Abstract
BACKGROUND: Fractional ablative CO(2) lasers are widely used for skin rejuvenation but are associated with post-procedural erythema, crusting, tenderness, and downtime. Carboxytherapy masks, a modality utilizing carbon dioxide, have been suggested to enhance healing and aesthetic outcomes post CO(2) laser treatment; however, controlled clinical data remain limited. OBJECTIVE: To evaluate the efficacy and safety of a topical carboxytherapy mask in enhancing recovery, reducing adverse effects, and improving patient satisfaction following fractional ablative CO(2) laser treatment. METHODS: Ten subjects (aged 45-70 years, Fitzpatrick skin types I-III) undergoing full-face fractional CO(2) laser resurfacing were enrolled in this randomized pilot study. Participants were assigned to either the active arm (n = 8, carboxytherapy mask was applied pre- and post-procedure and at designated intervals for 14 days) or placebo arm (n = 2, bland moisturizer). Outcomes included blinded investigator assessments of erythema, edema, crusting, healing rate, pigmentation, and wrinkle severity at Days 28 and 84; patient-reported diaries of discomfort and healing parameters; and self-assessments of satisfaction and global aesthetic improvement. RESULTS: The active group demonstrated reduced erythema during the first week (mean scores: Day 1, 3.1 vs. 3.5; Day 7, 0.6 vs. 1.0 for placebo). By Day 7, healing surface area averaged 97% in the active group with no crusting. At Day 28, the active group exhibited fewer fine and coarse lines (mean coarse line score 2 vs. 4 in placebo). At Day 84, coarse line reduction and abnormal pigmentation improvement favored the active group (0.75 vs. 1.5, respectively). Patient-reported tenderness, burning, and crusting were consistently lower in the active group, with higher satisfaction and confidence scores at both Day 28 and 84. No adverse effects were reported. CONCLUSION: In this pilot study, the carboxytherapy mask enhanced post-laser healing, reduced erythema and discomfort, and improved long-term wrinkle and pigmentation outcomes compared to placebo. These findings support the adjunctive use of the carboxytherapy mask to improve recovery and patient satisfaction after ablative CO(2) laser resurfacing. Larger, controlled trials are warranted to confirm these results.