Benefits, what to expect, safety, cost

CO2 – carbon dioxide – laser resurfacing uses targeted beams of light to remove the surface layer of your skin.

This type of laser treatment can:

Depending on the problem being treated, a dermatologist or cosmetic surgeon may also use fractional lasers, another type of CO2 lasers. Fractional lasers, however, are more superficial than traditional CO2 lasers, so they are mainly used to treat fine lines or skin spots.

Read on to learn everything you need to know about CO2 laser resurfacing.

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

When this happens, the epidermis, or surface 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 cosmetic surgeon or dermatologist can precisely target specific areas of your skin, so the treatment does not affect the rest of the skin nearby.

How to prepare

Your dermatologist will give you instructions on how to prepare for the treatment. Depending on your medical history, advance care usually involves:

  • avoid 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
  • take antiviral medicine for a few days before and after treatment if you have a history of herpes or shingles
  • stop smoking for 2 weeks before and after treatment, as smoking may interfere with healing

The procedure

Here is an idea of ​​what to expect on the day of your CO2 laser treatment:

  1. This outpatient procedure usually lasts between 30 minutes and 2 hoursdepending on the problem to be treated and the skin area to be treated.
  2. CO2 laser resurfacing involves some pain. The level of pain you experience will depend on the depth and extent of the resurfacing, the skill of the dermatologist or surgeon, and your own pain tolerance.
  3. You will be given a combination of local anesthetic and sedative to prevent pain and help you relax. For extensive resurfacing, you may receive general anesthesia so that you sleep during the treatment.
  4. Before the start of the treatment, your skin will be thoroughly cleansed and you will be given special glasses to protect your eyes from the laser.
  5. During the treatment, the dermatologist or surgeon will slowly move the laser wand over the area of ​​skin to be treated.
  6. You may be given an ice pack to apply to the treated area for 15 minutes to prevent swelling.
  7. Finally, an antibacterial ointment and a non-stick dressing will be applied to the treated skin. Leave it as directed, usually for 24 hours.

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

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

Wrinkles and fine lines

CO2 laser resurfacing can reduce the appearance of fine lines and wrinkles. It can be particularly effective on:

Not only can it immediately reduce the appearance of wrinkles, but it also encourages collagen production, which can improve your skin’s health over time.

Sun damaged skin

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

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

puffy eyes

Loose skin over the upper and lower eyelids can cause what is commonly known as “puffy eyes” or “hooded eyes”.

CO2 lasers can help firm the skin, and they can also help improve sagging eyelid skin and minimize the appearance of puffy eyes.

Acne scars

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

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

A 2018 report suggests combination therapy – including microneedling, subcision and a trichloroacetic acid (TCA) peel – may prove more effective for ice-pick type acne scars.


Dermatologists usually recommend other treatment methods, such as over-the-counter remedies or freezing, for warts. But they can use lasers on warts that don’t respond to other treatments.

Sebaceous hyperplasia

Sebaceous hyperplasia occurs when sebum becomes trapped in a sebaceous gland. When this happens, the gland enlarges and causes a small, waxy bump on the skin, usually on the face. Although harmless, some people have them removed for cosmetic reasons.

CO2 lasers can effectively remove these bumps and prevent them from growing back, although some research suggests that an erbium laser might be a better option. A 2020 review found that erbium laser treatment often requires only one session and has fewer side effects than CO2 and other lasers.

Skin cancer

CO2 lasers can help prevent or treat skin cancers by shrinking and destroying tissue with little bleeding or damage to surrounding tissue.

A dermatologist may use CO2 lasers on precancerous actinic keratoses or, in some cases, to treat certain types of early-stage skin cancer.

CO2 lasers, used since the early 1960sare considered safe and effective.

Yet, like most procedures, CO2 laser resurfacing carries some risks. Having the treatment performed by a reputable and board-certified dermatologist or plastic surgeon can significantly reduce the risk of complications.

Common side effects of CO2 laser resurfacing include:

  • discoloration and swelling of the skin
  • skin that feels raw, similar to a mild sunburn
  • itch
  • dryness and flaking
  • sun sensitivity

Deeper, more extensive resurfacing can make your skin look and feel like it might after a severe sunburn. Your skin may also ooze and blister.

It usually takes 1-2 weeks to recover from CO2 laser resurfacing. Following your dermatologist’s or surgeon’s aftercare instructions will help healing and reduce the risk of complications.

Here’s what to expect during the recovery process:

  • Your skin will be raw for the first few days and may look like sunburn with itching, stinging, and flaking.
  • Your skin may blister, ooze yellow fluid, and form a crust.
  • After about 5-7 days, your skin will become dry and start peeling. The skin underneath may look pink or pale which will gradually take on the color of your skin. This process may take up to one year.

These tips can help you during the healing process:

  • Avoid rubbing, scraping or scratching your skin.
  • Cleanse treated skin as directed by your doctor, usually 2 to 5 times daily with saline or vinegar solution.
  • Apply a thin layer of moisturizer or antibacterial ointment twice a day, as recommended by your doctor.
  • Apply an ice pack wrapped in a clean, soft towel to the area as needed for the first 24-48 hours.
  • Sleep with your head elevated to help reduce swelling.
  • Once your skin has healed, wear clothes that cover the area or apply sunscreen formulated for sensitive skin whenever you go outside.

To reduce your risk of complications and get the best results from the procedure, go with a reputable and board-certified dermatologist or plastic surgeon. You can ask your doctor for a referral or find one in your area through one of these online resources:

According True Self, CO2 laser resurfacing costs on average about $2,750. However, some of their reviewers report paying as much as $6,100.

The cost varies between ablative and fractional treatment – ablative laser treatment is more expensive. Other factors that influence how much you will pay for CO2 laser resurfacing include:

  • location
  • references and experience of your dermatologist or surgeon
  • the number of sessions needed to achieve the desired results
  • the area of ​​skin receiving the treatment

Insurance generally does not cover cosmetic treatments. That said, your insurer may cover laser treatments used for medically necessary purposes, such as the removal of skin cancer.

You can learn more about your coverage options by consulting your insurer.

When performed by an experienced cosmetic surgeon or dermatologist, CO2 laser resurfacing can rejuvenate your skin and treat certain skin conditions.

Considering CO2 laser treatment? Start by booking a consultation with a reputable professional for more advice on whether this treatment can help your skin concerns.

Adrienne Santos-Longhurst is a Canada-based freelance writer and writer who has written extensively on all things health and lifestyle for over a decade. When she’s not cooped up in her writing shed looking for an article or interviewing medical professionals, she can be found frolicking around her seaside town with her husband and his dogs or wading on the lake trying to master the stand-up paddle board.

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