CO2 (Carbon Dioxide) Ablative Laser

A laser with a 10,600 nm wavelength can target very small areas while emitting a very short pulse preventing unnecessary damage to the normal surrounding skin. Since this laser can be adjusted and customised, it is utilised in procedures requiring precise accuracy.

The laser is an ABLATIVE laser meaning it will burn whatever it comes into contact with. Therefore, this makes the “burning away” of certain skin lesions on the surface of the skin possible.

*Our aesthetic doctor will determine if the lesion you are keen to treat with CO2 laser is treatable or not at AEON, our aesthetic clinic in Singapore. This is at the sole discretion of our aesthetic doctor at AEON. You may be referred to another institution for further evaluation.

Due to it being an ABLATIVE laser, there is some pain involved and hence it is advisable to apply a topical anaesthetic cream before the procedure. Take note that even though this cream is applied, there can still be some pain experienced during the procedure especially if the lesion is deep.

Your eyes will first be protected with metal goggles. Then our aesthetic doctor will begin treatment, by gently applying the laser energy to your skin with part of the handpiece making physical contact with your skin. You may experience some heat and mild prickling sensations during the laser. There is also a slight “burning smell” which is the lesion and skin cells absorbing the laser energy and being “burnt away”. Depending on the size and depth of the lesion, the length of the procedure may differ.

There is no downtime in the sense of having to take leave and/or stay indoors after the procedure. Due to it being an ABLATIVE laser, there will be a depression or “crater” where the lesion previously was. There is no special aftercare needed in terms of topical applications, but to facilitate healing, a thin hydrocolloid dressing sticker will be applied onto the treatment site. You will be provided with extra “stickers” to change every 2 days until the skin has “filled up” or “levelled out”. This can take 3 days to 2 weeks depending on the depth of the lesion and individual differences. You can apply makeup on top of this sticker, wash your face and shower with the sticker on.

You may experience some redness and swelling around the treatment area that should resolve within a few hours but may last 2-3 days. Again, there is no requirement for you to stay indoors or avoid cosmetic applications afterwards. You will be able to return to work, apply makeup and resume most of your activities immediately. Please avoid exercise 1-2 days before and at least 2 weeks after the treatment during the healing process.

One of the most important things to avoid is UV radiation from sun exposure, especially immediately after the procedure. Do note that even weeks or months after the procedure at our aesthetic clinic in Singapore, it is well-advised to avoid prolonged sun exposure even with sunblock applied. Depending on your skin condition and sun exposure, you may develop darker pigmentations in the treatment areas. You are advised to apply sunblock every 1-2 hours when outdoors and avoid outdoor exposure especially during the peak sunlight hours of the day.

Recurrence of lesions treated with CO2 lasers is very common. The timing of recurrence can be within months of the treatment or years afterwards. Repeated treatment can be considered, but repeating a CO2 ablative laser on the same site can increase the risk of side effects listed below.

Due to this laser being ABLATIVE, there are more possible side effects to take into consideration compared to the other NON-ABLATIVE lasers.

There are options for laser(non-surgical) and surgical treatment for these types of lesion(s). Surgical treatment (excisional biopsy) has the advantage of very low recurrence and the potential for being able to send the lesion for biopsy (confirmation diagnosis) if needed. On the other hand, laser treatment has a higher risk of recurrence and no possibility of confirming the diagnosis as the lesions will be ablated (“burned away”). In the worst-case scenario, doing a CO2 laser treatment for skin lesions may lead to a more serious condition such as malignancy (cancer, pre-cancer) not being diagnosed.

Possible side effects and complications of the CO2 laser treatment are as follows:

• Pain: Numbing cream can be applied if desired to lessen the burning sensation of the laser which can be minimal to moderate.
• Swelling: The area can have some swelling for 1-2 days, especially around the eye areas. The swelling will subside without any additional treatment.
• Bleeding: There may be mild bleeding for 1-2 days but if bleeding continues, please contact us or see a doctor as soon as possible.
• Depressed scars (“craters”): Some areas may not heal completely and therefore leave a permanent depression in the treated area.
• Elevated scar: Some areas may heal in a manner where the skin grows more than originally present forming a “hump” or larger “hump” which is permanent.
• Infection: Persistent pain, swelling, discharge, pain, and fever could indicate an infection in which case topical and/or oral antibiotics may be needed after seeing a doctor. Wound healing could be compromised in this situation and wound complications may be more evident. These effects are rare.
• Erythema: Immediately after treatment, the skin area will appear red which gradually normalises over the next few months. There are cases where the redness can be permanent.
• Skin darkening (hyperpigmentation): The darker your skin tone and the more sun exposure you receive can cause the treated area to have a dark colour which can be permanent. Visit our hyperpigmentation treatment page to learn more about this skin concern.
• Skin lightening (hypopigmentation): Areas treated other than the face can leave a whitish spot especially if the surrounding skin is darker. This is permanent.
• Recurrence: The lesion can recur anytime after healing to many years later. Repeated treatment by laser on the same site can lead to more risk of scarring or other complications listed above.
• Remnant: The lesion may be so deep that it cannot be completely removed during one session. After healing, the area can be assessed to determine whether another session of treatment at our aesthetic clinic in Singapore is necessary.