and can cause significant redness, peeling, and discomfort.
Sciton Halo, on the other hand, is a hybrid fractional laser that combines both ablative and non-ablative wavelengths to address a wide range of skin concerns, including fine lines, wrinkles, and uneven skin tone. This treatment is less invasive than CO2 laser resurfacing and typically requires less downtime, with many patients able to return to work and regular activities within a few days.
When it comes to treating the under-eye area, both CO2 and Halo have their advantages and disadvantages. CO2 is more powerful and may be better suited for patients with more significant skin damage, while Halo is less invasive and may be a better option for patients who want to see results with minimal downtime. We personally find that Halo is a bit limiting, however, However, both treatments can be effective in addressing dynamic wrinkles and skin laxity, and your choice may ultimately come down to your personal preferences and desired outcomes.
It's important to consult with a board-certified dermatologist or plastic surgeon who has experience performing both CO2 and Halo treatments to determine which option may be best suited to your individual needs and concerns. They can help you understand the benefits and risks of each treatment, as well as any potential side effects and recovery time. Ultimately, the decision of which treatment to pursue should be made in collaboration with your doctor, based on your unique skin type and cosmetic goals.

Jason Emer, MD · Answer

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells and microneedling RF like Fractora PiXel8 or Morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

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