Fractional CO2 Laser Resurfacing — MiXto SX

The MiXto SX (manufactured by El.En. Group, Italy) is a fractional CO2 laser that operates at 10,600 nm — the wavelength at which water in skin tissue absorbs infrared light most efficiently. Unlike ablative CO2 resurfacing, which removes the entire epidermis, the fractional approach stamps a grid of microscopic treatment zones (MTZs) across the skin surface. Each MTZ is a column of coagulated tissue approximately 120–250 microns wide; the skin bridges…

The mechanism produces two simultaneous effects: ablation of the outermost damaged epidermal layers (removing wrinkles, pigmented lesions, and scarring), and deep dermal heating that denatures existing collagen and triggers a wound-healing cascade. Over the following 3–4 months, fibroblasts synthesise new, reorganised collagen and elastin — resulting in tighter, more uniform skin that continues to improve beyond the immediate post-peel appearance.

The clinical session lasts approximately 30 minutes for a full face. A topical anaesthetic may be applied 45 minutes before treatment for comfort. The post-treatment course follows a predictable pattern: days 1–2, the skin appears bronzed or dotted as MTZs desiccate; days 3–4, gentle peeling begins; days 5–6, the treated layer sheds completely to reveal fresh skin. Patients must use Avène Cicalfate cream and SPF 50+ sunscreen, and avoid direct sun…