UltraPulse® CO2 (Lumenis — fractional ablative laser resurfacing)

In a sentence: UltraPulse CO2 removes tiny columns of aged skin and heats the layer beneath to build new collagen—smoothing etched lines, softening scars and brightening sun damage—with more impact (and more healing) than “light” lasers.1

Who it’s best for

  • 40s–50s: visible wrinkles (esp. around mouth/cheeks), acne‑mark texture, blotchy sun damage.2
  • 60s: deeper etched lines and crepey skin when you want bigger change than non‑ablative lasers can deliver.3
  • Skin tones: Safest in lighter tones (Fitzpatrick I–III). Darker complexions (IV–VI) carry higher risk of temporary darkening (PIH); if treated, settings must be conservative and operator very experienced.3

What it can do

  • Soften deep and etched lines more than “light” fractional lasers.2
  • Smooth scars/texture (e.g., acne, surgical) and brighten blotchy sun damage.1
  • Treat face, neck, chest; fractional modes include ActiveFX® (more superficial), DeepFX™ (deeper columns), TotalFX™ (combo), and SCAAR FX™ (for thicker scars).4 5

What it can’t do

It won’t replace a surgical lift for heavy jowls, and it isn’t ideal for melasma‑prone skin. Expect real change in lines/texture, but plan for meaningful healing time compared with MOXI/LaseMD/Fraxel‑1927.

Treatment & sessions

  • During: after numbing, the laser creates microscopic channels that remove old skin and heat the dermis to stimulate new collagen. A full face usually takes ~20–45 min (longer if adding neck/chest).5
  • How many: many do 1 stronger session for a step‑change, or 2 lighter sessions 3–6 months apart.3
  • When you see it: once crusting/flaking passes (first 1–2 weeks), pinkness fades over weeks; smoothing keeps improving for 3–6 months as collagen remodels.3

Healing time & aftercare

  • Downtime: plan for ~7–14 days of visible healing (redness, oozing/crusting, then flaking). Pinkness can last weeks before it fully blends.6 7
  • Comfort: “sunburn” heat and swelling are common the first 24–72 h; cool compresses, ointment barriers and vinegar soaks (if advised) help.7
  • Aftercare basics: frequent cleansing + occlusive ointment early, antiviral prophylaxis if you get cold sores, and strict SPF/hat. Don’t pick crusts; avoid heavy heat/gyms until the skin closes.6

Safety & skin of colour

Ablative CO2 has a higher risk of post‑inflammatory hyperpigmentation (PIH) in deeper complexions. Many clinics avoid or test‑spot in Fitzpatrick IV–VI and use pretreatment lightening plus strict sun avoidance.3

Possible side effects & complications

  • Common: redness, swelling, crusting, “sunburn” sensation; milia or acne flares during healing.3
  • Less common: PIH, prolonged redness, cold‑sore reactivation (antivirals help).3
  • Rare: infection, scarring, hypopigmentation, eye‑area risks—why eye protection and skilled operators matter. (Events are tracked in FDA MAUDE.)8

Who should avoid or delay (contra‑/precautions)

  • Active skin infection/open wounds; active cold sore without antivirals.
  • Recent isotretinoin (your clinician will individualise timing).3
  • Strong keloid/hypertrophic scar tendency, prior radiation to the area, or certain connective‑tissue disorders—needs careful assessment.3
  • Pregnancy/breast‑feeding are commonly deferred.

Regulatory & platform notes (U.S.)

  • FDA 510(k): UltraPulse surgical CO2 systems (UltraPulse / UltraPulse DUO) are cleared Class II devices (product code GEX) for soft‑tissue ablation/coagulation and dermatologic/aesthetic procedures; see K151331 and earlier clearances (e.g., K951812).9 10 11
  • Modes/handpieces: manufacturer literature details ActiveFX/DeepFX/TotalFX and SCAAR FX for scar work; choice depends on depth/coverage and goals.4 1

How UltraPulse compares

  • Versus CO2RE/Tetra: all are capable CO2 platforms; results depend more on settings and operator than brand. UltraPulse is known for high peak power and specialized modes like SCAAR FX.4
  • Versus Er:YAG (ProFractional/Contour TRL): Er:YAG may re‑epithelialize a bit faster with less heat; CO2 often provides slightly more tightening at similar depths.3
  • Versus “light” 1927 nm lasers (MOXI/LaseMD Ultra): those give glow with 2–5 days’ flaking; UltraPulse aims for deeper smoothing but needs a true recovery window.

At‑a‑glance

  • Best for: etched lines, crepey texture, acne/surgical scars, field sun damage.
  • Sessions: often 1 (or 2 lighter) sessions; results build 3–6 months.
  • Downtime: plan 7–14 days healing; pinkness fades over weeks.
  • Operator matters: choose a clinic experienced with peri‑oral/peri‑ocular resurfacing and with your skin type.

References (open in new tab)

  1. Lumenis — UltraPulse overview (modes, indications)
  2. JAAD — High‑power fractional CO2 (deep dermal micro‑ablation)
  3. DermNet — CO2 laser candidates, risks & recovery
  4. Lumenis — UltraPulse brochure (ActiveFX/DeepFX/TotalFX, SCAAR FX)
  5. USF Health — TotalFX patient brochure (procedure & timeline)
  6. Clinic post‑care — CO2 recovery (heavy treatment)
  7. Clinic post‑care — CO2 pre/post instructions
  8. FDA MAUDE — example adverse‑event record (UltraPulse TotalFX)
  9. FDA 510(k) K151331 — UltraPulse / UltraPulse DUO (Class II, GEX)
  10. FDA database entry — K151331 details
  11. FDA 510(k) K951812 — (earlier) Modified Coherent UltraPulse CO2

Region notes: UltraPulse CO2 is widely offered in US/Canada/UK/EU/Australia. Specific claims and settings vary by country—confirm locally.

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