CO2 Resurfaceingbeauty / rejuvenation 

fraxis duo – co2 resurfacing

What is fractionated co2?

CO2 resurfacing is a cosmetic procedure done in office by a board-certified dermatologist that is used to improve the appearance of skin texture, wrinkles, pores, and laxity. Our Fraxis Duo CO2 laser system is a highly sought-after system because it can integrate multiple advanced technologies into one platform, making it a “gold standard” device.  This platform allows simultaneous use of RF microneedling with the CO2 procedure, thus treatments can be easily tailored to meet the specific cosmetic needs of our patients. Fractionated CO2 laser resurfacing yields dramatic improvement in skin tone and texture. This procedure evens out pigmentation and eliminates sunspots, as well as improves fines lines, including those around the mouth and eyes, giving the entire face a younger, refreshed appearance. By physically removing the top layers of damaged skin, CO2 laser resurfacing also has medical benefit, removing pre-cancers and stimulating growth of healthier younger skin

what is is used for?

This state-of-the-art device excels at treating a wide range of skin conditions. This device and is used for the following: 

  • Fine lines and wrinkles
  • Severe signs of sun damage
  • Age spots
  • Skin tone and texture improvement
  • Lifting and tightening
  • Acne scarring
  • Stretch marks
  • Surgical scars
  • Pore size reduction
  • Full skin resurfacing
how does it work?

In the 1990s, fully ablative CO2 laser resurfacing was the only technology available, and because this laser removed the entire skin’s surface at once, healing was prolonged and there was a higher chance of scarring or permanent pigmentary changes after treatment. More recently, fully ablative devices have been replaced with fractionated devices that offer both a faster recovery and fewer side effects. The fractionated CO2 laser works by focusing microscopic beams of light into the skin in a grid pattern. Because the laser targets water, a major component of the skin, it immediately vaporizes tissue when fired. This vaporized tissue removes brown spots and sun damage, and the resulting micro-wounds created by the laser stimulate a wound healing process that leads to collagen synthesis. This then smoothens fine lines and tightens skin. Because there are small areas of “normal” skin between the micro wounds, healing is accelerated. Typically, pink new skin is visible 5-10 days after the procedure.

who is a good candidate?

Healthy non-smoking patients who are seeking total skin rejuvenation or treatment of scars from surgery or acne are excellent candidates for fractionated CO2 laser resurfacing. Patients must be willing to follow postoperative care instructions diligently and stay out of the sun before and after the procedure. Patients must not have taken Accutane within the past 12 months. Patients with active inflammatory skin conditions may require treatment of these conditions before lasering, and those with very dark skin are not good candidates because of a risk hyperpigmentation (darkening) or hypopigmentation (lightening) of the skin.

what happens on the day of the procedure?

Topical anesthetic will be used to maximize your comfort before the procedure. Patients will be numbing for 45-60 minutes prior to the procedure. If you are anxious, you may be offered a medication to help decrease anxiety, but you will be awake during your treatment. If this is provided, then the patient will require a driver to take them home. After anesthesia is accomplished, Dr. Zamary will use a combination of treatment settings specifically tailored to your skin type and degree of rejuvenation desired. Following treatment, an emollient is applied, and post-care instructions are reviewed. The whole procedure from photos to post-treatment typically takes 1.5-2 hours.

What is the cost of the procedure?

The cost of the procedure varies based on the area treated (face, neck, eyelids), depth of the procedure, and amount of downtime. A cosmetic consultation with Dr. Zamary will be required to discuss the procedure, costs, and after-care. 

Post-treatment and recovery

On the day of your procedure, you will receive detailed instructions for postoperative care. Following these instructions is essential for maximizing your comfort, for achieving best results, and to avoid complications.  After your CO2 laser resurfacing treatment, you will look like you have a bad sunburn and your skin will be warm. Initially, swelling is usually most significant around the eyes. It is normal for the skin to be moist and even contain some crusting. Over the course of 5-7 days, the old, damaged skin will begin to come off and light flaking will continue for up to 14 days. Although your skin can remain pink for 4-8 weeks, most patients are able to apply make-up in 7-10 days post-treatment. We will watch your healing closely to make sure you are progressing well and that you are healing as expected. Our staff and Dr. Zamary are available for any questions you may have during your recovery period. 

Although your skin will be visibly tighter and smoother in 1 week after the procedure, final results are typically seen at 3-6 months later as it takes time for new collagen to synthesize

What do I need to have ready at home for aftercare?
  • Clean, soft washcloths
  • White vinegar soaks
  • Sterile guaze
  • Gentle Cleanser (Cetaphil Gentle Cleanser)
  • Physical sunscreen
  • Arnica pills (can be started the day before the procedure)
  • Aquafor oinment (large quantity)
  • Any prescriptions Dr. Zamary may have prescribed


What can I watch to learn more?