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How do I choose the best CO2 laser treatment?

Is there a difference between the UltraPulse CO2 laser /Fraxel repair /Pixel /Mixto/DOT lasers? I’m confused by all the different names and think the doctor will try to sell me on whatever machine he has- without it necessarily being the best for me. How can I know I’m doing the best treatment?

There are a lot of laser devices out these days and you do have to do your homework to keep things straight. There are basically 3 categories of lasers: 1) Fully ablative that includes CO2 and Erbium lasers, 2) Fractional Ablative lasers that include Mixto, Fraxel Repair, Lumenis Total Fx (these are both fractionated CO2), Pixel, DoT and others, 3) Fractionated non-ablative lasers such as Affirm, or Fraxel Restore

The main difference between these categories is the amount of downtime that goes along with them. The Fully ablative lasers require 1 treatment and will require 2-3 weeks to heal and possibly some redness beyond this time frame. The fractionated ablative CO2 lasers usually only take 1 treatment and reduce the healing time to about 1 week. The nonablative fractional lasers require 4-5 treatments but only have 1-2 days of redness for healing.

The other main consideration is results and what the treatment is for. A basic rule is that the more aggressive the laser, the better the results and the more the downtime. All lasers are indicated for wrinkles, acne scars, pigmentation, and sun damage. For wrinkles, more aggressive treatments are better.

This is some basic information to help you along. The other questions you should ask are what are my options. If the practice only offers one laser and one laser for everything then you should be wary. If options are presented to you with variable results and healing times then it is reasonable. Any serious laser practice will offer options or combination treatments. For example, our practice has multiple lasers for various applications so that we can offer options to patients depending upon their needs and lifestyle (healing time tolerance).

In terms of the CO2 laser, it is not the machine that is important, it is the kind of experience that your doctor has in dealing with the machine. CO2 machines are powerful and they do give wonderful results. But your physician has to have experience in the use of the particular machine.

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