CO2 Fractional Laser Resurfacing

CO2 fractional laser resurfacing at DermaEsthetic uses one of medical aesthetics' most powerful tools — the carbon dioxide gas laser — in a fractional delivery pattern to remodel the surface and mid-dermis. Unlike ablative CO2 lasers that treat the entire skin surface, the fractional approach creates thousands of microscopic treatment columns surrounded by intact skin bridges, dramatically accelerating healing while achieving deep collagen remodelling. MUDr. Šulcová applies topical anaesthesia one hour before each session; the full procedure takes 45–90 minutes. Fine lines, deep wrinkles, acne scars, sun damage, age spots and skin laxity on the face and neck all respond exceptionally well, with results lasting two to five years.

The carbon dioxide (CO2) laser emits light at 10,600 nm — a wavelength strongly absorbed by water. Every cell in the skin's epidermis and dermis contains water, so when the laser beam contacts skin tissue, it heats and vaporises the targeted cells in microseconds. In fractional delivery, a scanning array or stamping pattern creates columns of ablation (called microscopic treatment zones or MTZs) roughly 100–300 µm in diameter, separated by untreated skin bridges approximately the same width. The untreated bridges act as a reservoir of stem cells and keratinocytes that migrate inward to resurface the ablated columns within 24–72 hours — far faster than the full-surface healing required after traditional ablative CO2 resurfacing. At DermaEsthetic MUDr. Hana Šulcová applies a topical anaesthetic cream approximately one hour before the session to ensure patient comfort throughout the 45–90 minute procedure (the upper range for large areas such as full face plus neck). During treatment the laser handpiece is passed methodically across the skin in a grid pattern; patients experience a sensation of heat and mild stinging. Immediately after, the skin appears red and may have a grid-like patterning from the MTZs, with slight oedema. The post-treatment period involves one week of redness and mild swelling; a healing cream is applied and strict sun avoidance with SPF 50+ for a full month is mandatory — freshly resurfaced skin is highly susceptible to UV-induced post-inflammatory hyperpigmentation, particularly in Fitzpatrick types III–IV. Social downtime is approximately five to seven days. MUDr. Šulcová recommends scheduling treatment in winter months to minimise unavoidable incidental UV exposure during recovery. One or two sessions deliver optimal results for most patients, with improvement continuing over three to six months as the wound-healing cascade — collagen synthesis, extracellular matrix remodelling, dermal thickening — progresses. The remodelled dermis typically maintains its improved quality for two to five years. Conditions that respond well include fine and deep wrinkles on the periocular, perioral and cheek zones; acne scars; stretch marks; age spots (seborrhoeic and solar keratoses); surgical and burn scars; and general photo-aging. Contraindications include pregnancy, epilepsy, photosensitising medications, active psoriasis or rosacea, and a known tendency to herpes simplex outbreaks (prophylactic antiviral treatment is required in those patients).