Carboxitherapy: see what it is for, risks and if it works

The search for care with appearance is not new, so much so that the aesthetic market has been investing for years in resources that meet the demands and desires of modifying the body – either reducing some measures, preventing aging or remodeling a region.

Amid the desire to have a body closer to that desired, aesthetic treatments gain market and invest in technologies – and they are what stand out: with increasingly promising results and less and less invasive resources, non-surgical treatments move the industry .

In 2016, according to the Brazilian Society of Plastic Surgery (SBCP), the choice for less invasive methods – that is, non-surgical treatments – represented more than 47% of the consultations and procedures performed by aesthetic specialists.

The application of carbon dioxide is not exactly recent, as it has been used in medicine for some years. But now it has gained another purpose: to change the aesthetic appearance.

With less pain, less recovery time and better results, carboxitherapy now occupies the agenda of professional beauty specialists.


What is carboxitherapy?

Applications of medicinal carbon dioxide with a fine needle : this is basically all you need to reduce fats, cellulite , stretch marks and skin scars.

This is carboxitherapy, which derives from the technique created in 1932, in which carbon dioxide was applied to the subcutaneous tissue for medicinal treatments.

Today, the procedure stands out for its diversity of uses, low risks and side effects, in addition to the good results it provides.

Carboxytherapy is performed in offices, by injecting small amounts of carbon dioxide into different layers of the skin.

The depth depends on the objective, for example, to reduce measurements, it is between the skin layer and the fat layer, but if it is to treat stretch marks, it is directly on the scar.

The gas promotes blood circulation in the region, stimulates the production of collagen and helps in the elimination of fat cells.

On average, it takes between 10 and 15 sessions, but it is possible that the results will start to appear right after the first application.

Origin of carboxitherapy

Although the aesthetic use in Brazil is recent, the application of carbon dioxide under the skin has a longer history. It was in 1932 that therapy based on CO2 (carbon dioxide) began to be used in ambulatories and health centers at the French thermal station of Royta.

At the time, patients suffering from blood flow disorders (peripheral arteriopathies) were referred to treatments that consisted of dry baths or immersion of the affected body area in water and carbon dioxide.

In 1983, about 402 thousand people had already undergone treatments at the Royat station and the results were considered safe and promising, indicating that the oxygenation promoted by CO2 could, effectively, help in the recovery of the diseases.

Over the years, the practice was also tested for aesthetic purposes, and in 2001 there was already the 1st course in higher level of carboxitherapy linked to cosmetic surgery, at the University of Siena, in Italy.

What is it for and when to do it?

The application of subcutaneous carbon dioxide for aesthetic purposes can be used to help alleviate or treat conditions such as:


Carboxitherapy can be recommended for the treatment of cellulite, due to the stimulation of blood circulation promoted by gas and the oxidative (ie, reducing) action of fat cells.

It is through the reduction of fat cells that the appearance of cellulite is improved. With the supply of oxygen, more degradation of lipid concentration occurs, causing a reduction in this tissue.

As a consequence of the reduction of measures there is a reduction of cellulite.

In general, it takes between 5 and 10 sessions – between 1 and 2 times a week – for cellulite to be visibly reduced, even in cases where there are many holes in the skin.

Skin sagging

The flaccidity occurs due to the lack of collagen and elastin, proteins that give firmness and support to the skin. When they are lacking in the body, the skin looks fragile, thin and inelastic – that is, flaccid.

With carboxitherapy, the tissue is stimulated due to the dilation of blood vessels, which improves the oxygenation of the region and, in some parts of the body, can also promote the degradation of fat cells.

Together, these feats add more density to the dermis tissue, leaving it resistant, elastic and with a more hydrated appearance.

Stretch marks

Stretch marks are scars that appear on the skin after the collagen fibers are broken, due to the exaggerated extension and the fragility of the tissue.

Despite skin care, it is not always easy to prevent the appearance of marks – which are very common in adolescence and pregnancy.

Carboxitherapy for stria injects carbon dioxide directly into the scar, promoting oxygenation and increasing collagen production.

The collagen causes the region to be smoothed and the marks to become more regular in relation to the skin surface.

On average, it takes about 4 sessions before the results are noticed – but it is worth remembering that those red and purple scars are the ones that respond best to therapy, as they are more recent.

Read more: Stretch marks: what causes, how to avoid and treatments

Varicose veins (microvessels)

Varicose veins are veins that dilate due to the incorrect functioning of valves – structures that help the blood to flow in the correct direction.

It is important to note that not all varicose veins can be minimized or treated with carboxitherapy. Only those small fine vessels (microvessels), small and with a purple or reddish color.

Large varicose veins, with very intense protrusions or with colors closer to green, should be treated by doctors.

When applied directly to the varicose vein, CO2 assists in the restoration of the blood vessel wall, encouraging the blood to circulate again at the site, causing the microvarices to disappear immediately.

Dark Circles

The area under the eyes can be dark and very uncomfortable. Dark circles have several causes, such as stress , tiredness and biological conditions.

It doesn’t matter exactly why, but whoever wants to soften the darkened region may find in carboxitherapy a good option.

The oxygenation promoted by carboxitherapy makes the circulation reduce the darkened aspect under the eyes.

In addition, collagen, which is also stimulated by therapy, helps to reduce expression marks and sagging – which tends to increase with age and stress.

Localized fat

The excess of localized adipose tissue – that is, those fatty tissues in the waist, arms or thighs – is the result of the accumulation of adipocyte cells. When applying carbon dioxide to the tissue, vasodilation and improved blood flow to the skin occur.

The action generates an improvement in metabolism, which favors the breakdown of fat molecules, that is, the elimination of measures.

Generally, they are held between 1 and 2 sessions per week, and between the 5th and the 10th it is possible to notice significant reductions in measures.

But it is worth remembering that, especially for those who want to eliminate localized fats, adequate food and physical exercises must be combined with treatment.

It is also important to know that the treatment is not effective for weight loss, as it aims to reduce localized fat tissue, that is, concentrations that are difficult to eliminate.


Age and stressful conditions can cause wrinkles, which are (usually unwanted) changes to the skin, such as furrows or folds.

Related to the reduction of collagen and elastin fibers, which impair the elasticity and support of the tissue, wrinkles can be smoothed with the application of carbon dioxide.

With the application, circulation is optimized and the production of collagen results in smoother skin marks.

In addition, the stimulation of fibers promotes the maintenance of the region’s support, avoiding local flaccidity – which is usually associated with the marks of the dermis. That is, more collagen, less marks.

In general, after 3 sessions it is already possible to notice improvements in the skin, being indicated between 5 and 10 achievements so that the results are effective.

Post-plastic surgery

Carboxitherapy can be an option after plastic surgery or for the aesthetic correction of medical surgery, softening scars or improving blood circulation in the regions close to the cut.

Due to the stimulation of collagen fibers, the skin tissue tends to be recovered, decreasing marks and flaccidity that can remain after the surgeries.

Does carboxytherapy lose weight?

Directly, no . Carboxitherapy is quite effective in reducing measures, but in order to reduce weight in general, the technique is not the most suitable.

For those who undergo treatment for localized fat, it is possible to see some results from the first sessions – such as a few centimeters less at the waist or hips. Which is not exactly a weight loss.

Even in these cases, the ideal is to combine the procedure with a balanced diet and physical activities. Together, these habits promote better responses to treatment.

For those who want to lose weight, the application of CO2 can be indicated after the client reaches the desired weight – to reduce those localized fats that are more difficult to eliminate.

Capillary carboxitherapy

The process is basically the same: inject small concentrations of carbon dioxide to stimulate the region. But, when it is done on the scalp, the goal is another: to make more hair grow .

When a person suffers from severe hair loss, baldness or genetic inheritance, capillary carboxitherapy can help. On average, it takes between 10 and 20 sessions of about 40 minutes in fortnightly or monthly periods.

But, unlike the procedure done on the skin, the results tend to take longer, because only the stimulus of the region occurs, greater nutrition and oxygenation. The strands still need to grow – and that takes natural growth time.

Carboxytherapy device

The device used for carboxitherapy is simple and consists of a cylinder of medicinal carbon dioxide (99.9% purity) connected to the disposable needle of about 0.3mm.

The gas release is controlled, that is, the flow speed, the amount of CO2 and the application time are regulated with high precision. In total, each session can inject between 600mL and 2000mL (2L) of gas, approximately.

Some devices can also work with the emission of small electrical currents that stimulate the skin and help to minimize the pain of applications.

How does it work?

The basic process of carboxitherapy consists of oxygenating the region that receives the needle.

It is worth remembering that carbon dioxide is non-toxic, being a natural substance of human metabolism (oxidative actions of cells) and eliminated by breathing.

As CO2 has a great diffusion capacity, the body is able to absorb it and eliminate it quickly, making sure that, after application, only the vasodilation effect remains on the body.

But to understand the mechanisms that bring about the desired benefits, it is necessary to know that the gas exchange processes (oxygen and carbon dioxide) are directly related to the blood circulation.

That’s because the body needs oxygen to function properly, and a protein present in blood cells, called hemoglobin, is primarily responsible for transport.

When hemoglobin binds to an oxygen molecule, both pass through the bloodstream until they reach the tissue that needs oxygenation. Upon releasing this molecule, another one, carbon dioxide, binds to the protein. Now the destination is the lungs, where carbon dioxide will be released.

This process is constant and allows you to keep the gases in balance. But carboxitherapy upsets that balance and our body has a very intelligent system to readjust it by controlling blood flow.

When the body perceives a higher concentration of CO2 in a given region, the blood vessels are adjusted to bring more oxygen to the region and quickly eliminate carbon dioxide. With more CO2, the tissue is more nourished and healthy.

There is also another fundamental process for the results of carboxitherapy: as there is a distension of the tissue (a swelling), the fibers retract to recover the alteration. The retraction stimulates the production of collagen and improves the signs of flaccidity.

What are the effects of applying carbon dioxide?

After being applied, the main effects of carbon dioxide on the body are:

Stimulates circulation

It is important to consider that carboxitherapy promotes an aggression to the organism due to the injection of carbon dioxide and due to the piercing of the needle. Thus, the body responds immediately to aggressions, in order to control or prevent damage.

One of the first processes generated is vasodilation at the site, that is, an increase in the caliber of blood vessels, causing more oxygen to reach the tissue.

There are also processes to heal or restore the skin tissues due to the aggression of the needle and the distension caused by the subcutaneous swelling.

These mechanisms therefore cause an increase in blood flow, neovascularization (the appearance of new blood vessels) and a greater concentration of components (such as leukocytes, which generate tissue healing).

Release of oxygen in the tissue

Hemoglobin is a protein found inside red blood cells (blood cells), being responsible for the transport of oxygen throughout the body.

However, protein has about 200 times more affinity with carbon dioxide than with oxygen. In other words, the elevation of CO2 in a given region causes oxygenated blood to migrate to the site (hyperoxygenation) and gas exchange occurs.

This mechanism of gas balance in tissues, biochemically called the Bohr effect, results in a greater supply of oxygen and better tissue nutrition.

Fat reduction (lipolysis)

The injected gas causes an increase in pressure in the body region, which stimulates some substances, such as catecholamine, and triggers stimulations to the enzymes responsible for lipolysis (degradation of fat cells).

These enzymes act by degrading, wilting or eliminating the volume of cells, causing the reduction of local measures.

But there is, yet, another mechanism capable of reducing measures: the rupture of the membrane of these fat cells.

2011 studies, published in the scientific journal Cirurgia Plástica Estética, point out that it is above all the mechanical action of the gas that promotes the release of fat cells. That is, it is not only the chemical action (effects) of CO2, but also the force with which the gas enters the tissue.

The pressure of the injection breaks the fat’s connection with the tissue, causing it to be eliminated.

Tissue recovery

Due to the trauma that occurs at the site, caused by both the needle perforation and the action of inflating the subcutaneous layer, an inflammatory process begins. To remedy the damage, the body sends cells called fibroblasts, which are components of skin formation.

Recovery processes result in the production of collagen and other substances linked to tissue repair.

Thus, there are improvements in the thickness of the dermis, recovery of the lesion and reorganization of collagen fibers giving more integrity and strength to the tissue.

How is the application (depth)?

The amount of gas injected depends on the purpose of the treatment. In general, eliminating or reducing localized fat and cellulite requires higher concentrations of CO2.

The professional will evaluate all aspects and define the depth of application that can be separated into 3 injection plans:

  • Superficial : the needle is positioned at a 45º angle, causing the gas to be deposited on the superficial part of the skin, promoting nutrition and oxygenation – ideal for treating scars, sagging and skin marks.
  • Deep : with the needle tilted at 25º or less, the procedure stimulates the production of elastin and collagen (neocolagenesis) – indicated for stretch marks and wrinkles.
  • Hypodermic : the needle is aligned between 45º and 90º and reaches the adipose tissue – indicated for the reduction of measures and cellulite.

Rapid applications are made – each sting usually takes less than 5 seconds – and multiple – for the treatment of stretch marks, for example, it may be necessary to inject gas into each scar individually (the more streaks, the more stings).

Then, a manual massage is performed – with specific movements and pressure – to help the dispersion of the gas under the skin, optimizing its effects.

The session lasts according to the size of the treated region, usually lasts between 30 and 50 minutes for large areas (such as legs and buttocks) or between 20 and 30 minutes for small areas (such as the face).

In general, it is recommended to associate other therapies, such as lymphatic drainage , massages or other aesthetic therapies, according to professional guidance.

Read more: What is lymphatic drainage for?

Does carboxitherapy hurt?

In general, yes . The injection of gas can cause burning and pain at different intensities during the session, caused by the distention of the tissues. Usually, the discomfort is temporary and occurs only during the procedure.

As the procedure consists of pricks, even if superficial, it can generate pain or discomfort when the needle is inserted into the skin. But the sensitivity of each client and the application area greatly interfere with the sensation of pain.

Burning can be minimized by the temperature of the gas. Therefore, some professionals work with slightly heated gas, making the procedure less uncomfortable for the patient.

The application site tends to contribute to pain, and regions with less fatty layers may be more sensitive. However, other factors interfere, such as the professional’s own ability and the amount and speed that CO2 is injected.

Therefore, in techniques to reduce measures – which increase the speed of the gas for the breakdown of fat cells -, the pain can be more intense.

To minimize suffering – even if it is temporary – anesthetic ointments can be used that help to soften the skin and soften the discomfort, as instructed by the professional.

Which professional applies carboxitherapy?

Carboxitherapy can be done in aesthetics clinics, but the professional duly qualified for the procedure must have training in medicine, nursing, physiotherapy, biomedicine or pharmacy.

It is important that the professional still has specialization in dermatology, aesthetic physiotherapy, aesthetic dermatology or plastic surgery, for example.

Professionals trained in aesthetics can perform non-invasive procedures, that is, they do not pierce the skin.

How many sessions do you have?

The number of sessions must be evaluated by the responsible professional, as well as the time interval between each application. In general, it is common to have between 10 and 20 sessions, and some results can already be seen between the 1st and 3rd sessions.

Each client can be instructed to maintain a different frequency, according to the organization, the place of application and the objective, but always respecting at least an interval of 48 hours between each application.

In general, customers with cellulite, flaccidity and localized fats can be indicated for application twice a week, while in the case of stretch marks, an interval of approximately 15 days should be respected.

As the results are not definitive, maintenance sessions must be maintained. The frequency will depend on the analysis of the professional and the client’s staff.

In general, after at least 3 months the maintenance can be started, making applications once a month or as instructed by the specialist.

Care before and after carboxitherapy

In general, the procedure does not affect the routine before or after application. A few precautions are enough to make it possible to schedule a session in the middle of the week and not hinder work or going to the gym.

Recommendations before the session include not using creams, oils or products capable of penetrating the skin, and wearing comfortable clothes that do not compress the application site.

After the procedure, it is important to use high-factor sunscreen (over 50), avoid exposure to the sun and pay attention to the application site, not scratching or scratching.

It is possible, and even recommended, to maintain the routine of physical activities or lymphatic drainage sessions, according to the professional’s guidance.

Does Carboxitherapy Work?

The technique has been widely advocated by professionals and aesthetic centers. Along with the popularization of carboxitherapy, customer reports also indicate that the procedure has good results.

But it is important to note that there is still no scientific evidence, ensured by methodological procedures, that the technique is effective. That is, the reports and results are based on the observed results, constituting carboxitherapy as an experimental procedure.

Results: before and after

The result after carboxytherapy is a firmer, more elastic and stronger looking skin, regardless of the treated area – eyes or buttocks, for example.

In general, between the 1st and the 5th session it is already possible to notice differences in the firmness and filling of the region. Until the 10th performance, the measures and localized grease are reduced, and the cellulite and stretch marks are already smoothing.

Remembering that the results are also not permanent and, sometimes, it is necessary to carry out the treatment again. But, on average, the effect lasts for 2 years.

On the face (facial)

On the face, carboxitherapy can help smooth out wrinkles, expression lines, sagging, bags close to the eyes, dark circles and scars.

It is also possible to apply it to the neck and jowls, reducing concentrations of fat in the places:

In the belly

In the abdominal region, carboxitherapy decreases measurements, sharpens the waist, eliminates stretch marks and cellulite:

In the legs and butt

In the legs, hips and butt, the most recurrent uses are in stretch marks and cellulite:

Price: what is the value of the carboxitherapy session?

Prices vary according to clinic, professional and treatment goals. On average, each carboxitherapy session for the body costs between R $ 80 and R $ 150, and for the face between R $ 100 and R $ 170, remembering that at least 10 sessions are usually necessary.

Some beauty centers may offer packages for the complete treatment, so paying for the applications individually tends to be more expensive.

Risks and side effects

The main risks pointed out by professional beauticians involve pain, numbness and burning during application, rupture of small blood vessels – causing bruising – and bleeding, although they are rare.

In general, bruises (purple) tend to disappear quickly, but in some cases, there is a chance that the area will become dark and the stain will become permanent.

In addition, as the procedure pierces the skin – albeit superficially – there is a risk of infection if there is no proper hygiene.

However, it is noteworthy that despite being used for some years, aesthetic therapies based on carbon dioxide have no scientific endorsement and still present themselves as an experimental method, according to a note from the Federal Council of Medicine.

Therefore, although there are few associated and reported risks, knowledge about the efficacy and consequences of the procedure is not yet scientifically established.

In addition, the treatment can be expensive, considering that there will be about 10 sessions or more. But the price cannot be the only – or the main – factor to choose the aesthetic clinic.

The professional’s skill and qualification are very important to achieve a good result. Seek recommendations from people who have already done carboxitherapy and talk directly to the professional who will do the application.

Contraindications: who can’t do it?

Although treatment is less invasive than surgery, for example, there are a number of contraindications. Therefore, before performing the procedure, talk to your doctor and the esthetician dermatologist, informing you about situations such as:

  • Pregnancy or lactation;
  • Healing difficulties;
  • Skin infections or allergies;
  • Obesity or overweight;
  • Lung diseases;
  • Heart diseases;
  • Cancer or tumors;
  • Any type of drug treatment (continuous or punctual);
  • Anemias;
  • Liver changes;
  • Hypertension;
  • Diabetes;
  • Arterial thrombosis.

The search for changes in the body is increasingly facilitated by technologies and development in the field of aesthetics. Carboxitherapy is a procedure that is easy to apply and has quick results that can help improve the appearance of the skin and reduce fats.

The treatment, when combined with healthy eating and physical activity, provides good results to aesthetics, provided they are performed with appropriate and trained professionals.

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