LASER stands for Light Amplification by the Stimulated Emission of Radiation. Laser produces a single wave-length (colour) of light that can be sharply focused and very powerful, powerful enough to cut steel. Different substances absorb laser light preferentially. When the energy of a laser beam is absorbed, the material will generally heat up. By controlling the power of the laser, the length of the pulse, the size of the laser beam and other factors, different effects can be made to the substance (or tissue).

The carbon dioxide (CO2) laser was one of the first used in cosmetic medicine. It targets water and with enough energy in a short enough time, the laser beam will vaporise tissue. Its primary advantage over peeling and other laser techniques is that its effect is to tighten the skin naturally, while stimulating increased collagen production. The results approximate that of a mini-face lift, without incisions. CO2 laser resurfacing has been the “Gold Standard” for non surgical facial rejuvenation, removal of facial skin wrinkles and photo aging since 1995.

However, the CO2 laser was initially used to totally vaporise the surface layers of the facial skin. It required general anaesthesia and took seven to twenty one days for pink, shiny skin to regrow and up to three months for the pinkness to fade. Whilst the improvement in facial skin texture is material, this downtime meant it was not always a suitable treatment option.

The Erbium laser became more popular in the 1990s, as the skin healed faster but it also produces less power and removed fewer wrinkles. The 2000s saw the development of lasers like Fraxel, which is a non-ablative laser that pioneered using thousands of tiny beams of light to produce small “DOTs” of laser ‘burns’, which healed quickly. However, whilst Fraxel offered less downtime, the results were subtle at best.

Soon after Fraxel, the “Fractionated CO2 laser” became available, with a wide range of possible settings. This gave us the power of the CO2 laser and the ‘microbeams’ of Fraxel, providing optimal results but under local anaethesia (or numbing cream) with less discomfort and more rapid healing. It also gave us the ability to treat many more problem areas such as burns, surgical and acne scars, loose skin, stretch marks and mucosal surfaces over the whole body and all skin types.

The Fractional CO2 Laser delivers heat via microbeams or DOTs that penetrate into the skin and this triggers a natural healing process. The thermal damage causes collagen shrinkage, which is responsible for most of the skin tightening and skin thickening. The treatment decreases fine lines, wrinkles, scarring, uneven pigmentation and promotes a more youthful and fresher complexion.

There is immediate improvement (post-healing) but, most importantly, further improvements in skin tightness and density occur as a result of collagen remodelling around 30 days after treatment and continue for up to one year.

Because not all of the skin is resurfaced during each treatment, multiple treatments will further improve overall skin texture and appearance.

Timeline after DOT shows new skin at 1 week and skin tightening at 3-4 weeks

The CO2 fully ablative laser treatments tend to be restricted to the face and, despite the downtime, still produce exceptionally good results. The reason it is so successful on facial skin is due to the greater density of sebaceous glands and other deep tissue structures, which allow healing from below. Other parts of the body do not have the same tissue structure as the face and will not heal as well from full ablation. The DOT laser technique allows healing to occur from the remaining intact skin between each DOT – this has enabled us to treat almost any skin on the body.

Very recent technological advancements in the CO2 DOT laser (the V2LR) are now enabling us to treat mucousal surfaces, with the same exceptional, long-lasting results. The V2LR laser offers the unique “D Pulse” specifically designed for mucosal surfaces. It has a very brief (60 millionths of a second) high-energy pulse, which “drills” a very neat hole into the tissue to a depth of 1 – 1.5mm. Then, there is a longer, lower energy pulse that heats deep down into the tissue and stimulates the formation of new collagen.

Academy Laser Clinics uses the advanced SmartXide™ DOT CO₂ laser system. This laser has different scanners, configurations and hand-pieces to enable infinite treatment options:

Hi-Scan Ablative DOT Laser:

This skin laser has many different settings for power, width of beam and length of pulse. Depending on how the settings are configured, which requires training and expertise, the DOT laser offers different levels of skin rejuvenation, skin resurfacing, scar and acne healing and can even reduce the appearance of stretch marks. We treat all these conditions for skin rejuvenation at our skin clinic.

V2LR MonaLisa Touch Laser (bespoke to the SmartXide CO2 laser):

This is a specific scanner and probe producing the unique D-pulse, designed specifically for mucosal surfaces such as the soft palate and vulvovaginal tissue. With specialised hand-pieces, we use the V2LR to treat vaginal atrophy and incontinence symptoms, vaginal tightening, vaginal prolapse, vulva rejuvenation, plus snoring and sleep apnea conditions.