The continuous CO₂ laser is a laser used in dermatology and aesthetic medicine to treat certain benign skin lesions, rhinophyma, cosmetic tattoos and selected skin resurfacing indications. Although fractional CO₂ laser and Erbium laser are now the reference techniques for skin rejuvenation, the continuous CO₂ laser still has specific indications when precise tissue ablation is required or as part of combined treatment protocols. The choice between a continuous CO₂ laser, a fractional CO₂ laser, an Erbium laser or another technology is made during the consultation, after a complete clinical examination.
The CO₂ laser was one of the first lasers to be used in dermatology and cutaneous surgery. As early as the 1980s, it became an alternative to mechanical abrasion techniques, allowing tissues to be vaporized or incised with great precision.
At that time, it was mainly used to treat warts, genital warts, certain benign skin lesions and for tattoo removal. The laser operated in continuous mode, an effective technology but one associated with a higher risk of scarring and sometimes significant downtime.
The introduction of pulsed lasers in the mid-1990s gradually replaced the continuous CO₂ laser for many indications, particularly tattoo removal. A few years later, the development of scanning systems ("scanners") made it possible to introduce the first skin resurfacing treatments for skin rejuvenation and scar management.
These early treatments were highly effective, but also very aggressive. Recovery was lengthy and the risk of complications was higher, particularly when indications or treatment settings were not perfectly controlled.
A major breakthrough came in the 2000s with the development of the fractional CO₂ laser. By treating only a fraction of the skin surface during each session, this technology significantly improved the balance between effectiveness, safety and recovery time.
Today, the continuous CO₂ laser retains specific indications, mainly in dermatologic surgery. In aesthetic medicine, fractional technologies have become the reference standard for skin resurfacing, the treatment of wrinkles, scars and photoaging.
The CO₂ laser emits light at a wavelength of 10,600 nm, which is strongly absorbed by the water contained in the tissues. This property allows it to precisely target the superficial layers of the skin.
The energy delivered is immediately converted into heat, resulting in controlled tissue vaporization and stimulating the skin’s natural repair mechanisms. Over the following weeks and months, fibroblasts produce new collagen fibers, leading to a gradual improvement in the skin’s quality, firmness and texture.
The continuous CO₂ laser treats the entire skin surface. While highly effective, it is also more aggressive, with a longer healing time and a higher risk of side effects. Today, its use is mainly reserved for specific indications in dermatologic surgery.
The fractional CO₂ laser works on a different principle. Instead of treating the entire skin surface, it creates thousands of microscopic zones of ablation separated by areas of intact skin. These untreated areas promote faster healing, reduce recovery time and improve treatment tolerance.
The fractional CO₂ laser acts more deeply and provides greater stimulation of collagen production. It is particularly indicated for the treatment of pronounced wrinkles, acne scars and photoaging.
The Erbium laser acts more superficially. However, when used by an experienced physician, it can also be used for deeper treatment with fewer side effects than a CO₂ laser. It provides gentler skin renewal, with generally milder after-effects and a shorter recovery time.
The choice between these technologies depends on the quality of the skin, the indication and the desired treatment outcome.
In certain situations, combining the continuous CO₂ laser with the fractional CO₂ laser or other technologies can improve treatment outcomes. These protocols are reserved for specific indications and are tailored on a case-by-case basis.
Vertical wrinkles of the upper lip, also known as “barcode lines”, are among the most common indications for combined treatment approaches. Combining different techniques provides more even skin resurfacing while also stimulating collagen production.
Cosmetic tattoos of the lips or eyebrows containing certain pigments may react unpredictably to pigment lasers. In certain situations, the CO₂ laser can be used as part of a specific treatment approach to improve pigment removal.
Rhinophyma, characteristic of stage IV rosacea, is a progressive thickening of the skin of the nose that can be treated with a CO₂ laser. Depending on the extent of the lesions, a combination of different laser modalities can be used to precisely reshape the tissues.
The continuous CO₂ laser also continues to play a role in the treatment of certain benign skin lesions for functional or aesthetic purposes, including xanthelasmas, syringomas, keloids, certain neurofibromas, foreign body granulomas and ingrown toenails.
Treatment with the continuous CO₂ laser cannot be performed in certain situations.
It is contraindicated in the following cases :
Special caution is also required in patients :
Before treatment with a continuous CO₂ laser, several precautions are necessary to ensure the procedure is performed safely and to promote optimal healing :
Post-treatment care following a continuous CO₂ laser procedure is essential to promote proper healing and reduce the risk of complications.
Recovery depends on the depth of the treatment, the size of the treated area and the indication.
In the hours following the session, it is normal to experience redness and moderate swelling of the treated area, as well as a sensation of warmth or mild burning.
During the following days, temporary oozing followed by the formation of scabs is expected. These reactions are part of the normal healing process.
In most cases, re-epithelialization is achieved within 7 to 10 days. Residual redness may persist for several weeks, or even longer depending on the treatment settings.
The continuous CO₂ laser may cause side effects. Most are temporary and gradually resolve during the healing process. The risk of complications remains low when the treatment is performed by an experienced physician and when the pre- and post-treatment recommendations are followed.
The most common side effects are :
Less commonly, the following complications may occur :
Results primarily depend on the indication being treated. The continuous CO₂ laser allows tissues to be removed or reshaped with a very high degree of precision.
Depending on the indication, the treatment can notably :
Following an aesthetic treatment, improvement continues over several weeks thanks to the gradual remodelling of collagen. The final result is generally assessed between 3 and 6 months after the session.
Each indication requires a prior medical assessment. The consultation makes it possible to confirm the diagnosis, identify any potential contraindications, explain the benefits and limitations of the treatment, and define the most appropriate therapeutic strategy.
When several techniques are suitable, the choice is made according to the characteristics of the skin, the location of the lesions, and the desired outcome.
The cost of continuous CO₂ laser treatment is provided upon quotation, as it depends on the indication, the size of the area to be treated, the depth of the procedure, and the type of anaesthesia required.
The price of a session starts from CHF 800.
A personalised quotation is provided during the medical consultation.
Yes. Although the fractional CO₂ laser has become the reference standard in aesthetic medicine, the continuous CO₂ laser still has specific indications, particularly for certain benign skin lesions, rhinophyma, or as part of combined treatment protocols.
The continuous CO₂ laser treats the entire targeted surface, whereas the fractional CO₂ laser creates multiple microscopic treatment zones separated by areas of healthy skin. This fractional technology reduces recovery time while maintaining excellent efficacy.
Comfort depends on the indication being treated and the extent of the area treated. Depending on the case, a topical anaesthetic cream, local anaesthesia or, more rarely, general anaesthesia may be required.
The healing time varies depending on the indication and the depth of the treatment. A light treatment generally requires only a few days of recovery, whereas a more extensive treatment may require several weeks for complete healing.
When the lesion has been completely treated, the results are generally long-lasting. However, skin ageing naturally continues over time, which may justify further treatments depending on the indication.
The continuous CO₂ laser is a powerful laser that requires complete mastery of the treatment parameters in order to minimise the risk of complications and achieve the best possible results.
