Lesson 1Basic physics and tissue interaction of CO2 ablative fractional lasers (ablation, coagulation, thermal zone)This part reviews CO2 laser physics and tissue effects, including wavelength, water uptake, ablation and coagulation, microthermal zones, and how pulse shapes depth, heat damage, and results.
CO2 wavelength and water absorption basicsAblation versus coagulation balanceMicrothermal zones and lattice patternsThermal relaxation time and pulse designDepth of injury and collagen remodelingLesson 2Evidence base and guidelines for fractional CO2 in acne scarring (efficacy, comparative data with other modalities)This part sums up proof for fractional CO2 in acne scars, including success rates, scar type responses, lasting effects, comparisons with others, and main guidelines.
Key randomized and prospective trialsOutcomes by scar type and skin typeDurability of results and retreatment needsComparisons with erbium, RF, and microneedlingGuideline and consensus recommendationsLesson 3Treatment planning: number of sessions, intervals, cumulative approach, and combination therapiesThis part explains making personal treatment plans, including session numbers, gaps, buildup strategies, and mixing with other scar treatments while balancing good results, safety, cost, and expectations.
Setting realistic goals for scar improvementDetermining number of sessions and intervalsCumulative treatment concepts and endpointsCombining CO2 with microneedling or RFIntegrating fillers, PRP, and subcisionLesson 4Patient selection, contraindications, and risk factors specific to CO2 (skin type considerations, isotretinoin interval, active acne, keloid risk)This part reviews best patients and no-go factors for fractional CO2, stressing skin type, isotretinoin past, active acne, keloid risk, body illnesses, and drug use to cut bad results.
Assessing scar type and severity patternsFitzpatrick skin type and PIH riskIsotretinoin timing and acne controlHistory of keloids and abnormal scarringSystemic illnesses and drug interactionsLesson 5Practical technique: anaesthesia options (topical, local blocks), technique for uniform coverage, overlapping strategy, periocular and perioral modificationsThis part covers doing fractional CO2 treatments, including pain relief choices, eye safety, grid setup, overlap plans, smoke control, and changes for eye and mouth areas.
Topical and injected anesthesia optionsMarking, positioning, and eye protectionUniform coverage and overlap techniquePeriocular and perioral safety tweaksSmoke evacuation and room safetyLesson 6Parameter selection rationale: energy density (mJ/MTZ), pulse modes, density/coverage percentage, number of passes and spacingThis part explains picking and tweaking CO2 settings, like energy per MTZ, density, coverage, pulse types, passes, and spacing, fitting to scar depth, body area, and skin type for safe results.
Energy per MTZ and depth of ablationDensity, coverage, and overlap limitsPulse modes and stacking strategiesAdjustments for skin type and regionTest spots and titration over sessionsLesson 7Expected downtime and postprocedure care: wound care, dressings, topical agents, sun protection, timeline of healingThis part outlines expected recovery time, wound changes, and aftercare, including cleaning, dressings, creams, infection stop, sun block, and advising on healing time.
Typical healing timeline day by dayCleansing routines and wound hygieneUse of occlusive dressings and emollientsTopical antibiotics, steroids, and antiviralsSun avoidance, SPF, and pigment controlLesson 8Complications specific to CO2: prevention and management of infection, prolonged erythema, hypertrophic scarring, and postinflammatory hyperpigmentation (PIH)This part details CO2-specific problems like infection, long redness, thick scars, and PIH, stressing risk cut, early spot, and proven fixes.
Bacterial, viral, and fungal infectionsProlonged erythema and telangiectasiaHypertrophic scarring and contracturePostinflammatory hyperpigmentation careHypopigmentation and textural changes
