after Carboxytherapy refers to the cutaneous and subcutaneous administration of carbon dioxide gas [CO2] for therapeutic purposes. Carboxytherapy originated at the Royal Spas of France in 1932 with the treatment of patients afflicted by peripheral arterial occlusive disease. In South America and Europe, carbon dioxide therapy has been applied to the treatment of stretch marks, cellulite, and hypertrophic scars with impressive results. Studies have demonstrated that carboxytherapy improves skin elasticity, improves circulation, encourages collagen repair, improves the appearance of fine lines and wrinkles, and destroys localized fatty deposits. Carbon dioxide is a natural constituent of our very being. We breathe in oxygen, and we exhale carbon dioxide. Plants take up the carbon dioxide, and in turn give us the oxygen that we need. There are no known risks associated with carboxytherapy. Carbon dioxide injection.

Carboxytherapy for Stretch Marks
Stretchmarks are characterized by wide linear bands of discolored or wrinkled skin that occurs in areas of collagen damage due to stretching. Striae are usually found on the abdomen, buttocks, thighs, and breasts. Women develop striae more commonly than men, and striae are seen in 90% of pregnant women due to a combination of hormonal factors along with increased stress on the collagen and elastin in the skin. Some studies indicated that striae are a form of scar tissue that forms in response to collagen rupture and elastic fiber changes. Two types of striae are described, newly formed, reddish colored “striae rubrae” and older, white “striae albae.” The treatment of striae distensae has been challenging and various modalities have been studied. These include topical retinoids (Retin A), microdermabrasion, intense pulsed light (IPL) and fractionated laser skin resurfacing. Although striae are thought to be a result of collagen rupture and breakdown during stretching of the skin, until recently, few treatments actually targeted the root cause of the striae formation, the damaged collagen in the dermal layer. Furthermore, laser and light modalities are not safe for individuals with darker skin tones. Carboxytherapy is the only treatment available for both old and new stretchmarks that visibly repairs the broken collagen and is safe for all skin types. Carboxytherapy causes the formation of new collagen and subsequently thickens the skin to improve the appearance of the stretchmarks by rebuilding the collagen matrix.

Carboxytherapy for Cellulite
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 males 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 Thermage CL 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.

Carboxytherapy for Dark Undereye Circles
Carboxytherapy can dramatically improve the appearance of dark under-eye circles. Although sometimes caused by darkened pigment, or a hollow depression below the lower eyelids [tear trough deformity], the majority of dark under-eye circles are caused by poor circulation beneath the lower eyelids [vascular pooling]. Dr. Zdinak designed and conducted the first study in the English literature using carboxytherapy for rejuvenating the under- eye region. She found that by injecting a small amount of carbon dioxide gas just beneath the skin of the lower eyelid, circulation was increased and dark under-eye circles were markedly improved. The treatment takes only five minutes, and is virtually painless and risk-free. A series of 2-6 treatments spaced one week apart is all that is required to achieve a great result.

FAQ’s About Carboxytherapy

What is carboxytherapy?

Carboxytherapy is the administration of carbon dioxide [CO2] gas for therapeutic purposes. Carbon Dioxide is the gas that gives carbonated beverages their “fizz.” It should not be confused with Carbon Monoxide gas, which is a by-product of oil combustion that can be deadly.

How was carboxytherapy discovered?



Carboxytherapy was discovered in the Royal Spas of France in the 1930’s when bathing in the pools of carbon dioxide rich waters was shown to speed wound healing.

How does carboxytherapy work, in general?



Carboxytherapy takes advantage of a physiological principle known as oxygen off-loading. Carbon dioxide is naturally present in our bodies at all times and it is essential to the life processes of both animals and plants. With every breath, we inhale oxygen and exhale carbon dioxide. Plants absorb the carbon dioxide that we exhale and release oxygen back into the atmosphere. There are many types of cells that make up the human body—heart cells, brain cells, skin cells… even though they may have very different jobs to perform, all cells take up the oxygen that we breathe in and burn it to make energy to do their job, then give off carbon dioxide as a waste product. Have you ever noticed that if the blood supply is cut off to your hand that it will turn a distinctive shade of violet? What you are actually seeing is the accumulation of deoxygenated blood. Here is why. With each inhalation we breathe in oxygen to our lungs. This oxygen is picked up by the red blood cells in the tiny blood vessels of the lungs. Each red blood cell has holding space for precisely four molecules of oxygen. The oxygen-laden red blood cells are carried from the lungs via tiny blood vessels that lead to the heart. The heart beats, forcing the blood into the arteries so that the red blood cells can carry their oxygen-rich cargo to the hard working cells of the body. When the red blood cells encounter an area that has a high level of carbon dioxide, the waste product of cellular metabolism, the red blood cells become distorted, the oxygen is released to the needy tissues and the carbon dioxide is picked up by the now empty red blood cells [think of a subway train pulling into the station– the doors open, the passengers who have reached their destination get off the train, and the passengers who need to be transported elsewhere get on the train—all in a highly organized manner]. The carbon dioxide is carried back to the lungs, we exhale to get rid of the carbon dioxide, we inhale more oxygen, and the entire process begins again. So, how does carboxytherapy work? Dark under-eye circles, cellulite, and scars are believed to caused, at least in part, due to poor blood-flow to the region. By injecting a small amount of carbon dioxide gas into the area, we are “tricking” the body into increasing the oxygen flow to the area by compelling the red blood cells to pick up all of the excess CO2that we injected so that it can be carried back to the lungs for elimination from the body with the next exhalation.

What are some clinical uses for carboxytherapy?

Carboxytherapy is used for the treatment of dark under-eye circles, stretch-marks, cellulite reduction, and non-surgical fat sculpting on the face and the body.

What areas of the body can be treated with carboxytherapy?

Carboxytherapy can be used to treat the eyelids, face, neck, arms, stomach, buttocks, and legs.

What other benefits occur from carboxytherapy?

In addition to increasing oxygenated blood-flow to the region injected, carboxytherapy also increases collagen formation in the skin, giving it a more youthful appearance.

How does carboxytherapy work for dark undereye circles?

One major cause of dark under eye circles is vascular pooling. The capillary network of the lower eyelids can become congested for a variety of reasons. Normally, the tears drain from the eyelids into the nose, but if there is some obstruction due to chronic nasal congestion from seasonal allergies, previous nasal fracture, or a deviated septum, the drainage doesn’t function well, and the blood flow to the lower eyelids becomes sluggish, giving rise to the boggy blue tinge known casually as “allergic shiners.” The lack of appropriate oxygenation to the lower eyelid skin allows the bluish cast to show through the thin skin of the eyelids. Carboxytherapy works to improve the capillary network of the lower eyelids, as well as to increase the dermal collagen layer in the lower eyelid skin. By injecting a small amount of carbon dioxide gas into the affected areas, blood flow is increased and improved capillary networks are formed for longer lasting circulatory benefit. The bluish cast is replaced with a healthy pink tone. Once a series of treatments is completed, the skin has a more luminous appearance that lasts approximately six months.

How does carboxytherapy work for stretchmarks?

Stretchmarks (striae distensae) occur when the skin is stretched to the point where the dermal collagen ruptures. Carboxytherapy causes the formation of new collagen and subsequently thickens the skin to improve the appearance of the stretchmarks by rebuilding the collagen matrix.

How does carboxytherapy work for cellulite and fat reduction?

When injected via a specific technique, carbon dioxide gas is directly toxic to fat cells. The fat cells literally burst and are eliminated by the body.

If carboxytherapy is used to melt fat, won’t it make my eyelids hollow?

No. The technique used to treat dark circles beneath the eyelids is different than the technique used to treat fat. However, there are some instances where I may wish to dissolve fat beneath the eyelids using a technique that I created.

How is the carboxytherapy treatment administered?

There are several machines that are used to administer the carbon dioxide gas, but the basic components are the same. There is a tank of carbon dioxide gas that is connected by plastic tubing to a flow-regulator. The flow-regulator slows down the speed of the gas according to the rate selected by the physician. The gas emerges from the flow-regulator into sterile tubing that has a filter connected at the exit to remove any trace impurities before the gas is run through a tiny needle attached to the opposite side of the filter. The pure gas is now ready to be injected beneath the skin via the tiny needle.

What does carboxytherapy feel like?

Carboxytherapy doesn’t hurt; it just feels a little “weird.” Because of differences in the techniques used to treat the eyelids, stretch-marks, scars, and fat deposits, the sensation is slightly different depending upon what is actually being treated. I use numbing cream for all of my patients to diminish any discomfort associated with the pin-prick of the needle itself. When treating the eyelids, I tell my patients that the lower eyelids will feel puffy, like they were up crying all night, but that will subside once the gas is absorbed over the next five to ten minutes.

The treatment of stretch-marks and scars is relatively painless because this skin doesn’t have the same ability to sense pain. Some pressure from the gas may be felt as the stretch-marks are distended, and they can feel a bit itchy, but again this subsides in about five minutes once the gas is absorbed by the body. Scars generally feel no pain because there are no nerves in scar tissue. The treatment of cellulite and fatty deposits on the arms, abdomen, and legs has a unique sensation of its own. This is because a larger amount of the gas is injected directly into the offending fat deposits and allowed to expand. While the gas is expanding, you may feel some pressure in the area being treated that feels similar to when the arm is squeezed by a blood pressure cuff. The areas will feel warm and tingly for up to 24 hours after the treatment as the circulation to the area is improved.

How many treatments will I need?



This depends upon the severity of the problem being treated. Usually, six to twelve treatments spaced one week apart yields an excellent result.

Are there any side effects associated with carboxytherapy?

The only real possible side effect of carboxytherapy is the potential for a bruise at the injection site. Usually, the eyelids can be treated without leaving any marks, making it a truly “no-downtime” procedure. Bruising is very common when treating the arms and legs, so carboxytherapy might not be a good idea if you plan on wearing a bikini the following week during vacation.

Are there any risks associated with carboxytherapy?

There are no known risks associated with carboxytherapy. Carbon dioxide injection has been safely used for years to facilitate endoscopic surgeries of the abdomen. Carbon dioxide is also being injected directly into the bloodstream by invasive cardiologists for certain diagnostic and therapeutic procedures.

How long does a typical treatment session last?

The average carboxytherapy treatment takes approximately fifteen to thirty minutes to complete.