| DERMAL REJUVENATION | ARTICLE Key points ■ CO2 therapy, thanks to
the properties of this gas, can be considered one of the most effective and most studied treatments for the imperfections of the lower limbs
■ It is better to infiltrate
small amounts of CO2 along specific vectors rather than large amount of gas
Figure 6 Detachment lines for stretch marks treatment
areas. This is achieved through the vasodilation induced by CO2
therapy, as well as changes in blood flow
and vasomotion, which have been demonstrated by capillaroscopy, Doppler, and laser Doppler flow 6,7,8,12
. Furthermore, it has been shown that CO2 therapy
increased oxygenation of peripheral tissues, owing to the artificial Bohr effect and the lipolytic action on adipose tissue, without damaging the connective tissue or reducing the adipose tissue thickness 8–10,16,17
. Figure 1 shows landmarks used to divide the different
gluteal, trochanteric, and thigh regions. It is not necessary to infiltrate large volumes of CO2
to each area; rather,
small amounts in the direction of the vectors shown in Figure 2 can be used. Furthermore, it is important to treat with small intradermal CO2
points on the great saphenous vein path. Figure 4 and Figure 5 show the reduction of the thighÕs circumference and skin quality in a young patient at the end of a complete treatment.
Treatment of stretch marks Stretch marks (striae atrophic, atrophy dermoÐ epidermal striae) are injuries caused by the shredding of the dermis and epidermis. They appear like linear scars and their origin are related to breakage of the collagen fibres, which occurs when the tissue is not sufficiently elastic, and to ischaemic damage owing to distension of the dermal capillaries. Their occurrence is likely related to both mechanic (i.e.
weight loss) and hormonal factors (i.e. steroid therapy), while the existence of a genetic predisposition is not clearly demonstrated. The positive effects of CO2
therapy on the blood flow
and oxygenation of peripheral tissue contributes to reduce the hypoxic damage, which is related to the aetiology of stretch marks. Histological examinations performed after treatment with CO2
showed that it
modified, treatment by treatment, the structure of the dermis, inducing an increase in thickness and a more widespread distribution of collagen fibres 8
. Figure 6 shows the insufflation technique and Figure 7
shows the result obtained. The technique provides small infiltrations along the course of the stretch mark as shown in Figure 6, at the end of eight treatment sessions an improvement of skin quality can be noted (Figure 7).
infiltrations along some key
Figure 7 Stretch marks in a 44-year-old patient (A). Results after eight treatments (B)
Conclusions Data in the literature makes it possible to conclude that CO2
of vascular diseases and skin affections. Declaration of interest None declared Figure images Matteo Campana
■ It is mandatory to use safe and certified device for CO2
administration
therapy is a safe and useful treatment for a number
References
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