Thulium vs CO2 Fractional Laser — How to Choose the Right Resurfacing System for Your Clinic

Written by the Pure Tone Aesthetics Editorial Team • Last updated 21 October 2025

Both the Thulium Laser Pro and the Hestia-S CO2 Fractional Laser are powerful tools for skin resurfacing, yet they work in very different ways. Understanding those differences helps clinics plan the right treatment menu, match technology to indication, and maximise both patient results and business growth.

In this guide, Pure Tone Aesthetics compares the two technologies in practical, clinic-ready terms — covering treatment depth, downtime, patient comfort, profitability, and long-term value. Whether you run a busy aesthetics clinic or a medical-led skin practice, this will help you decide which system (or combination) best fits your patients and your business.

Who Should Choose Which?

Clinic takeaway Owning both systems allows total flexibility: Thulium Pro for mild-to-moderate concerns and quick recovery, Hestia-S CO2 for deeper rejuvenation and transformative change.

When to recommend Thulium Laser Pro

• Patient’s main concerns are fine lines, wrinkes, sagging skin, pigmentation, sun spots or uneven tone.
• They want smoother texture, tighter skin and smaller pores with minimal downtime.
• They have a busy lifestyle and can’t take a week off for recovery.
• They prefer gentle maintenance treatments every few months.
• Ideal for Fitzpatrick I–V skin types when treated conservatively.

When to recommend Hestia-S CO2 Fractional

• Patient presents with deeper wrinkles and sagging skin, acne scars or laxity.
• They are ready for longer recovery in exchange for more dramatic improvement.
• They need collagen remodelling and overall skin tightening.
• Best suited to Fitzpatrick I–III skin tones for resurfacing treatments.
• Excellent for once-a-year or flagship rejuvenation packages.

Tip: Offering both Thulium and CO2 allows clinics to provide a complete resurfacing pathway — from ongoing rejuvenation to advanced correction — strengthening loyalty and maximising treatment potential.

Technology Comparison — Thulium Pro vs Hestia-S CO2

How the technologies work

Thulium Pro (1927 nm): targets water in the upper skin layers. It creates controlled micro-channels in the epidermis to remove surface pigment and trigger new cell turnover. This improves tone and texture while leaving the deeper dermis intact.

Hestia-S CO2 (10,600 nm): penetrates deeper, removing tiny columns of tissue and heating surrounding skin. This stimulates collagen synthesis, softens wrinkles and improves scars. It also resurfaces the outer layer for smoother, firmer skin.

Best treatment indications

• Thulium Pro: pigmentation, sun damage, melasma management, rough texture, enlarged pores, fine lines, wrinkles and sagging skin.
• Hestia-S CO2: acne scarring, etched lines, deeper wrinkles and sagging skin, significant photo-ageing and deeper textural issues.

Typical number of sessions

• Thulium Pro: 3–4 sessions spaced 4–6 weeks apart, then maintenance.
• Hestia-S CO2: 1–2 sessions depending on the indication and intensity.

Downtime and visible healing

• Thulium Pro: light redness and flaking for 1–3 days; makeup often possible within 24 hours.
• Hestia-S CO2: redness, swelling and peeling for 5–10 days; strict aftercare required.

Comfort and anaesthesia

• Thulium Pro: mild warming sensation; topical anaesthetic usually sufficient.
• Hestia-S CO2: stronger heat; requires topical anaesthetic and effective cooling.

Skin-type suitability

• Thulium Pro: safe for a wide range of skin tones when performed carefully.
• Hestia-S CO2: ideal for Fitz I–III; use conservative parameters for darker tones.

Treatment Experience — What Patients Feel

Thulium Pro: During treatment, patients feel gentle warmth or tingling as the laser passes across the skin. Afterward, the skin appears pink and slightly tight, similar to a mild sunburn. This typically settles within a day or two, followed by fine flaking as the surface renews.

Hestia-S CO2 Fractional Laser: The energy penetrates deeper, so the sensation is more intense. Patients may feel heat or mild stinging. Post-treatment redness and swelling last longer, and a fine crust forms as healing begins. This gradually peels to reveal new, smoother skin underneath.

Understanding “fractional” technology

Both systems use a fractional delivery pattern, meaning only a fraction of the skin’s surface is treated at one time. Thousands of microscopic columns of energy are delivered, leaving healthy skin between each column to accelerate healing and reduce risk.

Downtime & Recovery

Thulium Pro: Most patients experience one to three days of pinkness and mild flaking. They can resume normal routines almost immediately if clinic aftercare is followed and SPF is applied daily.

Hestia-S CO2: Expect visible healing for around one week. The skin may be red, warm and tight, with peeling by days 4–7. Aftercare and sun avoidance are essential to ensure safe, even healing.

Aftercare guidelines

• Use clinic-approved soothing and hydrating products only.
• Avoid actives such as retinol or acids until skin is fully recovered.
• Apply broad-spectrum SPF 50 daily and avoid direct sun exposure.
• Do not pick or peel flaking skin.

Indications & Typical Outcomes

Thulium Pro: focuses on surface improvements — brighter tone, smoother texture, tighter more lifted skin, refined pores and reduction in fine lines and wrinkles. The effect builds gradually across several sessions.

Hestia-S CO2: delivers structural change — collagen renewal, softening of deep wrinkles, reduced scarring and tighter, more lifted skin. Results continue to improve over several months as new collagen forms.

Can treatments be combined?

Yes. Many clinics perform Thulium sessions to prepare and even out pigmentation, then schedule CO2 sessions for deep resurfacing once the skin is balanced. Always follow your clinic’s treatment spacing and safety protocols.

Clinic Profitability — Building a Balanced Menu

Thulium Pro is a repeatable, high-throughput service ideal for entry-level patients or ongoing maintenance plans. Hestia-S CO2 is the premium, high-value option for significant rejuvenation. Offering both increases patient retention and long-term value, allowing you to deliver visible outcomes at every price point.

Ready-to-Sell Treatment Packages

Clarity & Glow Programme (Thulium-led)

• Ideal for: uneven tone, mild pigmentation, texture issues, fine lines, wrinkless, sagging skin.
• Includes: 3 × Thulium Pro sessions (4–6 weeks apart) plus LED support and home SPF / hydrating serum kit.
• Result: brighter, tighter, lifted and smoother skin with minimal downtime — perfect as a maintenance or seasonal course.

Resurface & Remodel Programme (CO2-led)

• Ideal for: deeper wrinkles and sagging skin, acne scarring and advanced photo-ageing.
• Includes: 1 × Hestia-S CO2 treatment with optional follow-up, full post-care kit and in-clinic review.
• Result: stronger tightening and rejuvenation in fewer sessions with long-lasting improvement.

If You Could Choose Only One Machine — Which Should It Be?

If your clinic is planning to invest in just one resurfacing platform, the decision will depend on your patient demographic, your current treatment portfolio, and how much downtime your clients are willing to accept. Both lasers achieve outstanding skin rejuvenation, but they do so in different ways and on different timescales.

Thulium Laser Pro is the ideal choice if your goal is to deliver visible improvement with minimal disruption to patients’ daily lives. It combines precision and comfort, refining skin tone, improving texture, reducing pigmentation and gradually tightening the skin with repeat treatments. Thulium’s controlled energy stimulates collagen remodelling in the upper and mid layers of the skin, softening fine lines and lifting mild sagging without creating open wounds. Patients love its short recovery time, and clinics benefit from repeat bookings and strong word-of-mouth referrals. For most practices that treat a broad range of skin concerns and want flexibility, Thulium offers a balanced mix of performance, comfort and profitability.

Hestia-S CO2 Fractional Laser becomes the clear choice when your patients present with deeper wrinkles, more advanced photo-ageing, or acne scarring that requires structural change beneath the surface. It reaches deeper into the dermis, creating micro-ablative columns that trigger powerful collagen renewal and tissue tightening. While the treatment is more intense and involves a week or more of visible recovery, it delivers dramatic improvement in as few as one or two sessions. For clinics specialising in corrective skin work or for medical-led practices that want a flagship procedure with strong before-and-after photography results, CO2 offers unmatched impact.

In short, Thulium excels in progressive rejuvenation and ongoing maintenance programmes, while CO2 delivers transformative resurfacing for more severe concerns. Many clinics ultimately find that both complement each other perfectly — starting with Thulium to maintain and brighten, then moving to CO2 when deeper renewal is needed.

Safety & Skin Types

Both systems are clinically proven and safe when used correctly. Proper patient selection, conservative settings for darker tones and thorough aftercare minimise risk. Always follow training protocols and manufacturer guidance.

Pure Tone Training & Support

Every purchase includes full on-site installation, hands-on training, treatment protocols, marketing materials, and post-treatment photography guidance. Our UK-based after-sales team provides fast technical support and advice, ensuring your clinic stays productive and profitable.

FAQs

Is Thulium truly “no downtime”?

Thulium has very short recovery — light redness and flaking for 1–3 days. Most patients can return to normal activities almost immediately.

Which is better for acne scarring?

CO2 fractional is the preferred option for acne scars as it reaches deeper to remodel collagen and smooth uneven texture.

Can Thulium treat melasma safely?

Yes, using low-energy settings and strict sun protection. Thulium is often chosen for pigment-led concerns as it gently resurfaces without deep trauma.

How many treatments are needed?

Thulium: usually 3–4 spaced sessions; CO2: 1–2 sessions depending on severity and desired result.

Which skin tones can be treated?

Thulium suits most tones (Fitz I–V). CO2 is safest for I–III; treat higher tones only with advanced training and conservative parameters.

What anaesthesia is required?

Both use topical anaesthetic. CO2 may require longer numbing time and additional cooling measures.

Can I offer both systems profitably?

Yes. Thulium creates regular appointments and memberships; CO2 attracts premium cases. Together, they balance clinic traffic and revenue.

What training is included?

Comprehensive device training, protocols, marketing tools, and after-sales technical support are included with every purchase.

How should I promote each treatment?

Position Thulium as a gentle “no-downtime glow” treatment, and CO2 as a “transformational resurfacing” solution. Use before-and-after photos and clear recovery timelines.

Can treatments be combined?

Yes. Many clinics use Thulium for pigment and surface refinement before progressing to CO2 for deeper rejuvenation.