Demand for laser skin resurfacing keeps rising as patients look for reliable ways to smooth wrinkles, erase sun damage, and soften scars without surgery. As per a report, more than one million CO₂ and other laser treatments were performed in 2023 alone, a 4 percent jump from the year before. Among the many devices now available, the carbon dioxide (CO₂) laser remains the gold standard for deep collagen remodeling and dramatic texture improvement. Below you’ll find an easy-to-scan roadmap that shows exactly how s works, who gets the best results, and what recovery is really like—so you can decide if it belongs in your skin-renewal game plan.
How CO₂ Lasers Skin Resurfacing Works
A CO₂ laser is essentially a high-precision, water-seeking scalpel made of light. A sealed tube filled with carbon dioxide, nitrogen, and helium gases generates an infrared beam at 10,600 nm. Human skin is two-thirds water, and that water absorbs this wavelength instantly. Each pulse vaporizes the epidermis and heats the upper dermis to roughly 60 °C, a temperature that contracts existing collagen and signals fibroblasts to build new fibers.
Modern handpieces “fractionate” the beam into microscopic columns, leaving bridges of untouched tissue between injury zones. These microthermal zones speed re-epithelialization and cut the risk of prolonged redness compared with the fully ablative passes used in the 1990s. The FDA cleared all CO₂ laser platforms under 21 CFR 878.4810, product code GEX.
Key technical points
- Primary chromophore: intracellular water
- Adjustable depth: 50 – 150 µm ablation; coagulation halo up to 500 µm
- Energy delivery: scanned micro-pulses for fractional; contiguous pass for full-field
- Therapeutic target: neocollagenesis and controlled dermal remodeling
CO₂ Laser Skin Resurfacing at a Glance
A brief overview helps set expectations before the details.
| Fractional CO₂ | Full-Field CO₂ | |
| Typical indications | Fine–moderate rhytides, acne scars, dyschromia | Deep static lines, severe actinic damage |
| Session time | 30 – 90 min | 60 – 120 min |
| Social downtime | 7 – 14 days | 2 – 3 weeks |
| Average U.S. surgeon fee* | $1,829 | $1,829 |
*ASPS 2023 fee data
Who’s an Ideal Candidate?
You are likely a good candidate if you:
- Fall within Fitzpatrick skin types I–III. Fair-to-medium tones carry the lowest risk of pigment change at the treatment energies typically used for wrinkle and scar reduction.
- Have specific texture or tone concerns. Etched facial lines, acne or surgical scars, blotchy sun damage, and enlarged pores respond especially well to the ablative depth and collagen remodeling unique to CO₂ lasers.
- Are in good overall health and do not smoke. Adequate circulation and oxygenation speed re-epithelialization and lower infection risk.
- Can pause photosensitizing medications. You have been off oral isotretinoin for at least six months and do not use chronic topical retinoids or exfoliants in the week leading up to treatment.
- Can commit to strict after-care and sun avoidance for 7 – 14 days. Meticulous cleansing, ointment re-application, and SPF 30+ are non-negotiable for an even, complication-free result.
- Maintain realistic expectations. One session can markedly soften wrinkles or scars, but deeper creases or mixed pigment issues may need a staged plan.
Potential Risks & Side Effects
Even with updated fractional delivery and physician-grade after-care protocols, CO2 laser skin resurfacing creates a controlled injury, so specific reactions are expected, and a few complications remain possible.
- Immediate erythema and edema – Universal for the first 48–72 hours, gradual fade over 7–14 days is normal.
- Post-inflammatory hyperpigmentation (PIH) – Most common in Fitzpatrick IV–VI; reviews report rates ranging from 30 % to 68 % without prophylactic bleaching agents or strict UV avoidance.
- Infection (bacterial or fungal): Retrospective series place the incidence between 1 % and 4 % after full-face treatment, Pseudomonas aeruginosa and Staphylococcus aureus are the usual pathogens.
- Herpes simplex virus reactivation – Occurs in roughly 7 % of resurfacing patients when antiviral prophylaxis is not given.
- Acne flares, milia, or contact dermatitis – Transient eruptions observed in 10–15 % of cases; typically resolve with topical therapy.
- Hypopigmentation and prolonged erythema – Less frequent than PIH but documented, especially after aggressive, full-field passes.
- Hypertrophic or atrophic scarring – Rare (< 1 %) when experienced surgeons limit cumulative fluence, overlap, and enforce meticulous wound care.
Treatment Journey: What Happens on Procedure Day
Patients typically arrive a few minutes early to complete any last paperwork before being escorted to a private treatment room. At Seattle Plastic Surgery, Dr. Santos first reviews the planned settings and then decides on anesthesia: small, targeted spots often need only a topical numbing cream, while larger or more delicate regions may warrant injected local anesthetic or light sedation.
Once comfort is confirmed, Dr. Santos moves the handpiece methodically across the skin, delivering fractional CO₂ pulses in a grid pattern. Most people describe the sensation as brief warmth or pinpricks rather than true pain. Treatment time varies with the area covered but usually stays under two hours, after which a thin
Recovery Timeline & What to Expect
For the first two to three days, expect some swelling, oozing, and a strong “sunburn” sensation. By day 4, a light brown crust appears; as it flakes off over the next week, fresh pink skin is revealed. Most people have fully closed, peel-free skin within 10 – 14 days (up to 21 days after a deeper treatment). Light makeup is fine once peeling stops. Mild redness can linger for 2 – 3 months, occasionally up to six, before the new skin tone settles into its final, smoother look.
Expected Results & Longevity
Fresh, smoother, and slightly firmer skin becomes visible after peeling ends (about 10–14 days). Dermal fibroblasts keep laying down new collagen for up to six months, which gradually tightens the texture and softens deeper lines. Clinical follow-ups show that, once fully healed, improvements in wrinkles, scars, and tone typically last several years, provided daily broad-spectrum sunscreen and a basic medical-grade skincare routine remain in place. CO₂ lasers achieve these longer-lived results because their 10,600-nm beam ablates and coagulates deeper into the dermis than erbium: YAG or non-ablative fractional devices, sparking more robust collagen remodeling—but that deeper reach also explains the 7- to 14-day downtime most patients need for social-ready skin.
How much does the Laser Skin Resurfacing Treatment Cost?
Most providers quote $3,000 – $7,000 for a full-face fractional CO₂ session; treating a smaller zone (eyes only, perioral, neck) generally falls well below that range. Fees vary because providers must factor in laser platform, facility charges, anesthesia, and healing boosters such as platelet-rich plasma.
Seattle Plastic Surgery pricing
- CO₂ Laser Resurfacing (Local Anesthesia): $4,995
- CO₂ Laser Resurfacing (General Anesthesia): $5,995
Both options include surgeon time, facility use, and standard postoperative supplies.
Start Your Skin Renewal Journey with CO₂ Laser Skin Resurfacing
Ready to see whether fractional CO₂ laser skin resurfacing can fit your skin goals, timeline, and budget? Schedule a complimentary consultation with board-certified facial plastic surgeon Dr. David Santos at Seattle Plastic Surgery. Call (206)-739-0355 or click here to reserve your appointment and receive a personalized treatment plan.
