The carbon dioxide (or CO2) laser system can be used in several ways: "focused" for cutting skin without bleeding; "defocused" for superficially vaporizing skin; and "ultra-pulsed" for facial resurfacing. By delivering very powerful, rapid pulsing or scanning of the latest generation of CO2 lasers, dermasurgeons are able to resurface the skin for cosmetic improvement. This technique removes fine lines and wrinkles of the face, smoothes acne scars, and rejuvenates aging and sun damaged skin as it contours the skin surface.

When the CO2 laser's energy is defocused and not continuous (eg, when it is pulsed), warts, shallow tumors, and certain precancerous conditions can be eliminated.

When the CO2 laser energy is "ultra pulsed," thin layers of aged and sun-damaged skin tissue can be precisely vaporized without damage to the healthy surrounding tissue. In this way, skin is "resurfaced" so that facial wrinkles, scars, and blotchiness are reduced.

Dr. Tina S. Alster, founding director of the Washington Institute of Dermatologic Laser Surgery, is a clinical professor at Georgetown University Medical Center in Washington, D.C. Dr. Alster earned her B.S. and M.D. degrees from Duke University where she graduated magna cum laude and was elected to Phi Beta Kappa honor society. She interned at the University of Pennsylvania Hospital and completed her dermatologic residency at Yale, specializing in laser surgery. Dr. Alster pioneered the use of cosmetic lasers, having published numerous textbooks and related articles in the medical literature and lectured at symposia and congresses worldwide. She has been honored by her peers by receiving numerous awards and accolades and currently serves as the consulting dermatologist to Lancome. Send your questions to tina@smartnow.com.