Med spa service menus, aesthetic dermatology clinics, and social media platforms frequently promote carboxytherapy—the subcutaneous or intradermal injection of medical-grade carbon dioxide ($CO_2$) gas—as a versatile, non-surgical treatment for under-eye dark circles, localized fat deposits, cellulite, and stretch marks. Marketing brochures routinely describe carboxytherapy as a "natural, miracle gas treatment" and frequently label the procedure as "FDA approved."
The regulatory and clinical reality is far more nuanced. No carboxytherapy device has ever been approved or cleared by the U.S. Food and Drug Administration (FDA) for aesthetic indications, body contouring, fat reduction, or dark circle treatment. A comprehensive query of the FDA's 510(k) premarket notification database reveals zero clearances for cosmetic $CO_2$ injection devices, and the FDA's official reference on Non-Invasive Body Contouring Technologies omits carboxytherapy entirely. However, the procedure is not illegal: licensed medical providers can legally perform carboxytherapy using medical-grade gas and standard needles as an off-label use of an FDA-regulated medical gas under general medical practice laws. When examining the peer-reviewed clinical trial literature, carboxytherapy demonstrates modest, small-scale randomized controlled trial (RCT) evidence for vascular under-eye dark circles and stretch marks, but only limited small-sample evidence for cellulite — and for fat reduction, the best available ultrasound trial reported a statistically significant but modest decrease in subcutaneous thickness in only 30 subjects whose whole-body weight also fell during the study, which is nowhere near liposuction- or cryolipolysis-grade fat removal.
Understanding whether carboxytherapy is worth the time, discomfort, and out-of-pocket cost requires evaluating its physiological mechanism, the FDA database findings, the trial evidence across each advertised indication, safety profiles, anatomic danger zones, failure modes, and realistic cost benchmarks.
What Carboxytherapy Is: The Bohr Effect and Historical Origins
Carboxytherapy involves infusing controlled micro-volumes of medical-grade carbon dioxide gas beneath the skin through a fine 30-gauge or 32-gauge needle connected via sterile tubing to an electronic flow-regulator console.
The physiological cascade proceeds in three steps: (1) subcutaneous $CO_2$ injection creates localized hypercapnia (high $CO_2$) and transient tissue acidosis; (2) the Bohr effect — acidic pH and high $CO_2$ shift the hemoglobin-oxygen dissociation curve to the right, so red blood cells rapidly release bound oxygen into the local tissue; and (3) the microvascular and tissue response — acute vasodilation of pre-capillary arterioles (the erythema and warmth patients feel), release of vascular endothelial growth factor (VEGF) driving angiogenesis, and fibroblast activation producing neo-collagenesis and dermal remodeling.
Origins in 1930s French Spa Medicine
The therapeutic use of carbon dioxide gas originated in 1932 at the Royat Thermal Baths in France. Physicians noted that patients with peripheral obliterative arterial diseases, chronic venous insufficiency, and ischemic ulcers experienced accelerated wound healing and improved skin perfusion after bathing in carbon dioxide-rich thermal waters or receiving subcutaneous gas insufflations. Over subsequent decades, European and South American aesthetic practitioners adapted this vascular technique for cosmetic concerns.
The Biophysical Mechanism: The Bohr Effect
Carboxytherapy relies on well-established respiratory physiology:
- Localized Hypercapnia: When pure $CO_2$ is injected subcutaneously, it immediately creates a state of localized high carbon dioxide concentration and transient acidosis (lowered pH) in the interstitial space.
- Oxygen Release (The Bohr Effect): According to the Bohr Effect—first described by Danish physiologist Christian Bohr in 1904—hemoglobin's binding affinity for oxygen decreases in the presence of elevated carbon dioxide and lower pH. As capillary erythrocytes pass through the hypercapnic injection site, they offload large volumes of oxygen into the hypoxic tissue.
- Vasodilation and Angiogenesis: Local arterioles dilate rapidly to wash out the carbon dioxide, significantly increasing capillary blood flow. This transient tissue hypoxia and mechanical distension stimulate the upregulation of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF), promoting capillary sprouting (angiogenesis) and stimulating fibroblasts to synthesize new collagen and elastin fibers.
Is Carboxytherapy FDA Approved? What the Device Databases Show
A pervasive marketing tactic across aesthetic clinics is advertising carboxytherapy as "FDA approved." Prominent medical spa websites in major metropolitan areas explicitly claim that carboxytherapy is "an FDA-approved, safe treatment for fat and skin tightening."
These claims are factually false. An audit of the FDA's Center for Devices and Radiological Health (CDRH) regulatory databases establishes the factual landscape:
| FDA database check | Result |
|---|---|
| 510(k) premarket clearance database | Search for "carboxytherapy" in device names: 0 hits. All 30 "carboxy" matches in the full database are dental zinc polycarboxylate cements or bacteriological decarboxylase culture media — not aesthetic gas-injection devices. |
| Dermatologic "carbon dioxide" device hits | All are Class II powered laser surgical instruments (product code GEX, 21 CFR 878.4810) — $CO_2$ lasers, which cut or ablate tissue with light, an entirely different technology from subcutaneous gas injection. |
| FDA body contouring reference | The FDA's consumer reference on Non-Invasive Body Contouring Technologies covers cryolipolysis, focused ultrasound, radiofrequency, and laser lipolysis — carboxytherapy is not listed as a cleared modality. |
| Legal status in US practice | Medical-grade $CO_2$ is itself an FDA-regulated prescription medical gas (approved for uses such as insufflation and respiratory applications). Using it subcutaneously for cosmetic purposes is an off-label, physician-discretion use under state medical practice acts — legal to perform, but calling it "FDA approved" is a deceptive advertising claim. |
This regulatory pattern mirrors our investigation into how ultrasonic cavitation fared against the FDA 510(k) database: while clinics legally perform the procedure under general medical oversight, claiming that carboxytherapy is "FDA approved" is a major compliance red flag.
Indication-by-Indication Clinical Trial Audit
To evaluate whether carboxytherapy actually works, one must separate the peer-reviewed clinical trial data by anatomical indication. The quality of evidence varies dramatically depending on what you are treating.
| Indication | Clinical evidence grade | Key trial findings and realistic outcome |
|---|---|---|
| Periorbital dark circles (infraorbital vascular rings) | Moderate (small RCTs) | Statistically significant improvement in vascular darkness on objective measurement; fractional CO2 laser performed better in the one head-to-head RCT. |
| Stretch marks (striae distensae) | Moderate-low (small RCTs) | Measurable improvement in elasticity and appearance; inferior to fractional CO2 laser in the split-body RCT. |
| Cellulite (gynoid lipodystrophy) | Low (10-woman pilot + review caveats) | Degree improvement in one small pilot; systematic reviewers flag small samples and heterogeneous outcome measures. |
| Localized fat reduction (subcutaneous adiposity) | Low-moderate (one 30-subject split RCT) | Statistically significant but modest ultrasound-measured subcutis decrease, confounded by concurrent whole-body weight loss; not comparable to cryolipolysis or liposuction. |
1. Under-Eye Dark Circles (Infraorbital Hyperpigmentation)
The strongest clinical evidence supporting carboxytherapy is for periorbital dark circles, specifically dark circles driven by vascular stasis, microcirculatory pooling, and thin lower eyelid skin.
| Study and citation | Population and protocol | Design | Key findings and measured outcomes |
|---|---|---|---|
| J Cosmet Dermatol (2023; PMID: 36065678) | 30 patients, ages 23–52; 4 sessions of each therapy at 2-week intervals | Split-face RCT | Fractional CO2 laser beat carboxytherapy on patient and physician satisfaction; no significant side effects in either group. Authors' conclusion: CO2 laser is the better option for periorbital dark circles. |
| J Cosmet Dermatol (2022; PMID: 34971475) | 80 patients; weekly sessions for 6 weeks | Randomized flow-rate comparison (30 vs 60 mL/min) | Both flow rates significantly improved infraorbital dark circles with no difference between groups; the 60 mL/min rate caused significantly more side effects. |
| Clin Cosmet Investig Dermatol (2024; PMID: 39193094) | 39 participants; 5 sessions per side | Split-face comparison (carboxy alone vs carboxy + chemical peel) | Both sides improved significantly on Mexameter measurement of vascular (erythema index) circles; carboxytherapy combined with lactobionic acid improved the tear-trough vascular index in 82.1% of participants. |
- Vascular Dark Circles: In patients whose dark circles are caused by sluggish venous microcirculation showing through translucent lower eyelid skin, the Bohr effect significantly improves capillary perfusion, clearing pooled deoxygenated blood and improving skin elasticity. A 2026 quantitative imaging study in the Journal of Clinical Medicine (78 patients, 7 weekly sessions; PMID: 42194736) used elastography and vascular-index imaging to confirm measurable increases in periorbital microvascularity and tissue-viscoelasticity changes that tracked with clinical improvement — objective evidence that the vascular mechanism is real, and that radiological-clinical correlation can help with patient selection.
- Limitations on Pigment and Hollows: The same imaging work underscores what carboxytherapy cannot do. It adds no volume, so a structural tear-trough hollow (which requires dermal fillers or fat transposition) and deep dermal hypermelanosis (which responds better to targeted lasers or chemical peels) will not respond. For a comprehensive breakdown of causes, consult our guide on treatment options for dark under-eye circles by cause.
2. Stretch Marks (Striae Distensae)
Stretch marks represent dermal scars characterized by thinned epidermal layers, damaged collagen bundles, and fragmented elastin networks.
- Split-Body Comparison vs. Fractional Laser: A randomized split-body clinical trial published in Dermatologic Therapy (2022; PMID: 35762297) treated 30 patients with striae distensae — one side with fractional $CO_2$ laser, the contralateral side with carboxytherapy in the same session, six sessions four weeks apart. Both sides improved significantly (striae width decreased, ultrasound-measured dermal thickness increased), but the laser side won on global aesthetic improvement, patient satisfaction, and ultrasound measures ($P < 0.01$). Carboxytherapy's practical advantages are its non-ablative profile — no laser wounds, no healing interval — which matters for patients whose darker phototypes make them wary of post-inflammatory hyperpigmentation from ablative lasers, though the trial itself did not compare PIH rates between the two sides.
- Elasticity Improvements: An objective cutometric study published in the Journal of Cosmetic Dermatology (2018; PMID: 29214715) followed 15 women through 3 weekly carboxytherapy sessions over stretch marks on the stomach, buttocks, and thighs. Cutometer measurements showed statistically significant improvement in skin elasticity parameters ($R2$ and $R8$) within the striae ($P < 0.05$), and photographic documentation showed a 58% average improvement in stretch-mark visibility. See our overview of evidence-graded stretch mark treatments for comparative benchmarks.
3. Cellulite (Gynoid Lipodystrophy)
Med spas heavily promote carboxytherapy as a "cellulite eraser." However, when evaluating the structural pathophysiology of cellulite, the evidence is substantially weaker.
- The Pathophysiological Ceiling: Cellulite is caused by rigid, vertical fibrous septae pulling the skin downward while subcutaneous fat lobes herniate upward into the reticular dermis. Subcutaneous $CO_2$ gas injection does not sever or dissolve these dense fibrous connective tissue bands.
- Clinical Trial Findings: A pilot trial published in Clinical, Cosmetic and Investigational Dermatology (2016; PMID: 27578994) reported a significant reduction in cellulite grade (degree III to degree II, $P = 0.0025$) in 10 women after 8 weekly sessions, correlated with reorganization of fibrous lines on panoramic ultrasound. But the trial was tiny and unblinded, and reviewers are blunt about the bigger picture: a systematic review in the Journal of Cosmetic Dermatology (2022; PMID: 35124882) pooled 27 studies and found that while most reported improvement, sample sizes per condition were small, outcome measures were inconsistent across studies, and fat-targeting studies showed varying degrees of recurrence. A 2026 narrative review in Plastic and Reconstructive Surgery (PMID: 42154480) likewise concluded that further research is needed before comprehensive clinical guidelines can be written.
- Registry Status: A registered clinical trial evaluating carboxytherapy combined with Nd:YAG laser and subcision for cellulite (ClinicalTrials.gov: NCT05405062, enrollment 30) currently lists its official status as UNKNOWN with no published outcome data. For long-term structural release, compare these results with what actually works for cellulite.
4. Localized Fat Reduction: The Ultrasound-Measured Reality
The boldest marketing claim for carboxytherapy is non-surgical "fat destruction" or "gas lipolysis."
| Evidence layer | What it actually shows |
|---|---|
| Histological findings (Brandi et al., 2001; PMID: 11426306) | The foundational study injected $CO_2$ into subcutaneous fat and reported adipocyte membrane damage consistent with mechanical gas distension — a biological plausibility signal, not a clinical outcome. |
| Objective ultrasound RCT (Arch Dermatol Res 2025; PMID: 40459592) | A prospective, randomized, single-blind split-abdomen trial in 30 obese subjects: 5 sessions every 2 weeks on one side, untreated contralateral side as control. Two weeks after the last session, ultrasound showed a statistically significant decrease in subcutis thickness on the treated side. The authors concluded carboxytherapy is "a safe and effective modality in the management of local fat deposits." |
| The confounds reviewers point to | The same subjects' mean weight, BMI, and waist circumference all fell significantly during the trial — whole-body loss is not separable from the treated-side effect at this sample size. It is a single-blind, 30-subject, 12-week study with no long-term follow-up. |
| Bottom line for patients | Gas injections may produce a measurable, modest thinning of subcutaneous fat in small trials, and the 2026 PRS narrative review characterized the lipolytic effect as "mild." That is categorically different from cryolipolysis's durable ~20–25% fat-layer reduction per cycle or surgical liposuction. Patients expecting visible waistline slimming or abdominal fat elimination will be disappointed. |
So the honest reading is not "carboxytherapy does nothing to fat" — it is that the fat-reduction evidence rests on one small, confounded split-abdomen trial plus histology, while the effect size on offer is far closer to "mild" than to the before-and-after photos used to sell treatment packages.
Modality Head-to-Head: Carboxytherapy vs. FDA-Cleared Alternatives
To help patients and clinicians make evidence-based decisions, the following matrix compares carboxytherapy directly against FDA-cleared aesthetic technologies for the same target concerns:
| Modality and mechanism | Primary indication | FDA regulatory status | Clinical durability and cost |
|---|---|---|---|
| Carboxytherapy (subcutaneous $CO_2$ gas) | Vascular dark circles, striae distensae | Zero 510(k) clearances for aesthetic use | Modest/temporary; $75–$200 per session, typically 6–10 sessions |
| Cryolipolysis (CoolSculpting, controlled cooling) | Localized fat reduction (abdomen, flanks, thighs) | Class II cleared (product code OOK) | Durable ~20–25% fat-layer reduction per cycle; $750–$1,500 per applicator cycle |
| Fractional $CO_2$ laser (ablative micro-beams) | Stretch marks, atrophic scars, deep periorbital rejuvenation | Class II cleared (product code GEX) | Long-lasting collagen gain; $800–$2,500 per treatment |
| High-intensity focused ultrasound (Ultherapy-class) | Non-invasive subcutaneous fat reduction and skin lifting | Class II cleared (product code OHV) | Moderate focal reduction; $1,200–$3,000 per treatment |
| Hyaluronic acid filler (Restylane / Juvéderm) | Structural tear-trough hollowing | Class III PMA approved (specific indications) | Immediate volume, 9–18 months; $700–$1,200 per syringe |
Anatomic Danger Zones and Injection Protocols
Administering subcutaneous gas requires precise anatomical knowledge to maximize clinical response and prevent avoidable tissue complications:
| Target anatomical zone | Needle gauge and insertion | Gas volume and flow rate | Anatomic safety guardrail |
|---|---|---|---|
| Infraorbital lower eyelid (periorbital tear trough) | 30G–32G at 15° to 30° (superficial intradermal) | 10–20 mL total per eye; flow rate 10–20 mL/min | Direct needle away from the globe; stay on the orbital rim. |
| Striae distensae (abdomen, hips, breasts) | 30G at 15° to 30° (intradermal linear thread) | 50–100 mL per striation; flow rate 30–50 mL/min | Inject along the atrophic stretch-mark band directly. |
| Gluteal and thigh cellulite (subcutaneous adipose) | 30G at 45° to 90° (subcutaneous fat layer) | 200–500 mL per zone; flow rate 50–100 mL/min | Avoid intravascular puncture; aspirate first. |
1. The Periorbital Danger Zone
The skin of the lower eyelid is among the thinnest in the human body (less than 0.5 mm). When performing periorbital carboxytherapy:
- The needle must be inserted at a shallow 15-degree angle, resting above the orbicularis oculi muscle.
- The injector must anchor their finger along the infraorbital rim to prevent the needle tip from angling superiorly toward the orbital septum or globe.
- High gas volumes or excessive flow rates must be strictly avoided to prevent uncomfortable retrobulbar pressure sensations or eyelid edema.
2. Intradermal vs. Subcutaneous Depth
- For Stretch Marks and Dark Circles: The injection must be intradermal (superficial). Gas tracking within the reticular dermis causes immediate blanching and mechanical stretching of collagen bundles, which triggers fibroblast neo-collagenesis.
- For Cellulite and Adipose Tissue: The injection must be subcutaneous (at a 45-degree to 90-degree angle). Injecting superficial gas into dense cellulite without reaching the fat layer produces surface crepitus without altering underlying microcirculation.
Why Carboxytherapy Fails: Common Clinical Failure Modes
Patients who express dissatisfaction with carboxytherapy usually experience one of three common clinical failure modes:
- Treating Structural Tear Troughs as Vascular Rings: If under-eye darkness is caused by loss of the sub-orbicularis oculi fat (SOOF) pad or a deep congenital tear-trough depression, no amount of $CO_2$ gas will fill the structural hollow. The shadow is caused by overhead lighting casting a physical shadow over a bone depression. This requires volume restoration with a cohesive hyaluronic acid gel or autologous fat transfer.
- Expecting Liposuction-Level Fat Removal: Marketing that promises "melted fat" sets an impossible expectation. Because $CO_2$ gas does not freeze adipocytes (cryolipolysis) or thermally coagulate them (HIFU), the fat-layer change on offer is the "mild lipolysis" of the review literature — not a visible waistline transformation.
- Inadequate Treatment Frequency: The Bohr effect is a temporary physiological stimulus. Undergoing 1 or 2 isolated sessions produces transient flushing that fades within 48 hours. Meaningful collagen remodeling requires a disciplined series of 6 to 10 sessions spaced 7 to 14 days apart.
Injectable Carboxytherapy vs. At-Home Carboxy Gel Masks
Consumer confusion is compounded by the popularity of over-the-counter "Carboxy Gel Masks" sold online and in beauty stores.
| Feature | Medical injectable carboxytherapy | At-home carboxy gel mask |
|---|---|---|
| Modality and delivery | Subcutaneous needle injection | Topical gel + dry sheet |
| Gas source | Pure medical-grade $CO_2$ from a pressurized tank | Chemical reaction: sodium bicarbonate + citric acid |
| Depth of penetration | Deep subcutaneous and dermal | Superficial stratum corneum |
| Physiological effect | True local Bohr effect; capillary vasodilation | Surface tingling, mild exfoliation, hydration |
| Regulatory classification | Off-label medical procedure using a prescription medical gas | Topical cosmetic product |
Topical carboxy masks produce surface carbonation that gently exfoliates and increases temporary superficial blood flow, giving skin a refreshed glow. However, they cannot deliver gas through the dermis to replicate the vascular remodeling of medical needle injections.
Safety, Adverse Events, and the MAUDE Database
Carboxytherapy is generally considered a safe, low-risk procedure when administered by a trained medical professional using sterile technique, but it involves distinct procedural sensations and temporary side effects.
| Side effect or sensation | Typical duration | Clinical description |
|---|---|---|
| Burning / pressure sensation | During injection (2–5 min) | Mechanical stretch of tissue by gas. |
| Subcutaneous crepitus (subcutaneous emphysema) | 30 minutes to 2 hours | A "crackling" or spongy sensation under the skin as gas absorbs into tissues. |
| Localized erythema and heat | 1 to 4 hours | Intense vascular flushing and warmth. |
| Injection-site bruising | 3 to 7 days | Minor hematomas from needle punctures. |
The MAUDE Database Reporting Channel Gap
An inspection of the FDA's Manufacturer and User Facility Device Experience (MAUDE) database across 432,301 aesthetic device adverse-event reports reveals zero reports for carboxytherapy.
It is vital to understand this metric correctly: this zero does not prove absolute safety. Because carboxytherapy devices are not cleared medical devices with mandatory manufacturer reporting channels under 21 CFR 803, adverse events are simply not captured within the FDA's formal surveillance system.
Contraindications
Carboxytherapy should not be performed in individuals with:
- Severe cardiovascular disease or uncontrolled hypertension
- Acute thrombophlebitis or history of pulmonary embolism
- Active skin infections or open wounds at the injection site
- Severe respiratory insufficiency or COPD (impaired $CO_2$ elimination)
- Pregnancy or active breastfeeding
Treatment Protocols, Session Costs, and Med Spa Red Flags
If you choose to pursue carboxytherapy—particularly for vascular dark circles or stretch marks—understanding the standard treatment course and cost math prevents overpaying.
| Indication | Recommended sessions | Frequency | Total treatment cost |
|---|---|---|---|
| Under-eye dark circles | 4 to 6 sessions | Every 1–2 weeks | $300 to $900 |
| Stretch marks (striae) | 6 to 10 sessions | Every 2 weeks | $600 to $1,500 |
| Cost per individual session | $75 to $200 per area | — | — |
Critical Med Spa Red Flags
- Red Flag 1: "FDA Approved for Fat Loss." Any clinic claiming carboxytherapy is FDA-approved for fat reduction is misrepresenting regulatory facts.
- Red Flag 2: Single-Session "Miracle" Promises. Carboxytherapy is a cumulative biological therapy; anyone promising complete resolution in one session is being untruthful.
- Red Flag 3: Lack of Medical Oversight. Injections must be performed with single-use sterile needles, medical-grade $CO_2$ tanks with 0.2-micron antibacterial filters, and sterile technique by a licensed provider.
Frequently Asked Questions
Is carboxytherapy the same as carboxy gel masks sold for home use?
No. Injectable carboxytherapy delivers pure medical-grade $CO_2$ directly into the subcutaneous tissue via a micro-needle to trigger the vascular Bohr effect. At-home carboxy gel masks produce surface carbonation through a topical cosmetic chemical reaction, providing superficial exfoliation without deep tissue vascular remodeling.
Does carboxytherapy hurt, and what does recovery look like?
Most patients describe the injection as a strange, stinging, or heavy pressure sensation that lasts 2 to 5 minutes as the gas expands. Immediately afterward, you will feel a crackling sensation under the skin (subcutaneous crepitus) that resolves within 1 to 2 hours as the $CO_2$ is absorbed into the bloodstream and exhaled by the lungs. There is no downtime, though minor bruising can occur.
How many carboxytherapy sessions will I need, and how long do results last?
Under-eye dark circles typically require 4 to 6 sessions spaced 1 to 2 weeks apart. Stretch marks generally require 6 to 10 sessions. Results for dark circles can last 6 to 12 months, with occasional maintenance sessions recommended.
Is carboxytherapy safe around the eyes?
When performed by an experienced medical provider using low flow rates (typically 10 to 20 mL/min) and precise superficial placement along the infraorbital rim, carboxytherapy is safe. Providers must avoid injecting into the eyeball itself or using excessive gas volumes that could cause uncomfortable tissue distension.
What happens if CO2 gas accidentally enters a blood vessel?
Carbon dioxide is exceptionally soluble in human blood (more than 20 times more soluble than oxygen or nitrogen). When injected in small cosmetic volumes (10 to 50 mL), any microscopic intravascular entry is rapidly dissolved in plasma and cleared by pulmonary gas exchange, unlike atmospheric air embolisms which carry high ischemic risks. However, providers should still aspirate before large subcutaneous infusions.
Can carboxytherapy be combined with PRF or chemical peels?
Yes. Clinical trials (such as CCID 2024; PMID: 39193094) demonstrate that combining carboxytherapy with superficial chemical peels or platelet-rich fibrin (PRF) produces synergistic improvements in tear-trough darkness, addressing vascular pooling and epidermal melanin simultaneously.
Sources
- FDA — Non-Invasive Body Contouring Technologies (Aesthetic Cosmetic Devices): https://www.fda.gov/medical-devices/aesthetic-cosmetic-devices/non-invasive-body-contouring-technologies
- Plastic and Reconstructive Surgery — Carboxytherapy in Aesthetic Medicine and Aesthetic Surgery: A Narrative Review (2026): https://pubmed.ncbi.nlm.nih.gov/42154480/
- Journal of Cosmetic Dermatology — Carboxytherapy in dermatology: A systematic review (2022): https://pubmed.ncbi.nlm.nih.gov/35124882/
- Journal of Cosmetic Dermatology — Comparison of the efficacy of carboxytherapy versus fractional CO2 laser for periorbital dark circles (2023): https://pubmed.ncbi.nlm.nih.gov/36065678/
- Clinical, Cosmetic and Investigational Dermatology — The impact of carboxytherapy and combined treatments on dark circles (2024): https://pubmed.ncbi.nlm.nih.gov/39193094/
- Archives of Dermatological Research — Assessment of efficacy of carboxytherapy in reducing thickness of abdominal subcutaneous fat (2025): https://pubmed.ncbi.nlm.nih.gov/40459592/
- Dermatologic Therapy — Split body comparative clinical and radiological study of fractional CO2 laser versus carboxytherapy in treatment of striae distensae (Farouk et al., 2022): https://pubmed.ncbi.nlm.nih.gov/35762297/
- Journal of Cosmetic Dermatology — Cutometric assessment of elasticity of skin with striae distensae following carboxytherapy (Podgórna et al., 2018): https://pubmed.ncbi.nlm.nih.gov/29214715/
- Aesthetic Plastic Surgery — Carbon dioxide therapy in the treatment of localized adiposities: clinical study and histopathological correlations (Brandi et al., 2001): https://pubmed.ncbi.nlm.nih.gov/11426306/
- Journal of Clinical Medicine — Advanced diagnostic imaging and evaluation of periorbital dark circles (2026): https://pubmed.ncbi.nlm.nih.gov/42194736/
- Healthline — What You Should Know About Carboxytherapy: https://www.healthline.com/health/carboxytherapy
- ClinicalTrials.gov — Efficacy of Treatment of Cellulite Using Carboxy Therapy (NCT05405062): https://clinicaltrials.gov/study/NCT05405062
