121 East 60th Street, Suite 8AB, New York, NY 10022

Ph. (212) 285-1110

Long Island

901 Stewart Ave, Suite 240, Garden City, NY 11530

Ph. (516) 512-7616

New York City (212) 285-1110

Garden City, NY (516) 512-7616

Fractional CO2 Laser Resurfacing in New York

Fractional CO2 Laser Resurfacing in New York

The CO2 laser has been the gold standard for the treatment of wrinkles, sun damage and skin tightening for decades.  This technology got a major update with the advent of fractional CO2 laser resurfacing, a concept where the traditional beam of the CO2 laser became fractionated.  The concept behind fractional CO2 lasers is simple: Let’s not ablate or vaporize the entire skin all at once.  Instead Let’s place an array of microscopic CO2 zones of laser damage in the skin only ablating a fraction of the skin.  This revolutionary concept has led to much greater safety, few side effects and shorter recovery times for patients compared to traditional CO2 laser resurfacing while achieving similar clinical results.

Dr. Rokhsar was trained by the inventor of the CO2 laser resurfacing procedure, The late Richard E. Fitzpatrick, MD who is credited with being the father of laser resurfacing.  Dr Rokhsar was a laser fellow with Dr. Fitzpatrick, and alongside him, helped develop and refine the concept of fractional laser resurfacing.  Dr Rokhsar conducted the early clinical trials for Fractional non ablative laser resurfacing (Fraxel Restore) and later on Fractional CO2 laser resurfacing with the Fraxel Repair, which was the first Fractional CO2 laser which became available on the market.  

Dr Rokhsar is considered a world authority on laser resurfacing with Fractional CO2 lasers.  He has lectured extensively throughout the world on his CO2 laser techniques for the treatment of wrinkles, sun damage, skin tightening and scars.  Dr. Rokhsar’s CO2 laser results around the lower and upper eyelid surpass the results of surgical blepharoplasty, with the advantage of creating thicker skin, something surgery can not match.  Patients are referred to Dr. Rokhsar by dermatologist and plastic surgeon in New York and around the world for his unique expertise and unmatched results with fractional CO2 laser resurfacing.

CO2 Laser Benefits

There are many laser resurfacing options out there today.  Patients should consider that the skill and expertise of the doctor operating the laser is as important as the actual type of CO2 laser itself.  In other words,  laser treatments are only as effective as the medical doctor in control of using the device.  In many cases, patients seek out a “budget” solution, which either gives them no clear benefit from the laser procedure, or result in them  having to pay a premium to get their poor results corrected. Getting excellent results with a laser system is possible, but you must seek out a highly respected laser surgeon when it comes to a sophisticated device such as the CO2 laser. Dr. Rokhsar has been trained by the inventor of the CO2 laser resurfacing procedure and has extensive experience in laser resurfacing. He is considered an international authority in laser resurfacing and has spoken on this subject all around the globe.

The main advantage of the CO2 laser over all other lasers is the fact the beam of the CO2 laser is particularly hot.  It is this heat that directly contracts skin to get tighter wrinkle free skin.  Therefore the gold standard for the treatment of mild, moderate and deep wrinkles especially around the eyes as well as lines and wrinkles around the mouth and cheeks  is Fractional CO2 laser resurfacing.  There is no other device that can give results anywhere close to the results of the CO2 laser when it comes to wrinkle reduction on the face.  But remember to use only a very experienced board certified laser dermatologist for your fractional CO2 laser procedure.  The following conditions can be safely and effectively treated with laser resurfacing procedures: wrinkles, deep lines, fine lines, poor skin tone and texture, large pores, acne scars, surgical scars, burn scars, traumatic scars, sebaceous hyperplasia, fibrous papules of the nose,  uneven pigmentation, melasma, stretch marks, and pearly penile papules. Dr. Rokhsar will tell you which laser is best for you during your consultation. If you are interested in a laser resurfacing procedure, contact one of our offices in the Upper East side of Manhattan or Garden City, Long Island.

CO2 Laser Will Give You Smoother Skin

Smooth, radiant skin can be a sign of both youth and health. As a result, many of our patients want fewer wrinkles, better skin texture, smaller pores, and smoother skin with less scarring.  Laser skin resurfacing with the Fractional CO2 laser is an ideal option to achieve your skin goals.  Laser skin resurfacing with the CO2 or erbium lasers involves the removal of a layer of skin so that the new skin can flourish and fill in the wrinkles and crevices. The laser vaporizes the old wrinkled, sun-damaged, and scarred skin in a fractional manner, which initiates a cascade for new skin formation. The new skin is smooth, healthier with fewer visible lines, wrinkles, sun damage, and scars.

Laser skin resurfacing with the CO2 laser remains the gold standard for reversing the signs of aging associated with wrinkled skin. The CO2 laser also causes a dramatic tightening of the skin. For patients who have moderate to severe lines and wrinkles, and are not smokers or are able to stop smoking, fractional ablative lasers remain the treatment of choice. A one-pass laser resurfacing procedure has one week of downtime and a multiple-pass CO2 laser procedure has two weeks of downtime. Treatment of wrinkles with the CO2 laser is limited to the face, around the eyes and around the mouth.  The neck can also be treated with ablative lasers.  But, this must be done at lower energy settings, and only performed by skilled hands.  Dr. Rokhsar does not recommend ablative lasers such as the CO2 or Erbium lasers to be used on the chest.  Instead, non ablative lasers such as the Fraxel laser, is an ideal choice for smoother skin on the chest.   Fractional CO2 lasers can be used on burn scars anywhere on the body with good results.

CO2 Laser for the Face

CO2 laser treatment is a popular and effective option for improving the appearance of the face. The CO2 laser is an ablative laser that removes the outer layers of damaged skin, stimulates collagen production, and promotes the growth of new, healthy skin cells.

CO2 laser treatment can address a variety of skin concerns on the face, including fine lines, deep lines, wrinkles, acne scars, large pores, sun damage, skin looseness,  age spots, melasma, brown pigmentation, and uneven color tone and  texture. The procedure can also be used to treat some benign skin growths such as sebaceous hyperplasia overgrown oil glands in the skin which look like yellow dots), fibrous papules of the nose or angiofibromas, syringomas, and certain types of skin cancer.  Dr. Rokhsar uses the 2 mm beam of the CO2 laser to treat sebaceous hyperplasia, fibrous papules of the nose, as well as syringomas on the face or around the eyes with great success.  The other advantage of the CO2 laser is that it causes dramatic tightening of the skin in addition to wrinkle reduction giving smoother skin.  Lastly, the CO2 laser gets rid of thin paper skin, replacing it with thicker healthier younger looking skin.

CO2 Laser Treatment of Wrinkles

CO2 laser resurfacing is a cosmetic procedure that uses a laser to remove the outer layer of skin (epidermis and superficial dermis), which stimulates the growth of collagen, a protein that improves skin firmness and texture. This treatment can effectively treat all kinds of wrinkles, especially those around the mouth, cheeks,  and forehead in addition to wrinkles around the eyes.  The CO2 laser is also the most effective laser for skin tightening, especially around the eyes. Deep scars also respond well to the CO2 laser.

CO2 Laser for the Under Eyes

CO2 laser treatment for the under-eye area involves the use of a fractional CO2 laser to resurface and tighten the skin. This type of laser removes the thin outer layer of skin (epidermis and superficial dermis) and heats the underlying skin (dermis), which results in direct skin tightening and wrinkle reduction   It also stimulates the growth of collagen and elastin,  proteins which improve skin firmness, texture and elasticity.  As the skin heals and regrows, the treated area appears smoother and tighter with less wrinkles.
co2 laser resurfacing of the eyelids
Nonsurgical Eyelid Lift - co2 laser resurfacing eyelids
CO2 laser eyelid rejuvenation

CO2 laser treatment can improve a variety of skin concerns, including fine lines and wrinkles, sun damage, and acne scars. In the under-eye area, CO2 laser treatment can help reduce the appearance of baggy eyes, dark circles, and improve skin laxity.  Dr. Rokhsar’s results with the CO2 laser around the eyes are often better than results of a surgical eyelift, without any cutting or scars.

CO2 Laser for Acne Scars

Acne is the most common skin disorder affecting adolescents and young adults. In fact, 85 percent of all teenagers have had some degree of acne, most commonly a mild form but severe in many cases. It may seem incredibly difficult to have patience when you start your treatment for acne. However, keep in mind that if you stick closely to your individualized treatment plan, you will see results. When dealing with severe acne,  patients are often left with scarring.  These scars can be atrophic such as ice picks, box car, or rolling scars, or hypertrophic which means the scars are raised.  Atrophic scars are often found on the cheeks and temples, where as atrophic scars are commonly seen on the nose and chin.

Fractional CO2 lasers are used to resurface skin that has been damaged by acne scars, age, and sun exposure. The laser beams stimulate the skin to produce new collagen, a protein found in abundance in young skin. These lasers are used to improve uneven skin tone, smoothen scars, improve elasticity, and erase wrinkles. These lasers target and remove damaged areas of skin on a microscopic level by creating controlled “holes” of laser damage. This damage stimulates the damaged or scarred areas of skin to heal more evenly; replacing the damaged, aged, scarred areas with fresh skin. These lasers are more powerful than non ablative lasers such as the Fraxel laser because they create more controlled damage and they are hot. Fractional CO2 lasers can provide incredibly dramatic results with few treatments.  However, when treated with appropriate settings, most patients should experience about one week of downtime.

CO2 Laser Mole Removal

CO2 laser mole removal is a minimally invasive procedure that uses a focused beam of light to remove moles. This laser is able to target fleshy raised areas in the mole, while leaving the surrounding skin unaffected. This is one of the main benefits of using a laser for mole removal as it reduces the risk of scarring or damage to healthy skin compared to cutting in some instances..

During the procedure, a local anesthetic is applied to numb the area around the mole. Once the area is numb, the laser is used to remove or vaporize the mole. The procedure is typically painless, with the only discomfort being from the initial numbing injection.

After the procedure, it is normal to experience some redness, swelling, and scabbing around the treatment area. These side effects usually subside within a week or two. It is important to avoid sun exposure and wear sunscreen during the healing process to prevent any complications.

CO2 laser mole removal is generally safe and effective for removing benign moles. However, if the mole is suspected to be cancerous or precancerous, a biopsy may be necessary before the mole is removed. Additionally, if the mole is deep or large, surgical excision may be a more appropriate option.

CO2 Laser Wavelength

The wavelength of the CO2 laser is important because it determines the laser’s ability to penetrate the skin and target specific structures. CO2 lasers with wavelengths of 10,600 nanometers are commonly used in medical and cosmetic applications, including skin resurfacing and removal of skin lesions. The high absorption of the 10,600 nm wavelength by water makes it effective in vaporizing skin cells and stimulating collagen production.  This laser is considered the best treatment option for skin tightening and wrinkle reduction. No other laser has been able to come close to results achieved with the CO2 laser for wrinkles.

Tetra CO2 CoolPeel Laser

The CoolPeel treatment uses a Tetra CO2 laser system to deliver intense infrared light to the outer layers of the skin, stimulating collagen production and promoting the regeneration of healthy skin cells. This treatment is highly customizable, allowing the laser power and pulse size to be tailored to the patient’s specific age and skin concerns. The CoolPeel treatment is also unique in that it leverages an exclusive H-Pulse technology that delivers a fully-ablative treatment without causing thermal damage to the surrounding tissue.

The CoolPeel treatment can effectively treat a variety of skin conditions, including fine lines, wrinkles, sun damage, acne scars, redness, hyperpigmentation, and dull skin. The treatment can be used on delicate areas, such as around the eyes, and can be highly customized to target specific areas of concern.

SmartSkin CO2 Laser

The SmartSkin CO2 laser delivers a series of tiny microscopic laser beams to the skin. This fractionated energy penetrates the skin, which helps to clear away old and damaged skin cells. The body’s natural healing process then builds new healthy cells to take their place. The laser also stimulates the production of new collagen, which can improve skin elasticity and firmness.

SmartSkin CO2 laser can be performed on various areas of the body, including the face, neck, chest, arms, and hands. The procedure typically takes around 20 minutes, and the great results start almost immediately. Lasting results can be accomplished with just one treatment. Even the difficult upper and lower eyelid skin can be treated with this specialized laser.

Lumenis UltraPulse CO2 Laser

The UltraPulse CO2 laser is a powerful tool that can be used for skin resurfacing, acne scarring, pigmentation, and overall skin rejuvenation. Its unique technology allows for precise targeting of specific areas of the skin, resulting in minimal damage to surrounding tissues.

The UltraPulse CO2 laser comes in different modes, such as the DeepFX and ActiveFX modes, which are tailored to different skin types and conditions. The DeepFX mode is best suited for treating deep wrinkles, indented scars, and skin laxity, while the ActiveFX mode is ideal for treating sun damage, age spots, and overall skin texture.

During a laser treatment session, a topical anesthetic cream is first applied to the treatment area to ensure that the patient is comfortable throughout the procedure. The laser energy is then delivered to the skin in a controlled manner, causing the targeted tissue to vaporize and stimulating the growth of new collagen. Patients can expect some redness and swelling after the treatment, but these symptoms typically subside within a few days.

Lumenis AcuPulse CO2 Laser

The AcuPulse CO2 laser system is a complete ablative laser resurfacing workstation, featuring state-of-the-art technology for all aesthetic resurfacing needs. It offers a range of spot sizes and energy settings that can be customized for different skin types and concerns. One of the unique features of this system is the SuperPulse technology, which delivers short, high-peak-power pulses that minimize thermal damage to surrounding tissue.

The AcuPulse DUO CO2 laser system is another option that combines fiber and free-beam energy delivery on a single device. This system is available in 30W/40W models, with or without the SurgiTouch Scanner. The AcuPulse DUO laser is indicated for use in gynecology for applications such as laser incision, excision, ablation, and vaporization of soft tissue in gynecology for the treatment of cervical intraepithelial neoplasia (CIN), vulvar and vaginal intraepithelial neoplasia (VIN, VAIN), and conization of the cervix.

Both the AcuPulse and AcuPulse DUO CO2 laser systems are safe, effective, and versatile tools that can be used for a variety of cosmetic and medical applications. They are particularly useful for treating fine lines, wrinkles, and sun damage, as well as improving skin texture, tone, and pigmentation.

CO2 Laser Recovery

Typically, it takes around one week to recover from fractional CO2 laser resurfacing. During the recovery period, it is essential to follow your dermatologist or surgeon’s aftercare instructions closely to help with healing and lower your risk of complications.

Pain during the CO2 laser recovery period is minimal if you follow proper soaking and lubrication instruction, especially in the first three days. You may take acetaminophen for pain.  It would be unusual to need any more powerful pain meds.  If you are experiencing more severe pain, you need to contact your doctor because this could be a sign of a bacterial, fungal, or herpetic infection.  Dr. Rokhsar does not like to use steroids during recovery as it increases the risk of infection.  

Patients can apply makeup about one week  after the  treatment and resume their normal daily activities at that point.  However, depending on the energy levels used, you may notice some light flaking and peeling for a few weeks following treatment. Redness can also persist for a few weeks to a couple of months deepening on the type of skin.  This redness gradually gets better with time.  At about one week post procedure, you may apply makeup or cover up.  Your full results will not manifest till about 3 months post your laser treatment.

It is essential to keep your skin clean during the recovery process to prevent infection by doing regular vinegar soaks.  The use of cleansers and soaps should be avoided during the first week post treatment.  Avoid direct sun exposure. You may start using a broad-spectrum sunscreen of SPF 30 or higher one week after the procedure once your skin is fully healed. It is also crucial to avoid picking or scratching at any scabs or peeling skin to prevent scarring.  You may take antihistamines such as Zyrtec if you experience itching during the healing process.

Skin Moisturizing After CO2 Laser

Dr. Rokhsar recommends using a moisturizer that contains ingredients such as petrolatum, or Aquaphor. Other preparations should be avoided at all cost during the first week after your laser procedure.  After your skin is healed, Dr. Rokhsar will advise you as to the next level of moisturizers you may use.  

Dr. Rokhsar is the Best CO2 Laser Doctor in NYC

Dr. Rokhsar has been trained by the inventor of the CO2 laser resurfacing procedure and has extensive experience in laser resurfacing.  Dr. Rokhsar performs more CO2 laser procedures than any other doctor in New York and Long Island.   For those individuals who do not have the one week downtime or who wish to resurface other skin areas than the face or neck, the laser of choice remains the Fraxel laser.  Dr. Rokhsar is considered an international authority with laser resurfacing and has spoken on this subject all around the globe.  Many doctors in the New York area and around the country refer patients to Dr. Rokhsar for fractional CO2 laser resurfacing.  

As a top CO2 laser specialist in Manhattan, and with multiple advanced lasers on-site, Dr. Rokhsar is able to combine several lasers at the same time for the best results, depending on your skin’s unique needs. After all, there are many laser procedures on the market today. These lasers do everything from removing unwanted wrinkles to removing unwanted hair. Knowing which laser is right for you and which procedure will help you get the look you want is a vital step in any cosmetic surgery procedure.

CO2 Laser Results

Most patients begin to see results about one week after treatment. Results are cumulative and take about six months to see peak improvement. The skin will gradually heal as it regenerates from inside out. Dr. Rokhsar considers CO2 lasers to be safe and effective on lighter skin types, but extreme caution should be exercised  on darker skin tones including African-American, Indian, Asian, and Mediterranean skin.  For darker skin colors, Dr. Rokhsar in general, prefers to use the Fraxel Dual laser.   

Dr. Cameron Rokhsar has trained more doctors on fractional lasers than any other doctor. He has introduced this technology to countries such as Australia, Europe, South America, Canada, Thailand, and virtually every continent across the globe. Because of Dr. Rokhsar’s pivotal role in fractional laser development, he is considered one of the foremost skilled doctors in the world  to perform CO2 ablative skin resurfacing.

CO2 laser results

Fractional CO2 Laser Resurfacing - Before and After Photos patient*Results may vary.

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CO2 Laser Resurfacing FAQ

What are fractional lasers?

The Fractional CO2 lasers are powerful, ablative lasers used for skin resurfacing. CO2 lasers can improve skin elasticity, texture, fine lines, deep wrinkles, acne scars, surgical scars, burn scars, pigmentation, melasma, loose skin, uneven skin, large pores and sunspots. Fractional CO2 lasers work by creating tiny holes in the skin. The skin responds by rapid healing and peeling off old damaged cells to reveal new healthy skin. The depth of tissue that the CO2 laser reaches results in significant crusting, scaling, and peeling; and longer recovery time. In many patients, these lasers are preferred for sun-damaged skin, and wrinkles, improving the overall skin texture creating smooth young skin. CO2 lasers typically provide incredible results with only one treatment.

Laser skin resurfacing with the CO2 or Erbium lasers involves the removal of a layer of skin so that the new skin can flourish and fill in the wrinkles and crevices. The laser vaporizes the old wrinkled, sun-damaged, and scarred skin which initiates a cascade for new skin formation. The new skin is healthier with fewer visible lines, wrinkles, sun damage, and scars. Laser skin resurfacing with the CO2 laser remains the gold standard for treating age-related surface imperfections. The CO2 laser also can have a tightening effect on the skin.

What does CO2 laser resurfacing treat?

CO2 or Erbium laser resurfacing is designed to remove moderate to deep lines and wrinkles and loose skin on the face, lips, eyes or neck. The technique emits concentrated pulse beams of light to the skin in order to remove layers of skin in fractions. These lasers are ideal for treating wrinkles, poor texture, sun damage, large pores, pigmentation, loose skin, as well as scars, including acne, surgical and burn scars.

How does CO2 laser resurfacing work?

CO2 lasers are the most effective technology for minimizing wrinkles, poor texture, and loose skin on the face, neck, around the eyes, and around the mouth.. These lasers work by creating minimal burns to the skin resulting in collagen production. Fractionated CO2 lasers only treat microscopic laser columns that penetrate deep into the skin. Each pulse stimulates new skin production while evening out the irregularities in the skin. This laser also causes dramatic tightening of the skin to due the heat that it produces in the skin.

What are the different kinds of CO2 laser resurfacing?

There are two types of lasers that are most commonly used for resurfacing which are carbon dioxide (CO2) lasers and Erbium lasers. Each laser treats the skin at the epidermal and dermal level. The depth depends on energies used and the skill of the surgeon. The fractional CO2 laser resurfacing emits short-pulsed light energy or continuous light beam to create micro-damage sites. This minimal heat damage stimulates collagen production, ultimately leaving behind a newer and tighter layer of skin. CO2 laser resurfacing is considered one of the most effective treatments for those with wrinkled skin. The Co2 laser is able to penetrate deeper than erbium lasers, giving them their superior results in head to head studies. Fully ablative CO2 or Erbium lasers take off a layer of skin all at once. These lasers have linger downtime often requiring at least 2-3 weeks downtime compared to their functional variants. They also have a higher risk of side effects such as scarring and infection.

Does CO2 laser resurfacing hurt?

The CO2 laser hurts if proper numbing is not administered. With proper numbing the CO2 laser is painless. It takes skill to properly numb the face without undergoing general anesthesia. As the top CO2 doctor in New York, Dr. Rokhsar is an expert in numbing the face with local anesthetics. Dr. Rokhar uses a combination of nerve blocks, field blocks, tumescent numbing, numbing cream, oral sedatives, as well as Pronox (laughing gas) to make patients one hundred percent comfortable, without the need to put patients under general anesthesia. If you have had a painful experience with the CO2 laser, it just means that you were ot numbed adequately.

What are CO2 laser post-treatment instructions?

Dr. Rokhsar will provide clear instructions for after-treatment care. The skin is raw immediately post treatment, so it is important to keep the skin hydrated, preferably with Aquaphor healing ointment or vaseline for the first seven days until brand new skin is fully formed. It is also important to take the prescribed oral antibiotics, antivirals, and antifungal medications. Allowing the skin to dry out or scab will slow down the healing process. Cold compresses are also used to help reduce any swelling and sunburn feeling you may experience. In addition vinegar water soaks must be applied to the skin every two to three hours while awake. This keeps the skin clean and debris free.

Are there any side effects of CO2 laser treatments?

Side effects are rare with fractional CO2 lasers. It is crucial that you only allow a highly experienced CO2 laser specialist to perform your procedure for maximum safety. As a top CO2 laser doctor, side effects are unlikely in Dr. Rokhsar’s hands. Side effects of CO2 laser treatments include scarring, infection, changes in skin pigmentation potentially causing areas of darker or lighter skin, and burns. With proper technique and pots up care, these side effects should be rare when fractional CO2 laser treatments are performed in the hands of experienced board certified laser dermatologists.

How long is the recovery time for CO2 laser?

CO2 laser resurfacing causes dramatic tightening of the skin and wrinkle reduction usually with one laser treatment session. With Fractional CO2 lasers, one week of recovery can be expected. With fully ablative CO2 lasers, up to 2 weeks recovery and healing is common. Patients are usually swollen for a few days to a week and oozy and raw for 3-7 days with fractional Co2 lasers.

What is a fractional CO2 laser?

A fractional laser is a type of laser used for skin resurfacing and rejuvenation. It delivers a laser beam that is divided into thousands of microscopic treatment zones, targeting only a fraction of the skin at a time, which allows for more rapid healing and less risk of side effects than traditional laser treatments. Fractional lasers can be ablative or non-ablative, and they can treat a variety of skin concerns such as fine lines, wrinkles, scars, hyperpigmentation, and uneven skin tone and texture. The FDA has cleared fractional lasers for the treatment of periorbital wrinkles, acne scars, surgical scars, dyschromia, and pigmented lesions such as age spots, sunspots, and melasma. The Fraxel Restore Dual laser is a popular non-ablative option that combines two wavelengths to safely achieve optimal results with no downtime. Dr. Rokhsar was involved in the development of the Fraxel laser and introduced Fraxel around the world in 2004-2005 to Australia, Asia, Europe and in 2003 in South America.

Fractional CO2 treatments are also available and use an ablative laser for deeper skin resurfacing with approximately one week of recovery. Overall, fractional lasers are a safe and effective option for those seeking to improve the appearance of their skin with minimal downtime and risk of negative side effects. Dr. Rokhsar was trained by the inventor of the CO2 laser. He is considered an international authority on laser skin resurfacing procedures and has performed more of these procedures than any other physician in the U.S.

How does a CO2 laser work?

The CO2 laser emits a wavelength of light which gently heats the skin and evaporates skin in a controlled manner thereby stimulating new skin formation and also production of new collagen – a protein that improves skin appearance. The water within the skin cells absorbs this type of wavelength, resulting in the removal of thin outer layers of skin (epidermis) and heating of the underlying skin (dermis), which stimulates the growth of collagen and elastic tissue, restoring skin firmness and youth.

CO2 laser resurfacing can be used to address fine lines and wrinkles, moderate to severe lines and wrinkles, discoloration (including sun damage and age spots), acne scars, stretch marks, surgical and burn scars, and uneven skin texture on the face, and neck. It can also treat benign skin growths like enlarged oil glands (sebaceous hyperplasia), syringomas, xanthelasma, warts, and some skin cancers. Dr. Rokhsar was trained by the inventor of the CO2 laser, the late Richard Fitzpatrick, MD. He is considered an international authority on laser skin resurfacing procedures such as the CO2 laser and Fraxel laser and has spoken on this subject all over the world.

What is a non-ablative fractional laser?

A non-ablative fractional laser uses a device to deliver a beam that targets a fraction of the skin at a time. Unlike ablative lasers, non-ablative fractional lasers are less invasive and do not damage the surface layer of the skin. Instead, they gently heat the underlying skin tissue causing focused coagulation, leading to the production of new collagen in the skin. Fractional lasers are FDA-cleared for safety in treating periorbital wrinkles, acne scars, surgical scars, dyschromia, and pigmented lesions, such as age spots, sunspots, and melasma. This technique is a less aggressive approach than an ablative laser and has a shorter recovery time. The Fraxel Restore Dual laser is the gold-standard non-ablative laser used all over the world. Dr. Rokhsar was involved in the development of the Fraxel laser and introduced Fraxel around the world in 2004-2005 to Australia, Asia, Europe and in 2003 in South America. Dr. Rokhsar is an international authority on the Fraxel laser and has done more procedures than any other physician in the U.S.

How much does fractional laser treatment cost?

The cost of fractional laser treatment varies depending on several factors, including the type of laser treatment, the size of the area being treated, the provider’s level of experience, the practice location, and the number of treatments required.

Other factors can also impact the price of fractional laser treatment, such as the number of treatments required, the size of the treatment area, the skin condition being treated, and the geographic location. Additionally, the cost of the procedure is only part of the total price, and other related expenses may apply, such as aftercare and follow-up appointments.

How to prepare for a fractional CO2 laser?

To prepare for fractional CO2 laser treatment, there are several things you can do beforehand to ensure the best possible outcome. Patients will also receive a printout of detailed instructions during their consultation with Dr. Rokhsar.

Firstly, it is recommended to avoid sun exposure for at least one week prior to treatment, and to wear a broad-spectrum sunscreen of at least SPF 30 to protect the skin from further damage. Additionally, patients are advised to stop using retinoids and all skin rejuvenating products at least one week before the treatment. If patients are using any lightening creams, such as hydroquinone, they may be instructed to continue using them before the treatment to reduce the risk of post-inflammatory hyperpigmentation.

It is also important to avoid any tanning products or spray-tans before the treatment. If patients have any spray-tanning products on their skin, they should exfoliate the treatment area to remove the product. Any vitamin C or glycolic acid products should be avoided for at least three days before the treatment. During the treatment, local anesthesia is used to numb the area, and patients may be given an oral sedative to help them relax. Some patients also chose to take laughing gas like Pronox.

After the treatment, patients may experience swelling and redness for 2-7 days, and they are advised to avoid all sun exposure during the healing time. Dr. Rokhsar advises patients to apply vinegar/water soaks and Aquaphor healing ointment constantly throughout the recovery period for the CO2 laser. He also prescribes three medications to prevent infection. Following Dr. Rokhsar’s instructions for aftercare minimizes the chances of infection and makes the recovery period painless. If excessive bleeding or pain occurs, patients should contact Dr. Rokhsar or his office immediately.

How many fractional CO2 laser treatments are needed?

The number of fractional CO2 laser treatments needed varies depending on the extent of sun damage, scarring, or wrinkles and the intensity of the laser used. Generally, the results from one treatment lasts 3 to 5 years. The downtime from one treatment is approximately 5-7 days. During a consultation with Dr. Rokhsar, he will advise you on which procedure(s) is/are best for addressing your concerns and the number of sessions that may be needed.

How long does CO2 laser resurfacing take to heal?

The healing time for CO2 laser resurfacing can vary depending on several factors such as the depth of penetration of the laser, the type of laser used, the patient’s health, and their general healing rate. The procedure has 5-7 days of downtime during which Dr. Rokhsar advises patients to keep their skin moist with Aquaphor healing ointment and do vinegar/water soaks every few hours. Dr. Rokhsar provides patients with a print out of detailed instructions for aftercare.

Immediately after the procedure, the treated skin will be raw, swollen, and oozing. After the 5-7 day recovery period, the skin will transition into new, pink skin. The pink or red skin can be covered with makeup after the treated areas have fully healed. The pinkness may last up to 2 months, after which the patient will notice tighter, more youthful skin.

The optimal results of CO2 laser resurfacing can be seen three to six months after the treatment, as new collagen continues to develop and tighten the skin. Patients should follow Dr. Rokhsar’s aftercare instructions to help with healing and lower the risk of complications. Additionally, combining CO2 laser resurfacing with other skin-improving technologies such as RF Microneedling, Fraxel Restore, or injectable treatments such as Botox and fillers can enhance the results.

How long after the CO2 laser will I see the results?

Patients will see gradual improvement over time, with full results seen 3-6 months after treatment. However, some patients may see immediate results as soon as the redness and swelling go away, with more results appearing gradually over the next six months as new collagen is produced and internal repairs are completed. Patients will notice tighter, more youthful skin once new skin forms after the 5–7-day recovery period. During the recovery period, the skin will be very sensitive. The guidelines for post-treatment care should be followed to help the skin heal and prevent infection. The new skin appears pinkish which can last up to two months as the skin continues to tighten and improve.

The results of CO2 laser treatment can last for up to 5 years, depending on the aesthetic concerns being treated. Sun damage or pigmented lesions, for example, can be treated for a year or more if the patient takes care to avoid further skin damage. Results of a CO2 laser resurfacing treatment will likely generate permanent improvement in the skin, with the most apparent and dramatic results seen after the first six months.

Which is better, Fraxel Restore laser or Microneedling?

Both Fraxel laser and Microneedling are popular skin rejuvenation treatments that can address fine lines, wrinkles, and other visible signs of aging. However, which treatment is better for you will depend on your skin concerns and goals.

Fractional laser treatments use heat energy to penetrate the skin’s surface and safely heat the tissues, which stimulates collagen production and promotes skin tightening. It can effectively improve the overall tone and texture of the skin and can be used on the face and other parts of the body. Immediately after the procedure, the skin is red, swollen, and may flake for approximately 3-5 days after the procedure. Dr. Rokhsar recommends applying Aquaphor healing ointment or a ceramide-rich cream three times a day until the skin completely heals. However, there is no downtime and patients may return to their normal day-to-day activities.

Microneedling is another treatment that involves the use of tiny needles to create micro-injuries in the skin, triggering a healing response that stimulates collagen and elastin production. It can help improve skin texture and tone and is generally associated with minimal downtime and side effects such as redness, swelling, and dryness that subside within 24 hours of the procedure. Microneedling can also be used on various parts of the body and is suitable for patients of all ages. However, Microneedling has a higher risk of bleeding during the procedure than the Fraxel Restore.

Both procedures require multiple sessions for noticeable improvement of skin texture. The Fraxel Restore is the gold-standard for laser resurfacing and Dr. Rokhsar generally prefers the Fraxel over Microneedling as it has minimal bleeding during the procedure and is a more effective modality for improving scars, stretch marks, and sun damage.

What is the difference between Fraxel and fractional laser?

Fraxel and fractional laser are related terms that refer to specific types of laser treatments for the skin. Fraxel is a brand name for a type of fractional laser, but there are other types of fractional lasers as well. The main difference between fractional and non-fractional lasers is that fractional lasers treat only a fraction of the total surface area of the skin, allowing healthy skin to remain, minimizing downtime. Fractional lasers were developed to reduce recovery time and side effects, while also treating issues such as fine lines, loss of skin tone, and improving complexion.

Fraxel Restore Dual is a type of non-ablative laser that uses a fractional non-ablative Erbium laser to target only a fraction of the skin, stimulating collagen production while keeping the surface of the skin intact. The Fraxel restore dual laser is considered the best fractional laser and the most widely used and tested by most experts. It was also the first fractional laser developed. Dr. Rokhsar was involved in the development of the Fraxel laser and introduced Fraxel around the world in 2004-2005 to Australia, Asia, Europe and in 2003 in South America. Dr. Rokhsar is an international authority on the Fraxel laser and has done more procedures than any other physician in the U.S.

Overall, fractional laser treatment is a non-invasive treatment that uses a device to deliver a laser beam that targets a fraction of the skin at a time.

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About author - Dr. Cameron Rokhsar

Dr. Cameron Rokhsar

Dr. Cameron Rokhsar, MD, FAAD, FAACS, is the founder and medical director of the New York Cosmetic, Skin, & Laser Surgery Center. Dr. Rokhsar is a graduate of Harvard College and NYU School of Medicine. Dr. Rokhsar is double board certified in dermatology and micrographic dermatologic surgery, being one of the few select dermatologists in the country who is also fellowship trained in laser surgery. A researcher and innovator, Dr. Rokhsar is the creator of the non-surgical nose job and has been instrumental in the research and development of laser systems such as the Fraxel, CO2, Mirady, Vbeam, Themitight, and Ulthera devices. An Associate Professor of Dermatology at Mount Sinai Hospital in NYC, Dr. Rokhsar actively teaches the cosmetic dermatology clinic to the resident at Mount Sinai. An expert injector of fillers, and a trainer for many companies, patients fly in from around the world to see Dr. Rokhsar in his Garden City and Manhattan offices in New York.

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