Fundamentals and clinical applications of the fractional CO₂ Laser Microcoring Mode for Treating Aesthetic Disorders

Fractional CO₂ laser therapy has become established as an effective tool for the treatment of aesthetic disorders, promoting tissue regeneration with reduced recovery time. A specific mode, commercially referred to in Brazil as Microcoring, has gained popularity due to its predominantly superficial action, although the term originally described a different, non–laser-based technique. The application of the superficial mode aims to combine aesthetic efficacy with reduced tissue aggressiveness and minimal downtime. To critically analyze the technical fundamentals, biological mechanisms and clinical evidence supporting the use of this kind of laser in the treatment of aesthetic disorders, an integrative narrative literature review was conducted, encompassing publications from 2006 to 2025 indexed in PubMed, Scopus, Web of Science, and Google Scholar. Studies addressing the aesthetic use of fractional CO₂ laser therapy with descriptions of technical parameters and clinical outcomes were included. After screening, 16 studies were selected for qualitative descriptive analysis. The Microcoring mode promotes superficial ablation of the epidermis and papillary dermis with controlled penetration, favoring quick re-epithelialization and collagen remodeling. Studies demonstrated significant improvement in fine wrinkles, superficial scars, irregular skin texture, and enlarged pores, with high patient satisfaction rates and reduced recovery time. The combination with the deep mode (fusion mode) proved effective in the management of more complex conditions. Clinical and histological evidence supports the safety of this approach, including higher skin phototypes, when appropriately parameterized. Finally, microcoring mode of fractional CO₂ laser therapy represents an effective and safe alternative for treating superficial aesthetic disorders, offering advantages such as reduced downtime and lower intraoperative discomfort. However, greater technical standardization, scientific validation, and regulation of terminology are required to ensure reproducibility and promote international recognition of this practice.