We breathe in oxygen, we breathe out carbon dioxide. We all know that one basic fact. I don’t know about you, but as a student back in high school and before, I always imagined oxygen being the “good guy” and carbon dioxide the “bad guy”! But carbon dioxide has its redeeming qualities, and the one I’m talking about today is carboxytherapy.
Carboxytherapy is injecting carbon dioxide gas under the skin. The basic concept is that the body doesn't want CO2 in it, so when it is injected under the skin, the brain senses that somewhere in the body there is a deficit in oxygen, and responds by immediately sending a rush of blood to that area, rich not only in oxygen, but all the goodness that comes along with blood, that aid in wound healing and tissue regeneration.
The idea originates in France back in the 1930’s, when it was found that bathing in CO2 rich waters (naturally occurring spas) promoted wound and ulcer healing. In 2002 a study showed that in 80% of patients with critical lower limb ischemia, by bathing in CO2 rich water twice a day for ten minutes, doctors were able to salvage their legs, which were ulcerated and even gangrenous.
Many are drawn to the concept of carboxytherapy as it is considered natural, after all carbon dioxide is found in our bodies anyway, and it won’t be sticking around for long. It’s non allergenic and non toxic in low concentrations. Carbon dioxide has been used for a long time for injecting inside the abdominal cavity during laparoscopic surgeries, as a safe way to expand the abdominal cavity for better visualization and easier access. Even if a blood vessel is nicked during carboxytherapy it is still safe, as CO2 would not cause an air embolism at such low doses, and it is actually injected in the blood stream in certain heart procedures.
So what does injecting CO2 do exactly?
Tiny needle - not very uncomfortable, and many who did not like it felt it was still worth the discomfort!
Generally speaking, injecting CO2 into tissues alerts the brain that a certain area in the body is hypoxic (low on oxygen), which makes the brain do all it can to supply the area with oxygen, meaning increasing blood flow to that area.
Carboxytherapy causes vasodilation, regulates the circulation and causes new blood vessel formation. It also improves metabolism, which translates into more efficient elimination of waste products. Blood influx also brings in wound repair factors and growth factors; collagen and elastin production are stimulated.
Basically, injecting more superficially leads to skin rejuvenation (good for wrinkles, scars, acne scars, stretch marks, under eye circles, and overall better feeling and looking, tighter skin), while deeper injection leads to lipolysis (good for treating cellulite and body contouring).
The histology of the subcutaneous tissue after carboxytherapy shows that fat cells actually break down after an injection, while leaving vasculature and connective tissue unharmed. There is also improvement of skin elasticity.
By the same mechanisms employed above, carboxytherapy has also been successful in treating atrophic scars, ulcers, hair fall, and alopecia. It also has applications outside aesthetics, in improving vascular insufficiencies of various kinds, such as seen in Reynaud’s phenomena and erectile dysfunction.
Four months after one treatment of a new scar
What are the sessions like?
A session would probably last between 10 to 30 minutes, depending on what you are planning to do. Under eye injections take the least amount of time, cellulite and stretch marks take longer. Usually your doctor will take a before picture and then take another one after three or four sessions, which are usually 1 – 5 weeks apart. Most patients show tremendous improvement, but if there is no improvement after four sessions, your doctor might consider discontinuing carboxytherapy, as some patients simply do not respond.
What does it feel like?
The needle used is very tiny, you might feel its prick, followed by a sensation described as “tingling” or “like something moving under the skin”, or “tickling”; it really varies. There is also a feeling of pressure that might be a bit worrying especially in the under eye area, but it is completely normal and lasts less than a minute.
What are the benefits?
Carboxytherapy is a simple, quick, outpatient procedure that causes minimal discomfort, has no downtime whatsoever, and gives impressive results.
One month after the last of four sessions
Are there any side effects?
If done by a skilled physician, side effects are quite rare. It is noteworthy that CO2 has antiseptic properties of its own, which really lowers any risk of infection/inflammation. The redness that follows injection is expected, due to the increased blood flow and does not last long. Bruising is expected especially in the arms and legs, and those usually disappear in a about a week.
Who is a good candidate?
Think: the smaller the problem, the better the candidate. Deeper, older scars, deeper wrinkles, and excessive skin laxity do not respond as well. Body contouring works better for someone in the normal weight range with a few minor problem areas. My advice? Start in your thirties and go back regularly.
Thank you for reading!
N. Koutna. Carboxytherapy in Aesthetic Medicine. Aesthetic Medicine 2011; 4: 547-76.
F. Paolo et al. Periorbital Area Rejuvenation using Carbon Dioxide Therapy. Journal of Cosmetic Dermatology 2012; 11 (3): 223-8.