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Smooth Skin

Facial Resurfacing with Lumenis CO2 Laser


Over time, and with exposure to gravity and UV light, our faces and necks accumulate damage in the form of “photoaging” and aging in general. Skin is composed of three layers: the epidermis, dermis, and subcutaneous tissue. The dermis contains proteins, including collagen, elastin, and other important fibers, which affect skin’s strength and elasticity. UV radiation injures these important proteins, leading to the accumulation of damage in the form of wrinkles, drooping skin, broken blood vessels, mottled pigment, and sun spots, while gravity leads to the breakdown of collagen and elastin, allowing skin to droop and sag.

Carbon dioxide (CO2) lasers precisely remove the outer layers of damaged skin to reveal underlying new skin which is softer, smoother, and more youthful in tone and appearance. Collagen and elastin are produced during the healing process, causing tightening of the skin. Superficial CO2 delivers energy more “superficially”—this treatment excels at removing surface pigment, decreasing pore size, and polishing the skin’s surface; fine lines are significantly improved, and deeper lines are somewhat improved. Deep CO2 penetrates more deeply into the dermis, and while it has effect on skin pigmentation and pore size similar to superficial treatment, it more profoundly stimulates the production of dermal scaffolding and has a more intense tightening effect on the skin. Deep CO2 significantly tightens the skin and resurfaces wrinkles or scars on the face. Both superficial AND deep CO2 can be performed simultaneously, with minimal, if any, extension of “down-time”, for an additional fee.

For the majority of clients, CO2 is a “one-and-done” procedure with results akin to stacking approximately 6-8 IPL-type treatments.


CO2 takes approximately 60 minutes to perform, with approximately another 20 minutes following the procedure to relax with cold washcloths covering the treatment area. The client is brought to the room for numbing of approximately 15 minutes for comfort. Numbing medication is removed, and protection is applied to the eyes. CO2 thermal energy is delivered with a handpiece, and each pulse covers an area of approximately 0.7”. The typical client receives approximately 150 pulses to the face. Each pulse is generally described as a warm “zappy” sensation, and the client will see a flash of light despite having their eyes protected—this is normal! The treated area feels warm following treatment; we generally apply an ice-cold washcloth to one side of the face prior to starting the other side! Following treatment, an ice-cold washcloth is applied to the entire treatment area, and changed out several times before dismissing the client.


CO2 has a downtime of approximately 4 days until makeup may be applied over the treated area, and 8 days until completion of the peeling/shedding process. The treated area looks like a pretty intense sunburn with a tiny “waffle” pattern noticeable upon close inspection. The client will need to apply moisturizers in the form of Aquaphor, Neosporin, Aloe gel, or Neocutis Post-Procedure Enhancers (available for purchase) very frequently the first three days to keep the treated area moist at all times. Most will say that the treated area feels “very warm” for the first 6-8 hours (ice cloths help), then feels a bit like a sunburn thereafter. Skin feels tight and somewhat dry days 2-3, and then feels itchy days 3-7 as the skin is regenerating. We provide prescriptions, if needed, for anti-viral medications (if prone to cold sores), itching medication, and pain medication. Results are permanent and significant; the skin then “re-ages” with time. Peek result of skin tightening or resurfacing is seen around 3 months following treatment, as it takes time for collagen to form and the skin to remodel!