A Discussion about the MIXTO Laser

The MIXTO is the 3rd CO2 laser that I have owned and by far the best.

CO2 laser skin resurfacing is a technique that uses a laser to vaporize the surface layers of the skin.  This allows softening or elimination of wrinkles, abnormal pigmentation, scars and other skin imperfections.  Fractionated CO2 means the energy is delivered on a grid which I will demonstrate to you and is a modification which allows for much faster healing than standard CO2 and fewer complications in terms of changes of pigmentation or scarring.  It also allows the benefits of carbon dioxide lasering to be used safely on the skin of the neck, chest, and hands for texture, lines, color unevenness and sun damage.

The procedure is done in the office under local anesthesia (cream supplemented with nerve blocks) or with intravenous sedation depending on the extent of the area to be lasered and your preference.  It takes 30 to 60 minutes.  Each treatment gives you about a 30% to 50% improvement in texture, lines, and about an 80% improvement in age spots and pigmentary irregularities.  Occasionally, a second treatment can be done 6-12 months after the first.  You will be able to decide how much “down-time” you prefer.  If you prefer, we can give you two lighter treatments spaced apart by months instead of one stronger treatment.  We will discuss your goals and time limitations together.

There are several good studies that prepping the skin pre MIXTO Laser resurfacing will lead to faster healing and better result. This will involve a Retin-A product, glycolic acid pads and Hydroquinone depending on your skin type. These products can be obtained through my office.

What Happens After?

After the laser treatment, the skin is left moist with bland ointments until healed.  The grid is originally visible and then sloughs off.  There is swelling, oozing and crusting which heals in most cases within 5-10 days. This is followed by redness that usually fades to pink within 4 to 12 weeks depending on the depth of treatment. The light pink skin may last several months but is a sign of deep and more permanent resurfacing and is easily hidden. The initial bright pinkness may be initially covered by using a green concealer followed by an opaque foundation or Derma Blend. If this amount of healing time is unacceptable, we can do a light treatment, but the end effect will be less too.  During the healing phase, you must avoid the sun and use sunscreen daily to help prevent changes in skin pigmentation for about 1-2 months.  A bleaching compound (hydroquinone) may also be prescribed if you tend to hyper-pigment (darken) with skin injury.

Although complications are rare, they can occur.  These include:

  • Prolonged redness or itching
  • Milia (small whiteheads)
  • Temporary acne
  • Infection (viral or bacterial)
  • Changes in skin pigmentation (darker or lighter)

Please inform me of any previous facial cosmetic procedures, if you are pregnant or taking medications like Accutane, oral contraceptives, Retin-A, Alpha-Hydroxy or other acid creams, and if you have ever had fever blisters or shingles.

LET ME KNOW IF YOU SMOKE!  Nicotine will slow your healing and increase your risk of scarring and infection.  You need to be nicotine-free for two months before and one month after this procedure. This means no smoking, no vaping and no nicotine patches or other replacements.   Also, let me know if you have had pigmentary changes in response to skin injury or sun exposure or if you form thick scars or keloids.

It will be a pleasure to discuss laser skin resurfacing with you in my office.  Please do not hesitate to contact me if I can be of further assistance (804-320-8545).

Additional Information


Find Before and After Photos, Instructions, and Videos here: