Carboxytherapy in Dermatologic Surgery and Aesthetic Medicine: Current Knowledge and Future Perspectives - A Systematic Review

BACKGROUND and OBJECTIVE Carboxytherapy (CXT) is a minimally invasive procedure based on percutaneous or subcutaneous microinjections of carbon dioxide. Due to the Bohr effect, it influences the hemoglobin dissociation curve, improving tissue oxygenation, angiogenesis, facilitating vascular perfusion, and lymphatic drainage. Recent evidence suggests unconventional applications in dermatologic surgery and aesthetic medicine; these are focused with the present review. METHODS A systematic review was conducted by searching the PubMed library from January 2018 to July 2023, using the terms "Dermatologic Surgery, Aging, Rejuvenation, Scars, Cellulite, Alopecia, AND Carboxy therapy."Eligibility criteria included original studies aimed at discussing CXT in dermatologic surgery and aesthetic medicine. RESULTS The final synthesis included 41 articles distinguished by topic into studies on the role of CXT in facial rejuvenation (n.14), in cellulite, scars and fat deposits treatment (n.17), and other pathologic conditions (n.10). Overall, CXT is an effective antiaging treatment. Furthermore, CXT may play a role in several pathologic conditions including alopecia, lichen planopilaris, vitiligo, chronic diabetic wounds, temporomandibular arthralgia, and lipedema. CONCLUSION CXT, by promoting tissue oxygenation and microvascular and vascular perfusion, appears to have promising indications for several aesthetic and pathologic conditions, potentially offering satisfactory results with a minimally invasive, safe, and well-tolerated treatment.