NeoGen vs Fractional CO2 Laser: What Nitrogen Plasma Is For

Nitrogen plasma resurfaces without removing tissue, which is what lets it work up to the lash line and leave no open wound behind. Below, what NeoGen treats, what the recovery involves, and where a fractional CO2 laser is the better answer.

What NeoGen does

NeoGen is a nitrogen plasma treatment that heats the skin surface across the whole treated area to stimulate collagen remodelling, without vaporising or removing tissue. From £350 a session including VAT for the smallest areas we treat, such as lip lines or the eye area, with the price depending on the area treated.

Radiofrequency ionises nitrogen gas into plasma, and that plasma delivers heat to the skin. Nothing enters your skin and nothing is taken away. The epidermis is thermally altered but stays exactly where it is, working as a biological dressing while regeneration happens underneath, then separating a few days later.

Three consequences follow from that, and each one is the reason a clinician reaches for NeoGen over something else.

The eye area

Nitrogen plasma can be taken close to the lash line. Most resurfacing can’t comfortably go there, which leaves the crepey, finely lined skin around the eyes among the harder things to treat well.

This is also where NeoGen’s own randomised evidence sits. An evaluator-blinded randomised trial of eighteen people, published in 2019, treated one side of the face with three sessions three weeks apart and left the other side untreated. The treated side scored better on wrinkle grading, on instrument measurement of skin wrinkling, and on melanin index, with patients followed to fourteen weeks. It’s a small trial, split-face rather than against an active comparator, and the device manufacturer was among its funders. Read it as a real effect established modestly, not as a large body of work.

The eye area is what we lead on with NeoGen. It is the only indication with a randomised trial behind it, and nothing else on our menu goes safely to the lash line.

Full-field coverage

Fractional treatments, CO2 included, treat a grid of points and leave untreated skin in between for healing to spread from. NeoGen treats the entire field it passes over. No untreated islands.

That matters when the concern is spread evenly across an area, which is how photodamage and fine lining usually present, as opposed to sitting in discrete spots. Evenly affected skin tends to respond better to even treatment than to a pattern.

The energy also needs no chromophore, so the colour of what you’re treating doesn’t constrain it. That’s a reason to expect lower pigmentary risk than a light-based treatment, though it’s a mechanistic argument and not trial evidence. Temporary darkening was still recorded in the studies.

The recovery, and the intact surface

Because nothing is removed, you’re not left with an open wound to care for. The dried layer that forms is doing a job: it protects new skin forming underneath until it separates on its own.

The published figures. At low energy, re-epithelialisation complete at four days, erythema averaging six, and nine days for a first session to settle. At the higher settings that produce a resurfacing result, four to six days to re-epithelialise, with bronzing and peeling in between.

That’s a real recovery and worth planning around. Any clinic describing this as a lunch-hour appointment is selling you something, I’m afraid. Our day-by-day recovery guide sets out what each stage looks like.

What arrives later is the result. Biopsy three months after a course of three low-energy treatments found a band of new collagen at a mean depth of 72.3 microns, and the studies that followed patients to six months were still measuring improvement at that point.

Where fractional CO2 is the better answer

A fractional CO2 laser emits light at 10,600nm, which water in the skin absorbs. Tissue vaporises in narrow columns, leaving microscopic holes ringed by heat-damaged tissue. Tissue comes out, and the clinician controls how deep the columns go and how much of the surface they cover.

For established acne scarring and significant textural change, that depth does more than nitrogen plasma will. The strongest high-energy nitrogen plasma study treated ten patients with acne scarring at 3.5 to 4.0 joules, two passes, one session. Nine completed six months of follow-up, rating their scarring 33% improved, with blinded physicians putting it at 34%. Worth having, and by the authors’ own assessment less dramatic than multipass ablative CO2 achieves.

So the position is that these are different interventions and depth is the thing NeoGen doesn’t offer. If established scarring is your concern, Fractora radiofrequency microneedling from £400 per session including VAT is the better-evidenced option on our own menu, and a clinic with a CO2 laser is worth speaking to. Recovery from ablative fractional CO2 usually runs to a week or so of visible healing, sometimes longer.

You’ll also see nitrogen plasma sold as CO2-standard resurfacing with less recovery. No independent blinded head-to-head trial of the two has been published, as far as we can find, and nobody claiming equivalence has one to cite.

Frequently asked questions