What to Expect: CO2 Laser —
Mapped Before It Is Treated

The laser day follows a separate consultation. There, Dr SY maps each area by scar type and depth in angled light and photographs it; the photographs are kept in your medical record and never published. Tethered rolling scars and ice-pick tracts may need a first step of their own, subcision or TCA CROSS, because resurfacing does not reach them.

He asks about cold sores, keloid scarring, diabetes, immunosuppression, smoking, isotretinoin and medicines that make skin sensitive to light, and examines your skin type, since darkening is the main risk in Fitzpatrick III to V skin. Nothing goes ahead without your informed consent.

Preparing for the session

• Bring active acne under control first.
• Let any tan fade completely.
• Start a daily broad-spectrum sunscreen before the first session, and use any pre-treatment skincare you are given.
• Pause retinoid and acid skincare as advised; if a doctor prescribed your retinoid, check with them first.
• Mention cold sores: antiviral tablets are usually prescribed.
• Do not stop a prescribed medicine without asking the doctor who prescribed it.

Where your skin's reaction is hard to predict, a small test area may be treated first.

1. Your plan is confirmed and each scar is checked against the map.
2. The skin is cleansed.
3. A topical anaesthetic cream is applied to numb the treatment area.
4. Dr SY performs the laser himself on the DEKA Tetra Pro CO2, as the Tetra Pro Scar³ protocol, creating fine treated columns with intact skin between them.
5. Depth and density are set for each scar and for your skin type; density is reduced most in Fitzpatrick III to V skin.
6. As the passes go on, the skin reddens and swells, and pinpoint bleeding is expected.
7. A healing ointment goes on, and you go home with written aftercare matched to the depth and density of your treatment.

How the protocol works, and which scars it suits, is on Tetra Pro Scar³ acne scar treatment. Dr Sin Yong holds a Key Opinion Leader appointment with DEKA.

With the numbing in place, most people describe heat that builds with each pass and a hot, tight feeling over the treated zone, rather than sharp pain. A field of deeply treated scars is felt more than a broad, shallow pass over texture.

The heat and tightness ease over the evening after treatment.

What to do at home from the first evening is on the CO2 laser aftercare page.

How the skin usually looks from day to day, and when you can be seen, is on the CO2 laser downtime page.