DOT Carbon Dioxide (C02) is a fractional, ablative laser that is ideal for the treatment of sun damage, brown spots, wrinkles, texture, eyelid laxity, and acne scars. The laser creates controlled injury points which stimulate fibroblasts in the skin to make collagen, dramatically improving the skin’s texture, tone, and overall radiance. Each microscopic hole is surrounded by undamaged skin to expedite the healing process.
The results of the treatment are both immediate and progressive. Within two weeks, your skin will feel softer, look brighter, and have a more even tone. Over the next 3-6 months, new collagen will form to tighten and smooth lines. The number of treatments is unique to your concerns and skincare goals. We usually recommend starting with one treatment for overall facial rejuvenation. Multiple treatments may be recommended, typically spaced 1 to 3 months apart.
We often recommend other treatments and products that will help maximize and maintain optimal results (i.e. Botox, Dysport, fillers, tretinoin, Clear + Brilliant, Exilis, facials, etc). Please consult your provider to create an individualized care plan to achieve your unique goals.
What does the treatment feel like?
Topical anesthesia is applied to the skin one hour prior to treatment and Toradol, a strong NSAID, is provided. Patients often describe intense heat during the treatment as though their skin is sunburned. We use the PRO-NOX™ nitrous oxide sedation system, a self-administered, pneumatically driven gas system for the relief of pain and anxiety, making the procedure very tolerable.
What is my preparation for the treatment?
An in-office consultation with one of our physicians prior to scheduling the procedure is required. Unless otherwise directed, you may continue to use topical retinoids (i.e. tretinoin, Retin-A, Triluma, Melasma Quadruple Cream), antioxidants, and/or hydroquinone up to the day of your treatment. Patients must avoid sun exposure for at least two weeks prior to treatment. Patients with a history of cold sores may be given a prescription for an oral antiviral to prevent an outbreak. If you have a history of herpes/cold sores, we will want to start you on a treatment of 500mg twice daily of Valtrex starting the day before your procedure. Please call the office so we can prescribe the appropriate prescription if you need it. Do not wear contact lenses to your appointment. For your protection, metal eye shields will be placed over your eyes during the treatment. If vision impaired, wear eye glasses rather than contact lenses to the appointment.
What should I expect after my treatment?
Immediately following the procedure, the skin will feel hot and tight, as if sunburned. You may experience pinpoint bleeding immediately after the procedure and into the second day. You will not want to be seen for the first 2-3 days due to swelling, redness & crusting. Swelling will occur but should resolve in 3-5 days. Pain can be managed with ibuprofen or Tylenol, if needed. Laser grid marks will be visible for the first week. Redness and skin roughness are most intense in the first 2 weeks but may take up to a month to fully resolve. Wait 3 days before doing strenuous exercise. Be diligent in sun avoidance for the first 4 weeks and always protect skin with a zinc-based sunscreen. Allow at least 4 weeks before big events (i.e. weddings, reunions, photoshoots, etc). We will provide you with a post-procedure kit with instructions and products, which should last two weeks.
Are there any risks or possible side effects?
- Discomfort during the procedure is generally mild and we minimize this by pretreating you with topical numbing cream, blowing cold air and using the PRO-NOX™ system. After the procedure, you may have some skin sensitivity and feel hot in the area for a few hours to several days. You may use ibuprofen or Tylenol as needed for pain, although the pain is generally mild.
- Swelling is common and usually subsides within 3-7 days.
- Redness may persist for up to 1 month.
- Bleeding, oozing, crusting — Aggressive treatment may cause pin point bleeding, petechiae (small red dots under the skin surface), and/or oozing. Crusting or scabbing may form if the clear fluid or blood dries.
- Skin burns and blisters may occur, but are rare and unlikely.
- Acne or milia formation — A flare-up of acne or formation of milia (tiny white bumps or small cysts) may occur. These findings resolve as the skin heals.
- Herpes simplex reactivation — Herpes simplex virus (cold sore) eruption may occur in a treated area that has previously been infected with the virus.
- Infection — If blisters or bleeding are present, an infection of the wound is possible. Meticulous wound care must be observed to avoid scarring and associated pigment changes.
- Hyperpigmentation — During the healing phase, the treated area may appear darker. To reduce the risk of this, the treated area must be protected from exposure to the sun.
- Hypopigmentation — In some patients who experience pigment changes, the treated area loses pigmentation (hypopigmentation) and becomes a lighter color than the surrounding skin. This type of reaction may also be permanent and is rare.
Are there any contraindications?
CO2 lasering is contraindicated for people who have a predisposition to keloid formation or excessive scarring. It is also contraindicated for women who are pregnant or breastfeeding, for people who have taken Accutane in the past 1 month, and those with active cold sores. Individuals with vitiligo may not be appropriate candidates for CO2 laser resurfacing.
Modern Dermatology requires a credit card for scheduling of all aesthetic appointments (except Botox/Dysport/Jeuveau). We will remind you of your appointment 1 week prior in case you need to cancel or reschedule. Appointments broken without 48 business hours of notice will be charged a $250.00 cancellation fee for the time we reserved for you.