Carbon dioxide (CO2) laser resurfacing treatment is a cosmetic and medical treatment for the skin. Healthcare providers use it to treat cosmetic concerns like wrinkles, uneven skin tone, and loose skin. Medical uses include ablation of seborrheic keratosis (skin barnacles), in situ squamous cell carcinoma (Bowen's disease), rhinophyma (a severe form of rosacea), and melasma.
This article will cover the benefits and potential side effects of CO2 laser treatments. It will also discuss costs and how to find the right provider to perform the treatment. Hifu
The CO2 laser is a popular treatment based on its ability to successfully treat several different types of skin conditions.
The laser works by ablating (removing) the top layers of the skin, which promotes new skin cell growth and collagen production. Collagen is a structural protein in the skin.
A laser is a beam of light that passes through different substances, causing the light's wavelength peaks and troughs to line up and become a coherent, single-frequency, greatly powerful beam of light. The frequency of the beam determines what will absorb it. The CO2 laser is absorbed by water. On average, the body is 60% water.
When the CO2 laser beam hits the skin, the temperature of the water molecules in the cells instantaneously rises to double the temperature water needs to boil, vaporizing the tissue. This results in far less bleeding compared to other lasers. The heat also helps stimulate skin cell production deep within the skin.
CO2 lasers can treat deeper skin concerns as well as more superficial concerns. These can include:
One common use of CO2 lasers is for scar appearance reduction. This includes scars from acne, chickenpox, and other causes, although other kinds of lasers treat surgical and traumatic scars more often.
CO2 laser treatment results will vary based on a person's skin concerns and desired outcomes. Below is a list of potential CO2 laser treatment results.
CO2 laser treatment can even out the appearance of the skin. It can provide a uniform color by removing the sun-damaged layers of the skin to allow new, healthy skin to come to the surface.
Compared to other methods of evening out skin tone, the CO2 laser has better control over the depth, area, and the amount of damage the laser does.
One benefit of CO2 lasers is that it stimulates collagen production to tighten the skin. This reduces the appearance of wrinkles and gives the skin better elasticity and support to reduce sagging.
The CO2 laser can reduce the appearance of fine scars (like acne scars) and very superficial scars by removing the top layers of the skin to allow new skin to grow and blend with the surrounding skin. The laser also stimulates collagen production under the scar.
Compared to dermabrasion, another treatment for scar reduction, the CO2 laser causes less bleeding and crusting.
Wrinkle reduction is another benefit of the CO2 laser. Just like it does for other conditions, the laser stimulates collagen production to make the skin tighter and more elastic. With the top layers of skin removed, the wrinkle's appearance becomes less pronounced and looks smoother.
The face is the most popular area for CO2 laser treatment. However, it can treat just about any area of the body (e.g., removing warts from the bottom of the feet). Here are some of the most common spots:
The side effects of a CO2 laser may include redness, swelling, and irritation after treatment.
There is a possibility of developing unwanted pigment (color) changes in the skin. This can include post-inflammatory hyperpigmentation (a darkening of the skin that is treatable but can take a long time to clear up). Hypopigmentation (loss of skin color) can also occur, a permanent side effect by which the affected skin looks white.
Scarring will occur if the laser is over-applied and removes too much of the dermal layers. This can cause severe disfigurement, requiring treatment such as steroid injections and surgical scar revision. Infection—herpetic, bacterial, and yeast—can also pose problems.
It's important to review all possible side effects with a healthcare provider to determine if the benefits outweigh the risks in your particular case.
After CO2 laser treatment the skin may feel tight, raw, and sunburned. Skin will also peel from the layers of skin removed.
The doctor will apply creams to the laser-treated skin for seven to 10 days until the skin heals.
A dermatologist, plastic surgeon, or facial plastic surgeon who has experience with lasers performs CO2 laser treatment. Choosing a healthcare provider skilled with CO2 lasers is important because they will know precisely how much injury the laser should apply to acquire the desired results.
When looking for a clinic that performs CO2 laser treatments, inquire about the clinic and healthcare provider's experience, follow-up appointments, insurance coverage, and testimonials from other patients.
The cost of full-face CO2 laser resurfacing varies greatly across the United States. Fees can range from $3,000–$7,000, including the surgeon's fee, facility fee, and anesthesia.
CO2 laser treatment requires the application of a local numbing cream. However, a full-face CO2 resurfacing is quite painful and frequently requires conscious sedation anesthesia. An anesthesiologist or certified registered nurse anesthetist performs this.
The general healing time for a CO2 laser treatment is about two weeks. For the first five to seven days, the skin will feel red and raw. After that, the skin will dry out and begin to peel.
When the peeling is complete, the new skin will become slightly pink. After a couple of months, the pink will start to fade but may take up to a year to go away completely.
CO2 laser treatments remove the top layers of the skin. Removing layers of the skin poses a risk of infection. However, due to the laser's heat, a CO2 laser poses a less serious risk. Nonetheless, the signs and symptoms of an infection include:
CO2 laser treatments are an effective method for reducing the appearance of wrinkles, sun damage, and loose skin. Healthcare providers use it in clinical settings and can perform it on almost any area of the body. Though CO2 lasers are generally considered a safe treatment, there are potential side effects such as swelling, redness, and infection.
American Society of Plastic Surgeons. Laser skin resurfacing.
Omi T, Numano K. The role of the CO2 laser and fractional CO2 laser in dermatology. Laser Ther. 2014;23(1):49-60. doi:10.5978/islsm.14-RE-01
Yumeen S, Khan T. Laser carbon dioxide resurfacing. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
U.S. Dermatology Partners. What is CO2 laser resurfacing?
Memorial Sloan Kettering Cancer Center. Skin care before and after fractionated carbon dioxide laser treatment.
By Patty Weasler, RN, BSN Patty is a registered nurse with over a decade of experience in pediatric critical care. Her passion is writing health and wellness content that anyone can understand and use.
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