Why does CO2 work? — the Bohr effect
Carboxytherapy works through a physiological phenomenon called the Bohr effect. It was discovered in cardiology as early as the 1930s. It has been used in aesthetics since the 1980s.
- CO2 injection — carbon dioxide concentration in the tissue rises sharply
- Bohr effect — high CO2 causes haemoglobin to release oxygen more readily, raising pO2 in the tissue
- Vasodilation — CO2 directly dilates the capillaries, improving microcirculation
- Fibroblast stimulation — better circulation and oxygenation activate collagen production
- Lipolysis — in fat tissue, CO2 can activate lipase, which supports the breakdown of fat cells
- Swelling reduction — improved circulation supports lymphatic drainage
Indications — cellulite
Cellulite with a vascular component — a blue-red skin tone, a "marbled" look — often responds best to carboxytherapy. CO2 can improve microcirculation, reducing venous-lymphatic stagnation and oxygenating tissue more effectively.
- Particularly effective for vascular cellulite (bruised type)
- Areas: thighs, buttocks, abdomen
- Recommended series: 10–15 sessions, weekly
Indications — localised fat reduction
CO2 can activate tissue lipase in adipocytes, which in many people supports the gradual breakdown of fat cells. The effect is slower than with cryolipolysis, but the two treatments can complement each other.
- Areas: abdomen, inner thighs, arms, love handles
- Recommended series: 8–12 sessions
Indications — vascular dark circles
Dark circles caused by visible blood vessels are one of carboxytherapy's unique indications. The Bohr effect and vasodilation can reduce the visibility of blue-purple discolouration.
- Recommended series: 5–8 sessions, every 2 weeks
- An indication where CO2 has a particular advantage over other methods
Indications — stretch marks and scars
White, mature stretch marks (striae albae) have poor blood supply. CO2 can reactivate microcirculation and stimulate fibroblasts. In many people, this leads to a gradual thickening of the skin and a shift towards a more natural skin tone.
- Stretch marks — areas: abdomen, thighs, breasts, buttocks; series of 10–12 sessions
- Atrophic scars (indented, post-surgical, post-acne) — series of 6–10 sessions
- Mechanism: stimulation of neoangiogenesis and fibroblasts
Indications — body skin laxity
Loose skin after pregnancy, weight loss or inactivity — CO2 acts as a biostimulator and can support neocollagenesis. Recommended series: 8–10 sessions.
Facial carboxytherapy — when is it worthwhile?
Facial carboxytherapy is possible, but used less often than body treatments — mesotherapy, polynucleotides and bioremodelling usually give a stronger revitalising effect. The exceptions are dark circles and post-acne scars, where CO2 has a unique advantage thanks to its vascular mechanism.
What happens during a session?
- Disinfection of the area — skin preparation
- CO2 injection — a fine needle delivers the gas at a controlled flow rate
- A distinctive sensation — warmth, a gentle "crackling" under the skin, mild tissue tension — this fades after 2–3 minutes
- Gentle massage — distributes the gas through the tissue
- After the treatment — the skin may look slightly red for 30–60 minutes; this is a normal reaction
Carboxytherapy versus other body treatments
Carboxytherapy works by improving microcirculation and triggering lipolysis. It stands out for its zero downtime and the ease with which it combines with other treatments. For comparison:
- LPG Alliance — mechanical massage with RF, a manual mechanism, no downtime
- Emtone BTL — RF and acoustic waves, 6–8 sessions, no downtime
- Cryolipolysis — cryostimulation of adipocytes, 1–3 sessions, mild swelling possible for up to 2 days
- Injectable lipolysis — sodium deoxycholate, 2–4 series, swelling for 2–5 days