Lesson 1Basic physics and tissue interaction of CO2 ablative fractional lasers (ablation, coagulation, thermal zone)This part reviews CO2 laser physics and tissue effects, covering wavelength, water uptake, ablation and coagulation, microthermal zones, and how pulses control 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 evidence for fractional CO2 in acne scars, including results by scar type, 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, covering session numbers, gaps, buildup strategies, and mixing with other scar treatments while balancing 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-gos for fractional CO2, stressing skin type, isotretinoin history, active acne, keloid risk, body conditions, and meds to cut bad outcomes.
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 anaesthesia picks, 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 safely.
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, covering cleaning, dressings, topicals, infection stop, sun safety, and healing timelines for patients.
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 issues like infection, long redness, thick scars, and PIH, stressing risk cuts, early spotting, and proven fixes.
Bacterial, viral, and fungal infectionsProlonged erythema and telangiectasiaHypertrophic scarring and contracturePostinflammatory hyperpigmentation careHypopigmentation and textural changes
