Carboxy TheRAPY


This therapy originally developed in France at the thermal waters station of Royat. A group of cardiologists began treating patients with peripheral vascular disease there. In 1953 the cardiologist Dr Jean Baptiste Romuef published a paper documenting his 20-year experience treating patients with this technique. In 1956 another paper was published with 2400 cases of gangrene and intermittent claudication of the extremities treated with subcutaneous injection of a mixture of   carbon dioxide and oxygen. By 1983 402,000 patients had been treated at Royat in this manner. In 1994 more than 20,000 patients were treated. There was not a single long-term adverse reaction reported.

Since this time, hyperbaric oxygen has largely replaced subcutaneous use of carbon dioxide and oxygen in treatment of leg ulcers and peripheral vascular disease. In the last several years the technique of subcutaneous carbon dioxide treatment has been resurrected in Europe and South America for cosmetic use. Now it is starting to be popularized in the United States.Carboxytherapy is now used to treat stretch marks, scars, cellulite, localized obesity, edema, wrinkles and bags around the eyes, cellulite and loose skin.

Carboxytherapy is an innovative treatment technique in which carbon dioxide gas is infused under the skin. Depending on the technique it can be used to treat a number of conditions such as stretch marks, scars, localized obesity, cellulite, spider veins and loose skin. This is a nonsurgical cosmetic treatment, which is popular in Europe, Central and South America.
The injection of carbon dioxide actually increases oxygen delivery to the tissues by improving blood flow and by the Bohr effect. In the presence of carbon dioxide there is a decrease in binding of oxygen to hemoglobin. With the increased circulation, the increased delivery of oxygenated hemoglobin and the increased off loading of oxygen by hemoglobin, there is improved oxygen delivery to the tissue.

 Carboxytherapy causes a controlled injury when injected superficially by dissecting through layers of the dermis or hypodermis mechanically. The body repairs this by wound healing, increased blood flow, increased tissue oxygenation, the production of collagen, elastin, growth factors and inflammatory mediators.  When carbon dioxide is injected at a deeper level, below the dermis it kills fat cells. Wound healing results in a thicker dermis with more collagen and connective tissue with a smaller fat cell layer.  The vasodilatory, oxygenation and mechanical effects of carbon dioxide treatment are responsible for the beneficial effects on the skin and subcutaneous tissue.


Ocular Rejuvenation

The technique is performed by using a small 30G needle to inject carbon dioxide under the skin around the eyes and the crow’s feet. The carbon dioxide dilates the blood vessels improving the delivery of oxygen and nutrients to the skin. Improved circulation helps to eliminate the buildup of fluid between cells. The technique also results tissue remodeling with improved skin elasticity, thicker firmer subcutaneous tissue and better skin texture. There is an improvement in swollen bags and dark circles under the eyes. Eyelid wrinkles improve without having to resort to surgery or laser resurfacing.   

Bosniak and Zhilka in New York have conducted the first clinical trials using C02 to improve eyelid skin irregularities, decrease eyelid skin pigmentation, decrease dark circles that result from eyelid vascular pooling, increase the elasticity of eyelid skin, and to increase eyelid luminosity.
The number of treatments needed is dependent on the area to be treated and how the area looks prior to treatment. Once weekly, eyelid treatments typically begin to show an improvement in eyelid pigmentation after one to three weeks, an improvement in texture after two to four weeks, and an improvement in eyelid contour in 3 to five weeks. If the treatments are performed less frequently the results occur more gradually. The treatments continue until you see the results that you want. On the average, treatments need to be repeated after 6-12 months. This depends on the area being treated and the condition of the skin prior to treatment.



Cellulite refers to the lumpy fat bulges on the thighs and buttocks of over 95% of the normal female population. There are many reasons why most women are predisposed to cellulite whereas the condition is much rarer in men. To begin with, the underlying structure of the skin is different in male’s verses females.  Male skin tends to be thicker and the fibrous septae has strong cross-linking of the connective tissue. Females have thinner skin and no cross-linking of the underlying septae.  Women have more fat layers than men, and the subcutaneous fat layer in women is regulated by hormones and does not respond to diet and exercise. The female hormone estrogen causes these fat cells to store fat, whereas the male hormone testosterone stimulates the fat cells to break down fat.  So, women are genetically superior at storing energy in the form of fat to provide energy during pregnancy.  Women also have a higher percentage of body fat in the areas of the thighs, hips, and abdomen, and these fat cells are resistant to diet and exercise.  Directly beneath the fat layer there is a layer of connective tissue comprised of collagen called the “fibrous septae.” When the fibrous septae becomes damaged, the subcutaneous fat cells are pushed through the damaged regions and are squeezed into small bulges that give the overlying skin the “puckered” or “dimpled” appearance that we call cellulite. 

Women have tried numerous therapies to eliminate their cellulite including various creams, endermologie, lymphatic drainage massage, etc to no avail because none of these therapies correct the underlying physiological problems of poor circulation and damaged collagen septae. Two therapies that have shown promise in eliminating this difficult problem are the ThermageCL cellulite tip and carboxytherapy. Carboxytherapy was originally used for aesthetic purposes by the Brazilians to sculpt residual post-liposuction fatty deposits above the knees and histological studies showed that the fat cells were ruptured by the CO2 gas while leaving the remaining skin structures and nerves unharmed. Collagen remodeling was also shown to occur, as well as thickening and smoothing of the overlying skin



When carbon dioxide is injected superficially under scars, it subscises the tissue so that the adherent layers are separated. The skin repairs itself so that the scar contracts and becomes gradually smaller.



Carboxytherapy may be used on the face, the neck, the décolleté, the hands and the rest of the body to rejuvenate the skin. The skin texture is improved. The circulation is improved.  Skin tightening of the face, chin, eyelids, neck, upper arms and other areas may occur with superficial treatments. Thickening of the collagen in the dermis and hypodermis has been demonstrated. This can lead to diminished wrinkles and contraction of the skin.



Stretch marks or striae are a common problem that affecting many men, women and teenagers. They frequently appear as unattractive red, purple or white streaks across the hips, stomach, breasts, buttocks, flanks, thighs, arms, or shoulders. They may occur with pregnancy, rapid growth spurts, weight lifting, rapid weight gain or loss, and medical steroid use. Stretch marks happen when the tissue under the skin is pulled by rapid growth or stretching. Although the skin is usually fairly elastic, when it's overstretched, the normal production of collagen is disrupted. As a result, scars in the dermis called stretch marks may form.

At first, stretch marks may show up as reddish or purplish lines that may appear indented and have a different texture from the surrounding skin. Fortunately, stretch marks often turn lighter and almost disappear over time. Some have more severe stretch marks that result in permanent scars.
Laser or pulsed light therapy may help the redness. Resurfacing lasers remove the upper layers of the skin to improve the appearance. Microdermabrasion may be helpful but requires very many treatments for a mild to moderate improvement.

When carbon dioxide is injected superficially into the stretch marks it subscises the tissue so that adherent layers are separated. The skin repairs itself so that the stretch mark contracts and gradually becomes much smaller and less visible. Usually multiple treatments give the best results but the response varies for each person. We have seen moderate stretch marks almost disappear in one treatment but most require a series of several treatments. Combined treatments involving carboxytherapy, lasers and skin care products sometimes produce faster results.



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