Both laser wavelengths target water within tissue and can be delivered fractionally, treating microscopic areas while leaving surrounding tissue untreated.

The key distinction is how the energy interacts with the skin. Conventional 1927nm fractional Thulium treatment creates controlled thermal zones without the deliberate tissue ablation characteristic of fractional CO₂ resurfacing.

This affects the available treatment techniques, the healing response and the type of patient likely to benefit.

Thulium's generally more manageable recovery profile can make it an appealing option for patients who do not want the healing period associated with intensive ablative resurfacing.

That does not make it a replacement for CO₂. Its value comes from addressing the appropriate concerns using a different treatment approach.

Fractional CO₂ delivers energy into microscopic columns of tissue, producing controlled ablation and an associated thermal response. This provides an established treatment approach for selected acne scars, wrinkles and more significant skin texture changes.

The treatment can require greater preparation, more involved aftercare and a longer visible recovery period than non-ablative fractional treatment.

For the right patient, that recovery may be a reasonable part of pursuing a more intensive resurfacing outcome.

Pure Tone's Hestia S-CO₂ combines fractional resurfacing with precision operating modes and optional specialist functionality. Those capabilities should be considered in relation to the clinic's practitioner expertise and services.

Neither laser has a fixed recovery period that applies to every patient. The response depends on treatment settings, skin phototype, treatment area and individual healing.

Following 1927nm Thulium, temporary redness, warmth, swelling, dryness, bronzing or fine flaking may occur.

Fractional CO₂ generally involves a more significant visible healing response. Depending on the treatment, patients may experience redness, swelling, crusting, peeling and ongoing sensitivity during recovery.

A clinic should explain the expected recovery for the specific procedure rather than using blanket promises such as “no downtime”.

1927nm Thulium treatment may produce warmth, heat or prickling as energy is delivered to the skin. Comfort varies according to the protocol and individual sensitivity.

Ablative CO₂ resurfacing typically requires more substantial comfort and recovery planning, because the procedure removes microscopic areas of tissue.

Both should be delivered by appropriately trained practitioners following machine-specific protocols and a thorough assessment.

Skin phototype, pigmentation history, recent sun exposure, treatment area and previous reactions are important considerations for both Thulium and CO₂.

Post-inflammatory hyperpigmentation (PIH) is a recognised risk after laser treatment. This can be especially important when treating patients with darker skin tones or a history of pigmentary changes.

Ablative resurfacing requires particular care where significant inflammation may increase pigmentary risk. However, non-ablative treatment is not automatically risk-free.

The correct decision depends on individual assessment, available evidence and the practitioner's experience.

Pure Tone's Thulium Laser Pro Dual™ combines 1927nm Thulium with 1550nm Erbium Glass.

The 1550nm wavelength works deeper within the dermis and is particularly relevant to selected acne scars, fine lines, texture and collagen remodelling.

It remains a non-ablative fractional laser technology. It is not equivalent to CO₂ resurfacing and should not be expected to reproduce the same tissue effects.

For clinics seeing patients with mixed pigmentation and texture concerns, access to both 1927nm and 1550nm can provide valuable treatment flexibility.

Published evidence concerning 1927nm Thulium and 1550nm Erbium Glass provides useful context when assessing alternatives to more intensive ablative resurfacing.

A 2022 publication by Friedman and colleagues in Dermatologic Surgery discussed best practices and treatment recommendations for non-ablative fractional 1550nm and 1927nm lasers.

In February 2026, Goldman and colleagues published a review examining 15 studies involving patients with Fitzpatrick skin types III–VI.

The review discussed selected indications including acne scarring, photoageing and pigmentation, while identifying risks of PIH and gaps in the available evidence.

These publications support the importance of patient selection, wavelength choice and treatment parameters. They do not establish that one laser category is universally preferable to another.

Original publications:

Friedman et al. (2022) — Best Practices and Treatment Recommendations

Goldman et al. (2026) — Dual-Wavelength Fractional Lasers in Skin of Colour

We have also reviewed the newer research in detail: Thulium & Erbium Lasers in Skin of Colour — Clinical Evidence Review .

If patient demand is predominantly around pigmentation, tone, brightness and lower-downtime skin renewal, 1927nm Thulium deserves consideration.

If the clinic wants to offer more intensive ablative resurfacing for selected acne scars, deeper wrinkles and significant texture changes, CO₂ may be more relevant.

If the clinic also wants deeper non-ablative fractional treatment, adding 1550nm Erbium Glass may be useful.

And if the clinic already owns one of these technologies, the question becomes what the additional system can contribute to its existing treatment pathways.

Yes, where the clinic has sufficient demand and practitioner expertise to support both.

A patient seeking improvements in superficial pigmentation may be better suited to a Thulium treatment.

Another patient with more pronounced scarring may benefit from a different fractional approach, including ablative CO₂ when appropriate.

The advantage is not simply owning more equipment. It is having appropriate treatment options for different patient needs.

Pure Tone currently offers CPD-approved nurse-led practical training as part of its professional equipment supply.

For advanced laser systems, our approach also recognises the value of specialist laser knowledge and training tailored to the practitioners involved. Any specific arrangements can be discussed before purchase.

We offer flexible finance options and, for qualifying clinics, our Concierge Patient Launch Programme is designed to generate up to 20 verified appointments within the first 60 days. We also limit clinic availability within individual areas.