Healthcare professionals, such as dermatologists or plastic surgeons, may use carbon dioxide (CO2) lasers in skin resurfacing treatments. These lasers emit energy that removes the superficial layer of the skin and stimulates the formation of new skin cells.

A person may seek CO2 laser treatment to treat skin conditions, such as acne scars, fine lines and wrinkles, or skin aging.

This article explores how CO2 lasers work, the difference between different types of CO2 lasers, and the benefits that such lasers may provide. It also discusses the potential side effects of this treatment, the length of recovery, and alternative options.

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A CO2 laser is a tool that healthcare professionals may use to treat skin conditions.

CO2 lasers are part of a laser resurfacing process. The laser emits energy of a wavelength of 10,600 nanometers. Water within the skin cells absorbs this type of wavelength, resulting in the ablation of the superficial layer of the skin.

Learn more about laser skin resurfacing.

This treatment produces a type of heat injury. This stimulates the skin underneath, resulting in the formation of collagen. Collagen is a protein in the body that provides a tightly organized fiber network and contributes to the skin’s elasticity.

When the skin starts healing after laser treatment, new skin starts to form that may be smoother, tighter, or more elastic.

Laser treatment times depend on a person’s skin type, skin concern, and the manufacturer of the laser’s instructions.

Ablative CO2 lasers involve vaporizing the skin tissue. This treatment is more aggressive than nonablative lasers. However, because of this, ablative treatment may produce more dramatic effects and visible skin improvements.

Fractional CO2 laser treatment involves the application of a large number of microbeams. This creates columns of ablation through the skin while leaving the surrounding skin undamaged.

Fractional CO2 lasers minimize the risk of adverse effects due to the targeted nature of the laserbeam columns. This form of laser treatment also has a faster recovery time.

Generally, CO2 lasers provide the best results on people with Fitzpatrick type 1 or 2 skin. The Fitzpatrick system classifies the skin’s reaction to sunlight. The effectiveness of CO2 lasers on Fitzpatrick type 1 or 2 skin is due to a lower amount of melanocytes in paler skin. In turn, this makes it less likely that a person will experience hyperpigmentation or hypopigmentation after the procedure. Additionally, nonablative CO2 lasers may be more suited to people with darker skin tones.

However, research suggests that non-ablative fractional lasers are more favorable for people with Fitzpatrick type 4–6 skin. Fractional lasers may lead to better results for individuals with these skin types and the following conditions:

Learn more about Fitzpatrick skin types.

Ablative lasers, such as CO2 lasers, may help treat certain skin conditions, including:

A 2018 systematic review of 30 studies found that ablative fractional CO2 lasers were effective in treating acne scars. However, combination therapy may be more beneficial for people with ice-pick acne scars.

A small 2015 study found that fractional CO2 lasers may provide positive results in patients with post-burn scars. The participants reported minimal side effects, such as redness, crusting, and inflammation. These side effects lasted for a few months after treatment, and the participants treated the effects with topical creams.

A person may experience some side effects from CO2 laser treatment. Some of these include:

  • infection
  • delay in wound healing
  • scarring
  • skin peeling
  • skin redness
  • milia — small, yellow or white cysts that appear in clusters
  • changes in skin tone

With this in mind, people should always discuss any potential side effects with the healthcare professional providing the treatment.

The skin typically requires 2–4 weeks to completely heal from CO2 laser treatment. New skin begins to grow after around 2 weeks following laser treatment.

The skin will initially be quite raw and may have drainage immediately after laser treatment. It may also look and feel as if it is severely sunburned. Healthcare professionals will cover the skin with a mask bandage for a few days.

While the skin recovers, a person should do the following to prevent damage to the skin:

  • stay at home and avoid strenuous activity
  • not pick or scratch at the skin while it is recovering
  • use over-the-counter pain medication or ice packs to reduce pain
  • minimize direct sun exposure and use proper sun protection such as sunscreen
  • attend follow-up appointments to monitor recovery
  • take any prescription medication a healthcare professional prescribes

Several alternative treatments may have quicker recovery times than ablative CO2 laser resurfacing.

Dermabrasion

Dermabrasion is a skin resurfacing technique. It involves the use of abrasive materials, such as diamond fraises or wired brushes. Pneumatic or electric motors power the handheld devices that hold the abrasive material and rotate at varying speeds.

Healthcare professionals, such as dermatologists, will apply the abrasive material to the skin at varying speeds or pressure to penetrate the skin and stimulate new skin cell growth.

Dermabrasion may be suitable for improving the appearance of:

  • fine lines
  • liver spots
  • scars
  • actinic keratoses

Botox

Botox, or botulinum toxin, is a type of neurotoxin protein. The bacterium Clostridium botulinum produces this protein. This treatment paralyzes local muscles by stopping the release of the chemical acetylcholine. The effect lasts for 3–6 months.

A cosmetic surgeon or doctor will normally inject Botox into areas of the face. It is effective in treating skin conditions such as:

  • wrinkles
  • fine lines
  • uneven eyebrows
  • excessive sweating
  • acne vulgaris

Learn more about Botox.

Chemical peels

Chemical peels are chemical solutions, such as acids, that improve the texture and tone of the skin by removing the damaged outer layers of the skin.

According to the American Society of Plastic Surgeons, chemical peels may improve:

  • acne or acne scars
  • fine lines
  • wrinkles
  • uneven skin tone
  • rough skin
  • scaly patches of skin
  • some scars
  • sun-damaged skin

Learn more about chemical peels.

Retinol

Retinol is a form of vitamin A. It is available in various forms, including gels, creams, or liquid serums. A person can apply retinol to their skin topically.

According to the American Academy of Dermatology Association, retinol can help prevent premature skin aging if a person uses it daily.

Retinol may help improve:

  • acne scars
  • fine lines
  • wrinkles

However, a person should be careful when using retinol at higher strengths, as these can cause undesirable effects, such as pigmentation, redness, and a burning sensation.

Learn more about the best retinol creams to purchase online.

CO2 lasers are a skin care tool that can help minimize the appearance of scarring, wrinkles, and acne. This treatment may use ablative or fractional lasers. Side effects of CO2 laser treatment may include infection, skin peeling, redness, and skin tone changes.

Recovery from treatment normally takes 2–4 weeks, and a person will need to limit exposure to the sun and avoid scratching the skin as it heals.