eCO2 Plus™ (Lutronic — fractional CO2 laser resurfacing)

In a sentence: eCO2 Plus removes tiny columns of old skin and heats the layer beneath to spark fresh collagen—smoothing etched lines, softening scars and brightening sun damage—with more change (and more healing) than “light” lasers.1

Who it’s best for

  • 40s–50s: visible wrinkles (especially around mouth/cheeks), acne‑mark texture, blotchy sun damage.
  • 60s: deeper etched lines and crepey skin when you want a step‑change beyond non‑ablative lasers.
  • Skin tones: safest in lighter tones (Fitzpatrick I–III). Darker complexions (IV–VI) carry a higher risk of temporary darkening (PIH) after ablative CO2; if treated, parameters must be conservative and the operator very experienced.2

What it can do

  • Soften deep and etched lines more than “light” fractional lasers.2
  • Smooth scars and texture (acne, surgical) and brighten blotchy sun damage.1
  • Treat face, neck, chest; energy is placed in a pseudo‑random pattern (Lutronic’s Controlled Chaos Technology, CCT™) to spread heat and support safer healing.3 4

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 a true recovery window compared with MOXI/LaseMD/Fraxel‑1927.

Treatment & sessions

  • During: after numbing, the laser creates microscopic channels (removing tiny columns of skin) and warms the dermis to build new collagen. Full‑face usually takes ~20–45 minutes (longer if adding neck/chest).1
  • How many: many do 1 stronger session for a step‑change, or 2 lighter sessions 3–6 months apart.2
  • When you see it: after the first 1–2 weeks of crusting/peel, pinkness gradually fades; smoothing keeps improving for 3–6 months as collagen remodels.5

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: a “sunburn” heat and swelling are common the first 24–72 h; cool compresses, ointment barriers and (if advised) vinegar soaks help.8
  • Aftercare basics: frequent cleansing + occlusive ointment early, antiviral medication if you get cold sores, and strict SPF/hat. Don’t pick crusts; avoid heavy heat/gyms until the skin closes.5 7

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.2 9

Possible side effects & complications

  • Common: redness, swelling, crusting; milia or acne flares during healing.2
  • Less common: PIH, prolonged redness, cold‑sore reactivation (antivirals help).2
  • Rare: infection, scarring, hypopigmentation, or eyelid droop risk with aggressive eye‑area passes—hence the need for eye protection and expert operators.

Who should avoid or delay (contra‑/precautions)

  • Active infection or open wounds; active cold sore without antivirals.
  • Recent isotretinoin (timing is individualised by your clinician).2
  • Strong keloid/hypertrophic scar tendency, prior radiation to the area, or connective‑tissue disorders—needs careful assessment.2
  • Pregnancy/breast‑feeding are commonly deferred.

Regulatory & platform notes (U.S.)

  • FDA 510(k): Lutronic eCO2 laser systems are cleared Class II devices (product code GEX) for dermatologic/aesthetic procedures requiring ablation/coagulation/resurfacing; see K091115 and earlier K080496.10 11
  • Technology notes: manufacturer materials highlight CCT™ to pseudo‑randomise micro‑beams for wider spacing and heat dispersion per pulse.3 4

How eCO2 Plus compares

  • Versus Er:YAG (ProFractional/Contour TRL): Er:YAG may re‑epithelialise a bit faster with less heat; CO2 often provides slightly more tightening at similar depths.2
  • Versus “light” 1927 nm lasers (MOXI/LaseMD Ultra/Fraxel 1927): those give glow with 2–5 days’ flaking; eCO2 aims for deeper smoothing but needs a true recovery window.
  • Versus other CO2 platforms (UltraPulse, CO2RE, Tetra/CoolPeel): all are capable; results depend more on settings and operator than brand. eCO2 Plus is marketed for precision (0.1 mm) and CCT‑based delivery.3

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. Lutronic — eCO2 Plus overview (indications & areas)
  2. DermNet — CO2 laser: candidates, risks & recovery
  3. eCO2 Plus brochure — precision & CCT™ delivery
  4. eCO2 brochure — Controlled Chaos Technology details
  5. MSKCC — After fractionated CO2 laser (care & timeline)
  6. Clinic post‑care — CO2 recovery (heavy treatment)
  7. Clinic post‑care — CO2 pre/post instructions
  8. Clinic post‑care — vinegar soaks, comfort tips
  9. Review — PIH after CO2 laser & prevention
  10. FDA 510(k) K091115 — ECO2 Laser System (Lutronic)
  11. FDA 510(k) K080496 — MOSAIC eCO2 Laser System (Lutronic)

Region notes: eCO2 Plus is widely available in US/Canada/UK/EU/Australia. Specific claims and settings vary by country—confirm locally.

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