Carboxytherapy in the Management of Selected Skin Conditions–Applications in Monotherapy and Combined Treatments
Source abstract
Abstract
Carboxytherapy is a non-invasive therapeutic method involving the transcutaneous or subcutaneous administration of carbon dioxide (CO2), which stimulates microcirculation, neoangiogenesis, and collagen production. This narrative review summarizes the latest scientific findings (2020–2025) on the effectiveness of carboxytherapy in treating selected dermatological and aesthetic skin conditions, including periorbital dark circles, stretch marks, scars, and signs of skin aging. The article discusses both monotherapies and combination protocols, particularly with laser therapies and chemical peels. Numerous clinical studies confirm that carboxytherapy significantly improves skin elasticity, tone, hydration, and structure through mechanisms such as improved oxygenation, stimulation of fibroblasts, and controlled inflammation. Moreover, combination therapies frequently offer superior outcomes, especially in scar and stretch mark reduction. Carboxytherapy demonstrates high safety, minimal side effects, and broad applicability, making it a valuable tool in both medical and cosmetic dermatology.
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Research context
OpenAlex topics: Angiogenesis and VEGF in Cancer · Dermatologic Treatments and Research · Sympathectomy and Hyperhidrosis Treatments
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Department of Pharmaceutical Sciences, Collegium Medicum, Jan Kochanowski University, IX Wieków Kielc 19a, 25-516 Kielce, Poland
Department of Biochemistry and Pharmacogenomics, Medical University of Warsaw, 1 Banacha St., 02-097 Warsaw, Poland
Funding
Jan Kochanowski University
References (51)
Show source-provided references
1. Sakai, Y., Miwa, M., Oe, K., Ueha, T., Koh, A., Niikura, T., Iwakura, T., Lee, S.Y., Tanaka, M., and Kurosaka, M. (2011). A novel system for transcutaneous application of carbon dioxide causing an “artificial Bohr effect” in the human body. PLoS ONE, 6.10.1371/journal.pone.0024137 ↗
2. Effect of Carbon Dioxide Facial Therapy on Skin Oxygenation
3. Cutometric assessment of elasticity of skin with striae distensae following carboxytherapy10.1111/jocd.12465 ↗
4. Increase in collagen turnover induced by intradermal injection of carbon dioxide in rats
5. Subcutaneous carboxytherapy injection for aesthetic improvement of scars10.1177/014556131008900204 ↗
6. Evaluation and efficacy of carbon dioxide therapy (carboxytherapy) versus mesolipolysis in the treatment of cellulite10.1080/14764172.2017.1400175 ↗
7. The biology of VEGF and its receptors10.1038/nm0603-669 ↗
8. Study of the efficacy of carboxytherapy in alopecia10.1111/jocd.12501 ↗
9. Is carboxytherapy a good alternative method in the removal of various skin defects?10.1111/dth.12699 ↗
10. Effects of carboxytherapy on skin laxity10.1111/jocd.13337 ↗
11. The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews10.1136/bmj.n71 ↗
12. Facial Aesthetic Priorities and Concerns: A Physician and Patient Perception Global Survey10.1093/asj/sjab358 ↗
13. The eye area as the most difficult area of activity for esthetic treatment
14. Evaluation of the effectiveness of picosecond KTP and fractional thulium lasers on pigmented-type periorbital dark circles10.1007/s10103-024-04095-y ↗
15. Classification and characteristics of periorbital hyperpigmentation10.1111/srt.12831 ↗
16. Infra-orbital hyper-pigmentation (dark circles): A study of its prevalence, etiology and its association with other dermatological symptoms among young adults
17. Identification of Three Key Factors Contributing to the Aetiology of Dark Circles By Clinical And Instrumental Assessments of The Infraorbital Region10.2147/CCID.S217956 ↗
18. Case series of post-purpuric darkness on the periorbital area after aesthetic surgery10.1111/dth.12922 ↗
19. Clinical analysis and classification of dark eye circle10.1111/j.1365-4632.2012.05701.x ↗
20. Clinical efficacy and safety of 20% glycolic peel, 15% lactic peel, and topical 20% vitamin C in constitutional type of periorbital melanosis: A comparative study10.1111/jocd.12255 ↗
21. Alternative approach to treating dark circles: A case report10.1111/jocd.15349 ↗
22. Evaluation of the effects of carboxytherapy in the treatment of periorbital dark circles10.1111/jocd.16331 ↗
23. Effectiveness, safety, and patient satisfaction of carboxytherapy as an adjunctive treatment for periorbital hyperpigmentation10.1111/srt.13651 ↗
24. The Impact of Carboxytherapy and Treatments Combining Carboxytherapy and Selected Chemical Peels on Vascular and Pigmentary Components of the Dark Circles10.2147/CCID.S469708 ↗
25. Efficacy and Safety of Carboxytherapy versus Combined Microneedling with Topical Glutathione in the Treatment of Patients with Periorbital Hyperpigmentation: An Evaluator-Blind, Split-Face, Controlled Pilot Clinical Trial10.4103/ijd.ijd_394_21 ↗
26. A randomized comparative study of the effect of two different flow rates of carboxytherapy in the treatment of infraorbital dark circles10.1111/jocd.14714 ↗
27. Carboxytherapy, subcutaneous injections of carbon dioxide in the management of infraorbital dark circles: A reliable and effective procedure10.1016/j.jcms.2021.01.028 ↗
28. Platelet-rich plasma versus carboxytherapy in the treatment of periorbital dark circles: A split-face study10.1111/jocd.15051 ↗
29. Comparison of carboxy therapy and fractional Q-switched ND:YAG laser on periorbital dark circles treatment: A clinical trial10.1007/s10103-021-03274-5 ↗
30. Comparison of the efficacy of carboxytherapy versus fractional CO2 laser therapy for the treatment of periorbital dark circles: A randomized clinical trial10.1111/jocd.15337 ↗
31. Subcutaneous Injection of Drugs: Literature Review of Factors Influencing Pain Sensation at the Injection Site10.1007/s12325-019-01101-6 ↗
32. Skin ageing and its treatment10.1002/path.2098 ↗
33. In the shadow of the wrinkle: Theories10.1111/j.1473-2165.2011.00602.x ↗
34. Carbon dioxide: Maybe not the only one but an efficient and secure gas for treating local adiposities10.1007/s00266-011-9758-0 ↗
35. Assessment of efficacy of carboxytherapy in management of skin aging through evaluation of gene expression profile: A 2-split randomized clinical trial10.1007/s00403-023-02656-9 ↗
36. Pathological and Immunohistochemical Assessment of Aging of the Abdominal Skin Treated with Carboxytherapy: A Randomized, Split-body Trial
37. Objective, measurable assessment of the elasticity of the skin around the eyes following the carboxytherapy treatment10.1111/jocd.15599 ↗
38. The efficacy of radiofrequency, intense pulsed light and carboxytherapy in facial rejuvenation10.1080/14764172.2021.1880598 ↗
39. Clinical and immunohistochemical comparative study of the efficacy of carboxytherapy vs platelet-rich plasma in treatment of stretch marks10.1111/jocd.12481 ↗
40. Efficacy of carboxytherapy in treatment of stretch marks
41. Efficacy of carboxytherapy in the treatment of striae alba: A clinical, histopathological, and immunohistochemical study10.4103/egjp.egjp_41_21 ↗
42. Carboxytherapy for striae distensae: A promising modality10.1111/jocd.13844 ↗
43. Split body comparative clinical and radiological study of fractional CO2 laser versus carboxytherapy in treatment of striae distensae10.1111/dth.15668 ↗
44. The Influence of Carboxytherapy on Scar Reduction10.2147/CCID.S389380 ↗
45. The molecular basis of hypertrophic scars10.1186/s41038-015-0026-4 ↗
46. Preliminary results of the use of carboxytherapy in the treatment of pathologic scars: A minimally invasive alternative10.1016/j.jpedsurg.2022.12.008 ↗
47. Comparative study between the efficacy of botulinum toxin type A versus carboxytherapy in the treatment of postacne scars10.4103/sjamf.sjamf_121_21 ↗
48. Effectiveness of subcision using carboxytherapy plus fractional carbon dioxide laser resurfacing in the treatment of atrophic acne scars: Comparative split face study10.1080/09546634.2019.1595505 ↗
49. The use of Carboxytherapy alone or in combination with fractional CO2 laser for facial rejuvenation: A split-face comparative study10.1111/jocd.13470 ↗
50. Carboxytherapy versus its Combination with Fractional CO2 Laser for the Treatment of Striae Distensae: An Objective, Right-to-left, Comparative Study
51. Kołodziejczak, A., Rybak, A., and Rotsztejn, H. (2025). The Impact of Carboxytherapy in Monotherapy and in Combination with Lactobionic or Ferulic Acid and Ascorbic Acid on the Hydration and Viscoelasticity of the Skin Around the Eyes. Appl. Sci., 15.10.3390/app15041876 ↗