What is a Fractional CO2 Laser?
The Fractional CO2 Laser is an ablative laser, ablative meaning ‘wounding’, that actually vaporizes the top layers of your skin in order to allow the regrowth of new, more youthful skin.
Did you blanch at the word ‘vaporizes’? If so, it’s good for you to know that ‘fractional’ means that, only a fraction of the skin is affected instead of the whole surface. In a grid pattern like this:
The theory is that during the healing process, not only the treated skin, but the skin around it will benefit as well.
Do not confuse the Fractional CO2 with the traditional CO2 that affects the whole of the skin’s surface and carries a higher risk of infection & scarring. Traditional CO2 is rarely used for this reason.
How it Went Down
I actually tried fractional CO2 laser for neck wrinkles so let me tell you how it went. Some doctors will offer to do this procedure using only a topical anesthetic, but I decided pretty early on, that I would prefer not being awake while the top layers of my skin were vaporized.
I chose the here’s-my-amex-wake-me-up-when-it’s-done option (general anesthesia). I made a cute little video to show you how it went down:
Recovery from the CO2 Fractional Laser
I originally opted for just my neck and chest to be done but there was a confusion somewhere down the line and woke up with my face done too.
You can imagine my reaction when I woke up and saw this:
Day 1 (post procedure)
The white stuff you see on my face is Silvadene, which is short for Silver Sulfadiazine. Silvadene works by killing bacteria that may infect your skin. It’s the gold standard for the treatment of burns to help to avoid sepsis.
Actually Day 1 at 3 am. I don’t have a big tolerance for discomfort, but this super sucked. I was up at 3am the following morning and it wasn’t very fun. I was on Vicodin and it still stung pretty bad.
Do I look happy?
You’ll notice some swelling and a lot of caked Silvadene on top of the blood and pus.
I sent this pic to my cousin and told him we were on the way to the movies. Life’s little amusements :).
That beautiful garment on my shoulders is a sarong used as a shawl to block my face, neck and chest from the sun. This is one situation where a burka would be ideal.
TIP: Have about two weeks worth of throw away clothing available for the whole ordeal. Silvadene doesn’t always, but sometimes, can mess up your threads.
Day three is where the burning took a backseat to the itching. It felt like little red ants on my face, neck and chest. Horrible. Getting PTSD just thinking about it.
Also let it be noted that as you’re recovering it’s important to keep the treatment area clean so, twice a day, you have to lightly get the extra Silvadene off with a sterile tongue depressor, then rinse the wounds off with cool to luke warm water, and reapply the Silvadene in order to stave off infection.
NOT pleasant. And look at the nastiness it left in the tub every time.
The idea of getting in the shower was as appealing to me as dumping a bucket of boiling water over my head, so I opted for the bath. I filled the tub with a few inches of water and let the handheld nozzle dribble cool to luke warm water lightly over my face, neck and chest. The Silvadene never comes off totally.
Imagine trying to rinse Crisco off your body with a weak water fountain. It was like that.
Minor segue: When I decided to do the Fractional CO2, I was intent on getting a Laser Seal, which is a transparent silicone dressing that goes over your skin so that you don’t have to remove, wash and reapply Silvadene to your raw burned skin TWICE a day.
It just stays on and is taken off a week later.
I had no intention of doing the procedure without it and was happy to pay an additional $500 for it. Unfortunately, a few days before D-day I was told that my doctor was no longer using that product as they did not want to risk hyperpigmentation. 😮 !
I coulda (woulda shoulda) have cancelled the procedure right then but I had already psyched myself up, imagining the nice tight neck skin so I went through with it anyhow. It was a very stressful situation. Taking care of the wounds on my face, neck and chest the whole time made me worried about it getting infected.
Plus it really hurt and was a super pain in the ass.
My sense of humor started coming back by Day five. My looks, not so much.
This was a pic I sent to my girlfriend, who happened to get a FACELIFT the SAME day that I got my fractional CO2 laser treatment, and on Day 7 she was shopping at Nordie’s. So, not that the downtime was unexpected, but it gave pause to my thought process – would a neck lift have been the way to go?
Up to day 13 I was instructed not to put any product on my skin that contained alcohol because of the possibility of hyperpigmentation, with the exception of a teeny bit of Aquafor mixed into my Silvadene.
I was also able to start using the Revision Skincare Intellishade which has SPF 45 sun protection and a bit of coverage in it. It felt very thick, and I’m not a big makeup person so it was bothersome to me. The doc said it was ok to sleep with it on but the idea of sleeping with makeup on gives me the chills (not in a good way!) so I stuck with the Aquafor and Silvadene for bedtime.
I was given the OK to put some additional products on to cover my face and neck in case I went out in public. Now let it be known, I could care less who sees me during the recovery process but I do care about people having to be exposed to my recovery when all they wanted to do was have a nice dinner.
My face was super blotchy and pink and my neck and chest were really hyperpigmented, so it took some experimentation, but I finally found the magic combo:
Revision Skincare Intellishade Original, Revision Skincare Intellishade Matte, Pur Mineral 4-in-1 Mineral Tinted Moisturizer SPF 20, Miracle Skin Transformer Face SPF 20, Smashbox Camera Ready CC, and Monistat Soothing Chafing Relief Gel. In that order.
No exaggeration. But the results looked fine in the dark!
Much better right? But at the 8 week mark I started to panic when I noticed that my chest and neck had dark spots and lines all over it – ones that weren’t there before and that weren’t going away with time. And even on my shoulders!
The shoulder seems like no big deal UNTIL you attempt to go strapless, right ladies? And I was pretty frustrated after 8 weeks being told, very casually, to relax and wait TWO more! After 1 and a half weeks, when it kept getting darker, I raced back to the doctor’s office where she did an IPL to get rid of the darkness.
9 1/2 Weeks
A blister formed from the IPL which then popped and is now a scar. Ay Carumba!
Twelve weeks out I began to panic a little. I’d had 5 IPL treatments on my neck and chest (2 from the original doctor and 3 from my regular go-to guy, Glenn, at Skin Aesthetica), and all of a sudden I’m having to deal with orange peel skin on my face.
It really freaked me out because remember, I never intended for my face to be treated at all (MAJOR miscommunication between the staff and the doctor who did the procedure but I will address these sorts of issues in another article). My face skin was pretty awesome before so I was super bummed.
19 1/2 weeks out
My face skin has never been the same. It doesn’t feel as soft as it used to, but after a few IPL treatments with Glen I’m happy to have a more even skin tone again. But I am still healing.
My neck, well you be the judge:
BEFORE Fractional CO2 Laser:
AFTER Fractional CO2 Laser:
SCAR on Shoulder AFTER Complications of Procedure:
I see a bit of a difference in my neck, but my face skin is a little jacked up since it wasn’t in need of this treatment at all. It’s frustrating because I never asked for that procedure to be done which, I am sorry, may make my view on the whole procedure a bit biased.
Cost was $3,200 + IPL treatments at another office $2,500 = $5,700 (my lord, I should have gotten a neck lift!)
Regardless, I’ve learned a few lessons from this experience and some pointers that I’d like to share with you:
- DO NOT befriend your service providers. You will lose perspective, as will they, and make decisions that may not be right for YOU.
- Fractional CO2 Laser is only for you IF you have orange rind skin or acne scars. It is a last resort and not something to do for a bit of crepey skin. NOT worth it and there are better options.
- There is a large risk of hyperpigmentation. If you have major acne scarring or super large pores then that’s still a nice trade off – otherwise, not so much.
- If you elect to get this procedure make sure that you have plenty of expendable clothing because it will get intensely soiled from the Silvadene or other excretions you will encounter.
- If your doctor tells you it’s a week downtime then run out the door. He/She is not being realistic (to put it a nice way).
As always, I hope this was helpful!