Recommendations for the use of CO2 laser

Carbon dioxide laser (CO2 laser) – it is a versatile tool that is designed for everyday dermatological practice, as well as for aesthetic, cosmetic and anti-aging effects.

CO2 laser treatment provides minimal discomfort and fast recovery, allowing you to quickly return to your daily life.

In this article on estet-portal.com, read about the features of the use of this laser, indications for its use and the rules for working with this device.

• What is CO2 laser and how is it used
• Preparing for CO2 laser application
• General operating instructions for CO2 laser
• Care after CO2 laser applicationra

What is a CO2 laser and how is it used

The carbon dioxide (CO2) laser is the gold standard of the ablative laser.

CO2 laser emits an invisible infrared beam at 10,600 nm that targets both intracellular and extracellular water. When light energy is absorbed by water-containing tissues, vaporization of the skin occurs.

Indications for CO2 laser use.

Therapeutic indications:

• actinic and seborrheic keratosis;
  
  
• warts;
  
  
• moles;
  
  
• epidermal and dermal nevi;
  
  
• xanthelasma.

Other conditions that have been shown to respond favorably to CO2 laser resurfacing include:

• dermatofibroma;
  
  
• rhinophyma;
  
  
• skin photodamage;
  
  
• sebaceous gland hyperplasia;
  
  
• syringomas;
  
  
• actinic cheilitis;
  
  
• angiofibromas;
  
  
• keloid scars;
  
  
• neurofibromas;
  
  
• pyogenic granuloma;
  
  
• Pinky papules of the penis.

Aesthetic indications for CO2 laser use:

• periorbital and perioral wrinkles;
  
  
• face resurfacing;
  
  
• post-acne marks;
  
  
• dyschromia. 
  
  

Contraindications for CO2 laser use:

• use of isotretinoin within the previous six months;
  
  
• active skin bacterial or viral infection in the area being treated;
  
  
• history of keloids or hypertrophic scarring;
  
  
• previous radiation therapy in the treatment area;
  
  
• collagenss.

Peculiarities of the modern use of laser treatment

Preparation for CO2 laser application

Position the patient according to the affected area so that the area to be treated is close to the laser.

Clean the area with a 5% povidone iodine solution (alcohol should not be used as it is flammable).

Depending on the site and type of lesion, one of the following types of anesthesia may be administered:

1. Topical anesthesia

Using Eutectic Mixture of Local Anesthesia (EMLA) cream.

Apply 2 mg/cm2 topically under the occlusion for 60 min. The occlusion must be removed immediately before the procedure.

2. Local infiltration anesthesia

Lignocaine 2% is used with or without epinephrine 1:100000.

The dosage of regular lignocaine is 3mg/kg and lignocaine with epinephrine is 7mg/kg.

Injection of lignocaine with epinephrine should be avoided in areas with terminal arteries such as fingers, toes, earlobes, nose, and penis.

Using a 30G needle with an upward bevel, lignocaine with epinephrine is injected just below the planned laser area.

In the case of palms and soles, insert the needle at a 45° angle; to the surface of the skin.

In infiltration anesthesia, the anesthetic should be injected slowly to reduce pain.

3. Ring Block

The ring block is used to numb the fingers, toes and penis.

Eye protection

The patient's eye must be protected by a mask or wet gauze.

The dermatologist and assistants must use special glasses.

General operating instructions for CO2 laser

Hold the handle perpendicular to the lesion and press the foot pedal to fire the laser.

Vaporize lesions in a spiral, twisted, centrifugal, vertical or horizontal fashion.

Pedunculated lesions can be removed by vaporizing the base of the lesion.

Hold the lesion with notched forceps at the top, pull it to the side on top of damp gauze (to prevent charring of normal skin).

Always use wet gauze as dry gauze can ignite.

Wipe vaporized lesions with damp gauze. Be sure to dry the surface or wipe the water with dry gauzeher.

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Care after CO2 laser treatment

After using a CO2 laser, the following recommendations should be followed:

1. Always apply hydrocolloid dressings after a facial.
   
   
2. Antibiotics should be applied to the surface of the lesions for a week.
   
   
3. The scabs should come off on their own.
   
   
4. The patient must apply sunscreen three times a day from the first day after the procedure.
   
   
5. Allow the occlusive dressing to remain in place for three to seven days, after which healthy granulation tissue should appear underneath.
   
   
6. It is important to protect the wound from contact with dust, so if necessary, a plaster is applied over the wound.

Thus, the CO2 laser is an excellent multifunctional tool for the treatment of dermatological pathology and the correction of age-related changes.

Clinical study on the efficacy of a periorbital laser

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