CO2 Laser With Other Options vs Alternative Choices

Dr. Irwin, I follow you on Instagram and value your input on facial treatments. You are honest and straight forward. I have done CO2 laser two times in the past 6 years. I was very pleased with the results. I only had it done around my mouth; that is the area that really bothers me. I am 72 and in good health. I eat healthy and workout. I had a Halo treatment on my entire face in March 2023. I was not happy with the results. With that said, I am planning on doing CO2 laser treatment around my mouth in September. Do you think that is the best option for me? Also, do you know anything about EXOlE? It was recommended that I use it 3 days before the treatment. It is supposed to speed up recovery and stimulate collagen. I would appreciate any feedback or suggestions. Thank you, Debbi

Hi Debbi – Thank you! I think that if you’ve done well in the past with CO2, there’s good reason to think that you might get a good result again. I usually vote for doing full face so there’s some tightening everywhere and reduction of wrinkles. There is recovery time anyway, and it makes it less likely you’ll see a zone of demarcation between the treated and untreated area. The CO2 on the rest of the face can be done more lightly if you prefer. Why not get maximal results and it’s usually not much more expensive.

Laser assisted drug delivery (LADD) is a hot research topic. These wonderful scientists teach us more each year. It’s known that after a laser like CO2, we have about 30 minutes while microscopic channels are open. The channels allow the topical to soak in and improve skin in various ways, and help reverse sun damage.

Using CO2 with other options:

  1. CO2 with PRP (platelet rich plasma) Using your own activated platelets can speed healing and improve your results.
  2. CO2 with exosomes (Exoie and other brands). A newer approach and not much science on this yet. These creams should be used before and not WITH the laser.
  3. CO2 with 5-FU solution (the injectable used as a topical not the cream). Helps to reverse sun damage, prevent precancerous spots and possibly skin cancers.
  4. CO2 with Fraxel. Experts only please. These can be done same day targeting different parts of the face with different energies from these lasers. CO2 is usually not particularly good for brown spots and Fraxel Dual 1927nm is for example. Different lasers can be used on different parts of the face and blended for a better result.
  5. CO2 with RF skin tightening. Experts only please.  Using deeper long pulse RF, cooling the skin and then CO2 the same day can achieve remarkable results for tightening, texture, wrinkles, and acne scarring.

Deciding to use CO2 laser instead of other options:

If you don’t need the depth and certain advantages that CO2 laser provides, you might do just as well with a different laser option. This could be less expensive. For example:

  • If your issue is mostly brown spots, flushing or red veins, then IPL/BBL and or Vbeam (red only) will be a better choice.
  • If your issue is more stubborn brown spots and mild to moderate sun damage or acne scarring, then Fraxel Dual might be a good choice.
  • If your skin quality and elasticity is good, it’s possible radiofrequency could be a better choice.

I Hope this Helps,

Dr. Brandith Irwin, MD
Founder of SkinTour
Follow my skin tips and travels on Instagram!

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