A professional-grade fractional CO2 laser system operates by emitting a laser beam with a wavelength of 10,600nm, which is specifically targeted to be absorbed by the water content in skin tissue.
This energy vaporizes the tissue through ablation, typically reaching depths of 20 to 60 micrometers, while simultaneously creating zones of thermal necrosis (heat injury) between 20 and 50 micrometers. This controlled dual action—vaporization and heat—triggers a potent wound-healing response that deposits new collagen to physically restructure and smooth acne scars.
Core Takeaway Unlike older lasers that remove the entire skin surface, fractional systems create microscopic "thermal bridges" of injury while leaving surrounding tissue intact. This triggers the body’s deepest remodeling mechanisms (fibroblast activity and collagen synthesis) to fill atrophic scars, while the preserved healthy tissue ensures rapid recovery.
The Mechanism of Action
Targeted Energy Absorption
The system utilizes a 10,600nm wavelength, a specific frequency chosen for its high absorption rate by intracellular and extracellular water.
Because the skin is largely composed of water, this allows the laser to deliver energy efficiently into the dermal layers without dissipating unnecessarily.
Controlled Ablation Zones
The laser creates an array of microscopic perforations, often referred to as Microthermal Treatment Zones (MTZs) or ablation columns.
Within these columns, the laser energy vaporizes the epidermis and parts of the dermis to a precise depth (typically 20-60 micrometers), physically removing pathological scar tissue.
Thermal Necrosis and Coagulation
Beyond the immediate vaporization, the laser generates a controlled zone of thermal necrosis (residual heat damage) typically extending 20 to 50 micrometers around the ablation channel.
This heat effect causes immediate contraction of existing collagen fibers and acts as the primary signal for the body to begin the repair process.
Biological Remodeling
Stimulating Fibroblast Activity
The thermal injury triggers the release of epidermal heat shock proteins and activates fibroblasts, the cells responsible for structural framework in tissues.
These activated fibroblasts synthesize large amounts of new collagen to repair the microscopic wounds created by the laser.
Reorganizing Dermal Structure
As the new collagen is deposited, the tissue undergoes significant remodeling and reorganization.
This process effectively "fills in" the tissue gaps characteristic of atrophic (depressed) acne scars, resulting in a smoother texture and tightening of the skin.
The Fractional Advantage
By utilizing a fractional approach, the system leaves bridges of healthy, untreated tissue between the micro-thermal zones.
These reserves of healthy tissue facilitate rapid re-epithelialization (skin regrowth), allowing for aggressive treatment depths with significantly faster healing times than fully ablative resurfacing.
Understanding the Trade-offs
Intensity vs. Recovery
While the fractional method speeds up healing compared to older methods, CO2 lasers are still ablative, meaning they physically vaporize tissue.
This creates a mandatory recovery period involving wound healing, unlike non-ablative lasers which leave the surface intact but offer less dramatic remodeling.
Realistic Improvement Expectations
The remodeling process is profound but not absolute.
Clinical studies indicate an improvement rate for post-acne atrophic scars ranging between 50% and 81%, meaning multiple sessions may be required to achieve optimal restoration.
Making the Right Choice for Your Goal
To determine if this technology aligns with your clinical objectives, consider the following:
- If your primary focus is deep scar remodeling: The ablative capability of CO2 is superior for physically breaking down scar tissue and inducing the collagen synthesis necessary to "fill" atrophic depressions.
- If your primary focus is minimizing downtime: You must weigh the benefit of the fractional approach (which speeds healing) against the reality that ablative vaporization still requires a recovery phase to manage the thermal necrosis.
The fractional CO2 laser remains the gold standard for scar revision because it balances deep physiological remodeling with the safety of preserved healthy tissue.
Summary Table:
| Feature | Mechanism of Action | Clinical Benefit |
|---|---|---|
| Wavelength | 10,600nm (Water-targeted) | High precision energy delivery to dermal layers |
| Ablation Zones | Microthermal Treatment Zones (MTZs) | Physical removal of pathological scar tissue |
| Thermal Necrosis | Controlled residual heat (20-50μm) | Immediate collagen contraction & fibroblast activation |
| Fractional Logic | Microscopic thermal bridges | Rapid healing via surrounding healthy tissue |
| Expected Results | Deep dermal remodeling | 50% - 81% improvement in atrophic scars |
Elevate Your Clinic’s Results with BELIS Advanced Laser Technology
Are you looking to provide your patients with the gold standard in scar revision and skin resurfacing? BELIS specializes in professional-grade medical aesthetic equipment designed exclusively for clinics and premium salons.
Our advanced Fractional CO2 Laser systems offer the perfect balance of deep physiological remodeling and patient safety, ensuring superior outcomes for atrophic scars and skin rejuvenation. Beyond CO2 lasers, our portfolio includes:
- Laser Systems: Diode Hair Removal, Nd:YAG, and Pico Lasers.
- Anti-Aging & Lifting: High-Intensity Focused Ultrasound (HIFU) and Microneedle RF.
- Body Sculpting: EMSlim, Cryolipolysis, and RF Cavitation.
- Specialized Care: Hydrafacial systems, skin testers, and hair growth machines.
Partner with BELIS to bring cutting-edge technology to your practice. Contact us today to request a quote or consultation!
References
- Niti Gaur. A comparative analysis of carbon dioxide laser technique and derma roller therapy in post-acne scars patients. DOI: 10.33545/surgery.2018.v2.i1a.888
This article is also based on technical information from Belislaser Knowledge Base .
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