The following white paper and results of a preliminary clinical study was presented by Dr Daniel A Cassuto at the introduction of Lasering MiXto SX Fractional CO-2 Laser in 2007.

Background

CO2 laser resurfacing is a powerful tool for the treatment of several skin conditions such as fine and coarse wrinkles, scars of various origin, uneven pigmentation, dilated pores et al. Some major drawbacks have progressively limited its use: the need for effective anaesthesia, the downtime, the risk of dyspigmentation and scarring, the need for intensive postoperative care, the long-lasting erythema and the long avoidance of sun exposure

Fractional photothermolysis was introduced by Huzaira and colleagues in 2003. It was developed to overcome the above-mentioned drawbacks in the treatment of photo damaged skin. Fractional Laser Resurfacing with the midinfrared lasers uses an invisible laser beam which is strongly absorbed by water, in order to reverse the effects of skin aging and scarring. Near infrared wavelengths (Fraxel, Reliant, 1550nm; Lux 1540, Palomar) cause significant pain and require some form of anesthesia. This is a time consuming and costly aspect. Another disadvantage for the operator is that most of these devices are only capable of performing this kind of treatment. The use of ablative lasers in a fractional mode was introduced in 2006. The lesser depth of immediate tissue necrosis, in comparison to the mid infrared wavelengths, together with the possibility of further heat deposition in the dermis, significantly reduces the pain caused by the procedure, without decreasing its efficacy. A new CO2 laser (Active FX, Lumenis, 10600nm) with less penetration was shown to be more tolerable, but the 1.3 mm spot still makes some local anaesthesia and\or cooling necessary.