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Literature-based assessment · Updated July 2026
Questions and Answers About Carboxytherapy
What is carboxytherapy, how should the published evidence be interpreted, and how does the procedure differ from PRP? This publicly accessible professional article is aimed primarily at practices and professional users.
01Different proceduresCarboxytherapy uses carbon dioxide. PRP is prepared from the patient’s own blood.
02No blanket efficacy claimStudy results apply only to the procedure, protocol and field of use that were actually investigated.
03No general combination recommendationIndividual comparative studies do not justify a general recommendation to combine carboxytherapy and PRP.
In brief
Carboxytherapy involves the controlled application of carbon dioxide to or into tissue. Scientific publications examine a range of aesthetic and dermatological questions. Depending on the field of use, however, the evidence varies and is often limited by small sample sizes, differing protocols or short follow-up periods.
Carboxytherapy and PRP are not variants of the same method. Their source material, technology, process parameters and risks differ. This article therefore does not suggest that one procedure can generally replace the other.
Editorial and commercial context: prpmed currently does not sell carboxytherapy devices or consumables. Commercial links to the PRP range are clearly identified later in the article. These links do not imply that PRP is suitable for a particular medical or aesthetic question.
Contents of this article
01
What is carboxytherapy?
The term covers different invasive and non-invasive procedures. They should not be treated as technically or clinically equivalent.
Direct answer
Carboxytherapy refers to procedures in which carbon dioxide, or CO₂, is applied in a controlled manner to or into tissue. A distinction must be made between invasive applications involving intradermal or subcutaneous gas delivery and non-invasive systems intended to release carbon dioxide at the skin surface.
A CO₂ injection using a regulated device, a gas supply and sterile single-use materials is not technically comparable with a cosmetic mask or topical gel. Penetration depth, dosage, risks and the published evidence differ.
Invasive procedure
Injectable carboxytherapy
Carbon dioxide is delivered intradermally or subcutaneously through a needle. Gas volume, flow rate, pressure, application depth and target area depend on the protocol.
Because the skin barrier is penetrated, injection-specific risks and requirements for qualification, hygiene, informed consent and documentation must be considered.
Non-invasive procedure
Topical CO₂ systems
Masks, gels or combined cosmetic systems are intended to generate or release carbon dioxide at the skin surface through a chemical reaction.
Findings from studies of injectable carboxytherapy cannot automatically be transferred to such products. The specific system, its intended purpose and the data available for it are decisive.
Do not confuse it with CO₂ laser treatment: Fractional or ablative CO₂ lasers use laser energy. Carboxytherapy, by contrast, is based on the application of carbon dioxide gas or topical systems intended to release CO₂.
02
How is carboxytherapy proposed to work?
A biologically plausible mechanism is not the same as a clinically proven benefit.
Direct answer
Local changes in microcirculation, the oxygen–carbon dioxide balance and mechanical or metabolic tissue reactions are discussed. These mechanisms do not, by themselves, establish general clinical efficacy.
After local CO₂ application, the carbon dioxide concentration in the tissue rises temporarily. In connection with the Bohr effect, this may influence the release of oxygen from haemoglobin. Vascular reactions and possible effects on tissue structures are also discussed.
Whether this produces a clinically relevant benefit must be assessed for the specific question using suitable studies. Relevant factors include the comparator group, outcome measures, follow-up period and precise description of the protocol used.
Microcirculation
Local vascular reactions are described as a possible component of the proposed mechanism.
Tissue response
Chemical, mechanical and local inflammatory reactions may be involved, depending on the method of application.
No guarantee of success
A proposed mechanism does not replace robust clinical evidence for a specific treatment objective.
03
Which questions have been investigated?
Mention in a publication does not amount to general recognition, authorisation or a treatment recommendation.
Scientific publications have examined skin texture, periorbital hyperpigmentation, local subcutaneous fat, the appearance of cellulite, striae, scars and selected dermatological questions, among other topics. [1] [2]
Important distinction: Results may only be related to the procedure, protocol and study population that were actually investigated. Data on CO₂ injections do not automatically demonstrate an effect of a mask, gel or another device.
Aesthetic questions
- Periorbital hyperpigmentation
- Skin texture and age-related skin changes
- Local subcutaneous fat
- Appearance of cellulite
- Striae and scars
Dermatological research
- Selected forms of hair loss
- Individual pigment disorders
- Adjunctive approaches for certain skin changes
- Combinations with other dermatological procedures
The strength of the evidence is not the same in every field.
04
How should the evidence be interpreted?
The available publications do not provide a uniform picture for all advertised fields of use.
Direct answer
Clinical studies and reviews are available for some narrowly defined questions. Overall, however, the evidence is heterogeneous. Common limitations include small samples, differing protocols, absent control groups and short follow-up periods.
A 2022 systematic review summarised several dermatological fields of use. Because methods and study quality varied, it does not support a single conclusion for all applications. [1] Another review describes possible disadvantages and adverse reactions alongside the effects investigated. [2]
Periorbital hyperpigmentation
Carboxytherapy and PRP have been examined in smaller comparative studies. A systematic review of the eye area also points to the limited quality and comparability of much of the evidence. [4] [5] [6]
Limited and indication-specificLocal abdominal fat
A randomised clinical trial reported a temporary reduction in subcutaneous fat. The observed effect was not maintained over time. [3]
Temporary study signalStriae, skin appearance and cellulite
Smaller clinical studies and case series are available. Differences in gas volume, application depth, treatment intervals and outcome measures limit transferability.
Heterogeneous evidenceComparison with PRP
Direct comparisons address individual questions. They do not establish general equivalence or overall superiority of either procedure.
No general rankingFor practice: General statements such as “promotes collagen”, “activates circulation” or “regenerates the skin” are not sufficient grounds for a specific clinical or purchasing decision. The individual system, intended purpose, protocol, user qualification and available evidence must be assessed.
05
Is carboxytherapy safe and painless?
Blanket claims such as “risk-free”, “painless” or “suitable for everyone” are not professionally defensible.
Direct answer
Adverse reactions and procedure-specific risks are possible. Their type and frequency depend on the route of application, treatment area, gas volume, technique, device and individual circumstances.
With invasive applications, the literature describes pressure, pain, burning, redness, swelling, bruising and gas collections in the subcutaneous tissue, among other reactions. [2] General risks of invasive procedures also apply, including infection, needle-related injury and errors in device settings or application.
Possible local reactions
- Pain, burning or a feeling of pressure
- Redness and local warmth
- Swelling or bruising
- Temporary crackling in the subcutaneous tissue
- Local tenderness
Possible sources of error
- Unsuitable or non-approved components
- Incorrect flow, pressure or volume settings
- Unsuitable application depth or target area
- Deficiencies in hygiene or single-use materials
- Insufficient medical history or risk assessment
Which contraindications must be considered?
A definitive online list that applies to every system and every application would not be reliable. The instructions for use and intended purpose of the specific system, the type and area of application, health status, concomitant medication and individual medical assessment are decisive.
General online information does not replace medical history, examination, informed consent or product-specific risk assessment.
06
What should practices review before introducing the procedure?
Introducing an invasive procedure is not merely a purchasing decision.
Practice owners should jointly assess technical, hygiene-related, staffing, medical and legal requirements.
Technology and materials
System and compatibility
- A system suitable for the intended use
- Gas quality and supply in line with manufacturer information
- Controllable gas volume, flow and pressure parameters
- Approved tubing, filters, adapters and needles
- Maintenance, functional checks and documentation
Organisation and responsibility
Qualification and workflow
- Appropriate professional qualification of users
- Procedure-specific standard operating procedures
- Medical history, informed consent and documented agreement
- Hygiene plan and disposal of single-use materials
- A defined response to adverse reactions
Who may perform carboxytherapy? There is no universally applicable answer. Relevant factors include the exact type of procedure, professional qualification, national law and the intended purpose of the system used. These points should be professionally reviewed for the actual practice location before the procedure is introduced.
07
Carboxytherapy and PRP: what is the difference?
Both procedures are discussed in aesthetic and regenerative medicine, but they are based on different principles.
Direct answer
Carboxytherapy uses carbon dioxide. PRP is prepared from the patient’s own blood by centrifugation. The source material, equipment, process parameters and risks differ fundamentally.
PRP using the patient’s own source material
For PRP, venous blood is collected and centrifuged using a system intended for this purpose. The aim is to obtain a plasma fraction whose composition depends on the system and process used. Relevant factors include the tube, anticoagulant, separation gel, rotor, relative centrifugal force, run time and collection technique.
A more detailed assessment is available in the article PRP treatment: procedure, effects and limitations.
| Feature | Carboxytherapy | PRP |
|---|---|---|
| Source material | Carbon dioxide or a topical CO₂ system | The patient’s own venous blood |
| Basic principle | Local application or injection of CO₂ | Blood collection, centrifugation and recovery of a plasma fraction |
| Technical equipment | CO₂ system, gas supply, tubing, filters and, where applicable, needles | Suitable centrifuge, PRP tubes, blood collection materials and accessories |
| Critical parameters | Gas volume, flow, pressure, depth, area and treatment interval | Tube type, additives, RCF, run time, rotor and collection technique |
| Evidence | Varies by question and is often limited | Varies by indication, preparation and protocol |
| Available from prpmed | No carboxytherapy systems at present | Tubes, sets, centrifuges and accessories for professional PRP workflows |
Can carboxytherapy and PRP be combined?
Smaller studies have compared both procedures for individual aesthetic questions. [5] [6] They do not establish a general recommendation to use carboxytherapy and PRP together or in a particular sequence.
A professional assessment would need to consider the objective, sequence, interval, cumulative tissue irritation, infection risk, aftercare and evidence for the specific question.
Can PRP generally replace carboxytherapy?
No. General interchangeability cannot be inferred. A meaningful comparison requires the same clinical question, comparable populations, clearly described protocols and relevant clinical outcomes.
08
Which materials are part of a PRP workflow?
Selection must be based on the intended purpose, instructions for use and compatibility of the components.
Blood collection, tube system, centrifuge, rotor, process parameters and sterile downstream handling should be considered as one connected workflow. Individual products should not be selected or used solely on the basis of a general blog statement.
Commercial links to our range: The following links lead to prpmed shop categories. They are not recommendations for a particular medical indication.
Practice equipmentPRP starter setsPreconfigured sets for professional PRP workflows. Contents, intended purpose and compatibility must be checked for each set.View starter setsPreparationPRP tubesTube systems with different additives, pack sizes and technical characteristics.View PRP tubesDevice technologyCentrifugesDevices for professional sample and PRP workflows. Regulatory status and intended purpose differ by model.Compare centrifugesBlood collectionBlood collection accessoriesSafety and butterfly systems in different versions for professional blood collection.View blood collection accessoriesCalculation aidRCF/RPM calculatorMathematical conversion of RCF and RPM using the actual rotor radius. This is not device-specific approval.Open calculatorFundamentalsWhat are PRP tubes?Professional article on additives, intended purpose, centrifugation parameters and system differences.Read professional article
Technical note: RPM values must not be transferred from one centrifuge to another without verification. The relative centrifugal acceleration acting on a sample depends on speed and rotor radius. Manufacturer information, intended purpose and the protocol specified for the system remain decisive.
09
Frequently asked questions about carboxytherapy
Concise answers without individual treatment advice.
What is carboxytherapy in simple terms?
Carboxytherapy is the controlled application of carbon dioxide to or into tissue. In invasive procedures, CO₂ is delivered through a needle. Non-invasive systems release carbon dioxide at the skin surface.
Is non-invasive carboxytherapy the same as a CO₂ injection?
No. Topical systems and injection procedures differ technically, in penetration depth and in the evidence available.
Is the efficacy of carboxytherapy generally scientifically established?
No general efficacy claim can be made for all advertised fields of use. Studies exist for individual questions, but their quality and transferability vary.
Is carboxytherapy painless and risk-free?
No. Pain, burning, pressure, redness, swelling, bruising and other adverse reactions are possible. Invasive applications also involve general injection risks.
How many carboxytherapy sessions are required?
There is no generally valid number. It depends on the specific procedure, protocol, objective and individual circumstances.
Can carboxytherapy permanently remove local fat?
A randomised trial reported a temporary effect that was not maintained. It does not support a blanket claim of permanent fat removal.
Is carboxytherapy the same as PRP?
No. Carboxytherapy uses carbon dioxide. PRP is prepared from the patient’s own blood by centrifugation.
Can PRP and carboxytherapy be combined?
Individual studies compare the two procedures for selected questions. They do not establish a general recommendation regarding combination or sequence.
Which materials are required for PRP?
Depending on the system, suitable tubes, a compatible centrifuge, blood collection materials, syringes, needles and further accessories are required. Intended purpose, instructions for use and compatibility are decisive.
Does prpmed sell carboxytherapy devices?
prpmed currently does not sell carboxytherapy devices or consumables. Products and professional information for PRP workflows are available.
10
Selected scientific sources
The sources concern carboxytherapy, periorbital hyperpigmentation and individual direct comparisons with PRP.
- Najmeh Ahramiyanpour, Mohammad Shafie'ei, Nastaran Sarvipour, Rezvan Amiri, Zahra Akbari: Carboxytherapy in dermatology: A systematic review. Journal of Cosmetic Dermatology, 2022. PubMed PMID 35124882
- George Kroumpouzos, Gulhima Arora, Martin Kassir, Hassan Galadari, Uwe Wollina, Torello Lotti, Stephan Grabbe, Mohamad Goldust: Carboxytherapy in dermatology. Clinics in Dermatology, 2022; 40(3):305–309. PubMed PMID 35667826
- Murad Alam, Divya Sadhwani, Amelia Geisler, Imran Aslam, Inder Raj S. Makin, Daniel I. Schlessinger, Wareeporn Disphanurat, Marisa Pongprutthipan, Nataya Voravutinon, Alexandra Weil, Brian R. Chen, Dennis P. West, Emir Veledar, Emily Poon: Subcutaneous infiltration of carbon dioxide (carboxytherapy) for abdominal fat reduction: A randomized clinical trial. Journal of the American Academy of Dermatology, 2018; 79(2):320–326. PubMed PMID 29698710
- Lauren Michelle, Delila Pouldar Foulad, Chloe Ekelem, Nazanin Saedi, Natasha Atanaskova Mesinkovska: Treatments of Periorbital Hyperpigmentation: A Systematic Review. Dermatologic Surgery, 2021; 47(1):70–74. PubMed PMID 32740208
- Eman Nofal, Reham Elkot, Ahmad Nofal, Fatma Eldesoky, Shymaa Shehata, Maha Sami: Evaluation of carboxytherapy and platelet-rich plasma in periorbital hyperpigmentation: A comparative clinical trial. Journal of Cosmetic Dermatology, 2018. PubMed PMID 29297970
- Samar M. El-Tahlawi, Marwa M. Fawzy, Zeinab El Maadawi, Sara M. Yasen, Nesreen M. Aboraia: Platelet-rich plasma versus carboxytherapy in the treatment of periorbital dark circles: A split-face study. Journal of Cosmetic Dermatology, 2022. PubMed PMID 35514239
Further PRP information and professional products
Are you reviewing the technical equipment for a professional PRP workflow? Here you will find PRP sets, tubes and centrifuges for medical professionals.
Commercial notice: the linked pages belong to the prpmed product range. Product selection must be based on the relevant intended purpose, instructions for use and system compatibility.
Content notice: This article provides general, literature-based information. It does not contain an individual diagnosis, treatment recommendation, guarantee of success or instructions for performing a procedure. The individual medical assessment, intended purpose and instructions for use of the products, internal standard operating procedures and the legal and professional requirements applicable at the place of use remain decisive. A disclaimer cannot correct an inaccurate or misleading factual statement; the article itself has therefore been written cautiously.