Thulium laser or CO2 laser: differences, uses and how to choose
The CO2 laser removes skin, whereas the thulium laser only heats it. Almost all the differences follow from this: effect per session, downtime, suitability for darker skin and the question of who is permitted to use the device. This page puts the two lasers side by side.
SIACSKIN has two devices for this: the FRACO CO2 XL as an ablative fractional CO2 laser with a gentle CoolPeel mode, and the TULIX as a non-ablative fractional laser with 1927 nm thulium and 1550 nm erbium glass. You will find out which one suits which skin concern and which type of business.
Thulium laser or CO2 laser: which laser suits which skin concern?
The thulium laser suits pigment, sun damage, a dull skin tone, fine lines and pores, while the CO2 laser suits deep wrinkles, pronounced scars and coarse skin texture. The reason is the way each one works. The thulium laser heats the epidermis without opening it and renews it gently. The CO2 laser ablates fine columns of tissue and so provides a much stronger stimulus for new collagen. The deeper the concern lies and the more healing time is possible, the more likely the choice is to fall on the CO2 laser.
At SIACSKIN, the TULIX is the non-ablative device with 1927 nm thulium for the epidermis and 1550 nm erbium glass for the dermis. The FRACO CO2 XL is the ablative fractional CO2 laser for skin rejuvenation, scars and wrinkles.
Is the thulium laser a gentler alternative to the CO2 laser?
Yes, the thulium laser is regarded as a gentler alternative: it improves the complexion and pigment without removing skin, but achieves less per session than a CO2 laser. Technically, it is not a weaker CO2 laser but a different procedure. Both target the water in the skin and work fractionally, that is, in many small dots. The CO2 laser vaporises tissue in the process, whereas the thulium laser only heats it. The surface stays closed, and the skin is red and rough for a few days rather than raw. In return, it takes a course of sessions rather than one powerful session.
SIACSKIN explicitly lists the TULIX as a complement to ablative systems such as the FRACO CO2 XL. Anyone who wants a milder approach with the CO2 laser uses the CoolPeel mode on the FRACO CO2 XL.
Thulium laser or CO2 laser: how do downtime and healing differ?
After the thulium laser, redness usually lasts 1 to 3 days, whereas after a classic CO2 session you should expect 1 to 2 weeks of downtime. With the thulium laser the skin is red and warm, between day 3 and day 7 it flakes finely, nothing weeps and no crusts form. With the CO2 laser the skin is very red and swollen for 2 to 3 days, after which fine brownish crusts come away. Slight redness can remain for a few more weeks. Sun protection factor 50 is part of the routine in both cases.
The TULIX works with little downtime. For the FRACO CO2 XL, SIACSKIN states 10 to 14 days with a classic setting and 3 to 4 days in CoolPeel mode. The care steps are set out in the aftercare guide.
How many sessions does the thulium laser need compared with the CO2 laser?
With the thulium laser, 3 to 5 sessions at intervals of 4 to 6 weeks are usual, whereas with the CO2 laser 1 to 3 sessions are usually enough for skin rejuvenation. For scars it tends to be 3 to 5 with the CO2 laser, at intervals of 4 to 8 weeks. The difference follows from the strength of the stimulus: the ablative laser achieves more per appointment and needs longer breaks, while the non-ablative laser spreads the effect over a course of sessions. In the end, what counts is what fits better into everyday life: a few appointments with healing time or several without a long break.
On the TULIX, 1927 nm and 1550 nm can be used individually or in combination. The FRACO CO2 XL covers the powerful single session as well as the CoolPeel course.
Thulium laser or CO2 laser for dark spots and melasma: which is safer?
For pigment spots, and above all for melasma, the thulium laser is the safer choice. Pigment cells readily respond to intense heat and to inflammation with new, darker pigment. An ablative laser provides exactly this stimulus and can trigger dark patches, particularly in darker skin types and in melasma. The thulium laser at 1927 nm acts in the epidermis, where the pigment is usually located. The pigment is shed outwards as the skin renews itself, with the surface closed and at low energy. Consistent sun protection remains the prerequisite.
The TULIX lists melasma, sun damage, age spots and pigment disorders as applications and is specified for all skin types. The FRACO CO2 XL is the device for skin texture, scars and wrinkles.
Does the thulium laser hurt less than the CO2 laser?
Yes, the thulium laser is generally felt to be considerably milder than the CO2 laser. It feels like a warm, fine tingling. With gentle settings, cooling is often enough; otherwise a numbing cream is left to take effect for 20 to 30 minutes. The fractional CO2 laser is clearly noticeable without numbing. Here the cream is left on for 30 to 60 minutes, the pulses feel like short, hot pinpricks, and afterwards the skin burns for 1 to 3 hours as it does with sunburn.
The TULIX works with air cooling and an infrared thermal sensor in the handpiece. In the CoolPeel mode of the FRACO CO2 XL, less heat reaches the tissue. In addition, the KYROMASTER cools with cold air before, during and after the session.
Is a beautician in Germany allowed to use a CO2 laser, and is the thulium laser an alternative?
Not in Germany: under the German NiSV regulation, ablative laser applications such as treatment with the CO2 laser may only be carried out by licensed doctors with the relevant specialist or continuing training. The same applies to applications that breach the epidermis as a protective barrier, and to the treatment of pigment spots and blood vessels. A non-ablative thulium laser does not remove any skin and is the gentler alternative. Whether, and for which treatment, you may use it with proof of specialist qualification depends on the application. Clarify this with the competent authority before you buy. Other countries regulate this differently.
For beauty salons in Germany, therefore, at most the non-ablative TULIX is an option, and only for applications that are not reserved for doctors. Its cloud software includes NiSV-compliant treatment documentation. The FRACO CO2 XL belongs in the hands of a doctor. Training and specialist qualification courses are offered by the SIAC Akademie.
Thulium laser or CO2 laser: which device should a studio or practice buy first?
For businesses that want to work without long downtime and in courses of treatment, the thulium laser is the more sensible starting point; for medical practices focusing on scars and wrinkles, it is the CO2 laser. The non-ablative laser appeals to a broad clientele: short downtime, all skin types, less dependence on the season and treatments that are booked as a course. The CO2 laser offers the more powerful single treatment, but requires healing time, more aftercare and experience. Who is permitted to carry out which treatment is regulated differently from country to country.
The TULIX needs no consumables and has no shot limit. The FRACO CO2 XL additionally comes with a Cutting-Head and a gynaecological applicator. You can clarify which order suits your business in the free consultation.
