Does the type of CO2 laser machine matter? I am 64 years old with some acne scaring and wrinkles.

Question

In researching, it looks like the Ultrapulse CO2 machine is the 'gold standard' and is the only laser that does not cause 'thermal damage'. The fraxel and pixel and Acupulse (?) CO2 seemingly do cause this damage. Should I look for a Dr. who uses the Ultrapulse?

Jason Emer, MD · Answer

Each Doctor will have their preferred laser. Typically I recommend adding clear and brilliant, fraxel, viva 4-6 weeks after co2 to improve this along with microneedling/prp to get the best outcomes with texture and tone.  Please see an expert. Best, Dr. Emer.

Elham Jafari, MD · Answer

Hi and thank you for your question! When it come to CO2 laser machines, the key is to make sure they are from reputable manufacturer and FDA-cleared (or approved by other relevant agencies in other parts of world). In my experience and opinion, each manufacturer tries to make some incremental improvements and tweaking to set their machine apart from others, but it is usually more marketing than real difference in clinical results. When undergoing fractional CO2 laser treatment for acne scarring and wrinkles, the magic is done by the delivery of high-energy tiny beams of CO2 laser that hit the skin at some areas while leaving the areas in between intact. This "insult" will stimulate the natural healing process of the skin, leading to synthesis and rearrangement of collagen. Slight variations between various laser machines might make this process a bit more effective, but the real-word clinical difference in results is often minimal. The more important factor is to do the treatment by experienced staff at a clinic under supervision of physician. I hope it helps and good luck!

Jeff Rapaport, MD · Answer

In in my opinion, the CO2 ultrapulse is the gold standard for ablative laser resurfacing. However, this laser has more side effects than the fractionated lasers that you mentioned. The side effects are due to Thermal damage. The primary side effect with the CO2 ultrapulse is hypopigmentation. This can occur between 2 and 5% of the time. The other lasers are fractionated and have a lower side effect profile. I think it's important to remember that it's not the laser , it's the person who's operating the laser. Find an experienced laser surgeon. Ask to see photos.

Robert Applebaum, MD · Answer

The type matters in the sense that for example Fraxel CO2 has less down time ,but you might need up to 4 treatments to see a meaningful result. They do the same job, just each has different downtime and side effect profile.

Davin Lim, MBBS, FACD - Account Suspended · Answer

The Ultrapulse is often not needed for most forms of acne scarring- the exception is with subdermal fibrosis. This accounts for less than 3% of the scars that I typically encounter. Rather than seek out the laser, seek out someone who has knowledge and the METHOD to treat your scar type. In the US Dr Emer, Dr Weiner, Dr Rapaport and Dr Novick all have extensive experience in scar revision. I wish you well, Dr Davin Lim. Brisbane. Australia

Does the type of CO2 laser machine matter? I am 64 years old with some acne scaring and wrinkles.

Answers (5)

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