CO2 Laser Resurfacing

laser resurfacing uses targeted beams of light to remove the superficial layer of your skin.

Depending on the issue being addressed, a dermatologist or cosmetic surgeon might also use fractional lasers, another type of CO2 lasers. Fractional lasers, however, are more superficial than traditional CO2 lasers, so they’re mainly used to address fine lines or blotchy skin.

How does CO2 laser resurfacing work?

C02 laser resurfacing uses pulses of laser light. These beams penetrate the skin’s surface, where water in the skin cells absorbs them.

When this happens, the epidermis, or superficial layer of your skin, is vaporized. The dermis, or middle layer, heats up, stimulating the growth of new collagen fibers. As the area heals, new firmer, smoother skin replaces the old layers.

During CO2 laser resurfacing, a physician can target specific areas of your skin with precision, so the treatment won’t affect the rest of the skin nearby.

How to prepare

Your physician will give you instructions to prepare for treatment. Depending on your medical history, pre-care typically involves:

•  avoiding tanning or heavy sun exposure for 4 weeks before treatment

•  not using medications that cause sun sensitivity, such as doxycycline, for 3 days before treatment

•  taking an antiviral medication for a few days before and after treatment if you have a history of herpes or shingles

•  quitting smoking for 2 weeks before and after treatment, since smoking can interfere with healing

The procedure

Here’s an idea of what to expect on the day of your CO2 laser treatment:

1.   This outpatient procedure generally takes between 30 minutes and 2 hours, depending on the issue being addressed and the area of skin receiving treatment.

2.   CO2 laser resurfacing does involve some pain. The level of pain you experience will depend on the depth and extent of resurfacing, the skill of the dermatologist or surgeon, and your own pain tolerance.

3.   You’ll receive a combination of local anesthetic and a sedative to prevent pain and help you relax.

4.   Before the treatment begins, your skin will be thoroughly cleaned and you’ll receive special eyewear to protect your eyes from the laser.

5.   During the treatment, the physician will move the laser wand slowly over the area of skin being treated.

6.   You may receive an ice pack to apply to the treated area for 15 minutes to prevent swelling.

7.   Finally, an antibacterial ointment and nonstick dressing will be applied to the treated skin. Leave this on as instructed, usually for 24 hours.

You may need more than one treatment session, depending on the treatment required and intensity of the laser used.

What are the benefits?

CO2 laser resurfacing can treat numerous cosmetic and medical skin issues, from visible signs of aging and sun damage to scars and skin cancer.

Fine lines and wrinkles

CO2 laser resurfacing can lessen the appearance of fine lines and wrinkles. It may prove especially effective on:

•  crow’s feet, or lines and wrinkles under and around the eyes

•  lines and wrinkles on the forehead

•  laugh lines, or those appearing around the mouth

Not only can it reduce the appearance of wrinkles right away, it also encourages collagen production, which can improve the health of your skin over time.

Sun-damaged skin

Exposure to UV light may contribute to visible signs of skin aging, such as:

•  wrinkles

•  sagging due to decreased elasticity

•  rough and uneven skin texture

•  liver spots and sunspots

•  spider veins

CO2 laser resurfacing can significantly reduce the appearance of all of the above.

Baggy eyes

Loose skin above the upper and lower eyelids can cause what’s commonly known as “baggy” or “hooded eyes.”

CO2 lasers can help tighten skin, and they may also help improve eyelid skin laxity and minimize the appearance of baggy eyes.

Acne scars

C02 laser treatment helps reduce the appearance of acne scarring by stimulating collagen production that helps tighten and smooth out the scars.

That said, it may not work on all types of acne scars.

A 2018 reviewTrusted Source suggests — including microneedling, subcision, and a trichloroacetic acid (TCA) peel — may prove more effective for ice-pick type acne scars.


Safety and side effects

CO2 lasers, in use since the early 1960sTrusted Source, are considered safe and effective.

Still, like most procedures, CO2 laser resurfacing does involve some risk. Having the treatment performed by a reputable, board certified physician can significantly minimize your risk of complications.

Common side effects of CO2 laser resurfacing include:

•  some skin discoloration and swelling

•  skin that feels raw, similar to a mild sunburn

•  itching

•  dryness and peeling

•  sun sensitivity

Deeper, more extensive resurfacing can leave your skin looking and feeling like it might after severe sunburn. Your skin might also ooze and blister.

Potential complications

CO2 laser resurfacing can occasionally lead to:

•  infection

•  acne flares

•  cold sore reactivation, if you have a history of cold sores

•  scarring

•  milia, or very small skin bumps

•  hyperpigmentation

•  skin burns and injuries, if the laser is not used correctly

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