Fractional CO2 Laser Treatment for the Face, Neck and Upper Chest

The CO2 laser is an ablative laser, like erbium lasers. Its beam destroys the outer layer of the skin, the epidermis, and at the same time heats the layer beneath it, the dermis. This heat, and then the repair that follows, make aftercare necessary after the session.

"Fractional" describes how the energy is distributed. Instead of treating the entire surface as one continuous area, the laser treats small microscopic columns of skin, from the epidermis down into the dermis, and spares the rest. The tissue left intact between the columns serves as a reserve the skin draws on to repair itself after the treatment.

"Ablative" and "non-ablative" describe what the energy does to the surface of the skin, whereas "fractional" describes how it is distributed. These are two separate questions, and a fractional facial laser can be ablative or non-ablative. The fractional CO2 laser is both ablative and fractional; a non-ablative laser is a different technique that does not remove the outer layer. Intense pulsed light, for its part, is not a laser, even though it is sometimes offered for similar concerns.

Choosing a facial laser treatment therefore means the technique must be specified: removing the outer layer of the skin is not the same as treating it without removing it.

Looking in the mirror, you may see fine lines setting in, a change in skin texture, a scar left by acne, spots or a neck that is showing its age. These are different concerns: they do not have the same cause, and they do not call for the same approach.

CARE MD offers fractional CO2 laser treatment on the full face, the neck, the upper chest, the face and neck, or the face, neck and upper chest. The fact that an area is offered does not mean the laser is appropriate for what you see there: during the assessment, the doctor first establishes what is observed, then whether this laser is an option for you, whether another approach would be better, or whether it would be better to do nothing.

A wrinkle that deepens when you move your face, a fine wrinkle visible at rest, visible pores and uneven skin texture look alike from a distance, but they are not examined in the same way. During the assessment, the doctor starts with the nature of what you see, then looks at your skin, its history, what you expect and how much recovery time you can allow yourself. The doctor also reviews the alternatives, including doing nothing.

Fractional CO2 laser treatment requires the skin to repair itself: this burden must be weighed against the change you are looking for. For your fine lines or your skin texture, the doctor considers the change you are looking for and the risks before choosing this laser or another approach.

A scar is a depression or a raised area; a dark spot is related to pigment. The two are not assessed in the same way, and skin colour is a factor when comparing options. Acne scars are first assessed by their type and cause, before any device is chosen: a narrow, deep scar, known as an ice pick scar, does not look the same as a wider depression. Its shape and depth matter in the examination.

No laser makes a scar disappear. When a change occurs, it is judged over months, and during the assessment, the doctor checks how you have healed in the past, including any history of keloid scars, before discussing options.

A treatment proposed for the face does not automatically carry over to the neck. The skin of the neck heals less well than facial skin, and thickened scars, sometimes permanent, are possible there after fractional CO2 laser treatment. For the upper chest, the doctor asks the same question during the assessment: how does this skin heal?

That is why the neck and upper chest have their own examination. The doctor checks how the area heals, your history of scarring, the caution this area requires and your expectations for it, before saying whether the laser is an option there.

The laser removes the outer layer of the skin and heats the layer beneath, but this mechanism guarantees neither the effect you are looking for nor its duration. Your skin, the area and how it heals are part of the decision. A result seen in someone else does not predict yours.

The number of sessions varies: some people need several treatments, and the doctor discusses this with you during the assessment. How long the change lasts also varies from person to person; this is discussed during the assessment, along with any maintenance.

The disappearance of visible reactions is not enough to judge the result or to resume using all your products. For a scar, a change can take months to appear: the first few days are not enough to judge its extent.

During the Global Aesthetic consultation, the doctor examines your skin and the area. This examination shows which changes are possible, how the characteristics of your skin can influence the result and what your risk of side effects is. Together, you decide whether the laser is right for you and, if so, which approach to take.

Bring the list of your medications and supplements; mention your current and past medical conditions, previous treatments and procedures, any cold sores, how you heal and your sun exposure. Also prepare your questions: is this laser a good option for what I want to change, what other options are there, what will I feel, what aftercare and follow-up are involved, and how much does the proposed treatment cost. CARE MD, a clinic in Sainte-Thérèse, welcomes you for this consultation.