Carboxytherapy: Does It Hurt? A Complete Guide to Pain and How to Manage It

What you feel during carboxytherapy

Carboxytherapy consists of injecting carbon dioxide (CO2) under the skin through a very thin needle. The gas diffuses into the tissues, improves circulation, and stimulates local metabolism.

Does it hurt? The honest answer: it depends on the area and your sensitivity. But in most cases, the discomfort is tolerable.

Typical sensations

During the injection:

Small initial prick (very thin needle, 30G)
Sensation of pressure or swelling under the skin
Crackling (the gas diffusing into the tissues — a peculiar sound and feeling)

Immediately after:

Sensation of heaviness or tension in the area
Possible slight burning (lasts a few minutes)
Transient redness

The day after:

Small bruises at the injection sites (normal)
Slight sensitivity to touch

Area by area

Thighs and buttocks (cellulite):

The most common treatment. Pain: low-moderate. The injections are multiple but superficial. The crackling sensation is more strange than painful.

Abdomen:

Pain: low. The skin of the abdomen is relatively thick and less sensitive.

Inner thighs:

Pain: moderate. Thinner and more sensitive skin. Closer to nerve endings.

Knees:

Pain: moderate-high. Area with little subcutaneous tissue.

Arms:

Pain: low. Similar to the abdomen.

Dark circles (advanced aesthetic use):

Pain: high. Extremely sensitive area. Not all centers offer it.

How long a session lasts

A typical session lasts 15-30 minutes. The number of injections varies from 10 to 30+ depending on the treated area. Each prick lasts a few seconds.

The standard protocol consists of 8-12 sessions, once or twice a week.

How to reduce discomfort

Thinner needle

Ask your doctor which needle they use. 30G or 32G needles are virtually painless on entry. The main sensation is not the needle, but the gas.

Reduced flow rate

The gas can be injected more slowly. Less pressure = less discomfort. Ask if this is possible.

Gas temperature

Some devices warm the CO2 before injection. Gas at body temperature = less discomfort.

Distraction

Carboxytherapy is a repetitive treatment (many injections in sequence). The mind anticipates each prick. If you are distracted — with music, conversation, or better yet, with a VR headset — the perception of discomfort is significantly reduced.

Virtual reality is particularly suited to carboxytherapy because:

The session lasts 15-30 minutes (perfect time for an immersive experience)
The pain is intermittent and predictable (prick-pause-prick)
Anticipatory anxiety worsens the perception of every single prick
Not having to see the needle approaching each time eliminates the visual trigger

Comparison with other treatments

Mesotherapy: similar (multiple injections) but with solutions that can burn more
Laser hair removal: different pain (thermal vs prick) but comparable intensity
Cryolipolysis: initially more intense, but then subsides; carboxytherapy is constant but mild

Carboxytherapy is generally well tolerated. Most patients describe it as "uncomfortable but not painful."

For whom it is more difficult

People with a low pain threshold
People with a fear of needles (belonephobia)
Anxious people who anticipate discomfort
Those who have to undergo many sessions and accumulate treatment "fatigue"

For these people, having a distraction solution during the session is not a luxury — it is the difference between completing the cycle and abandoning it halfway.

Carboxytherapy is an effective treatment with manageable discomfort. Clinics that offer Lemons in the Room during sessions eliminate the visual trigger and anticipatory anxiety between one prick and the next — the difference between completing the cycle and abandoning it halfway.