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Procedure
ProcedureSkin Prescription

Fractional CO2 Laser

Also known as ablative laser resurfacing, laser resurfacing

The most powerful skin resurfacing available. Serious results, serious downtime, and serious risk on deeper skin tones.

Evidence
Very strong
Typical cost
$1.5k – $6k
Permanence
Long-term
Timeline
Initial improvement at 4 weeks; collagen remodelling continues for 6–12 months.

US $1,500–3,500 per full-face session.

How it works

A fractionated ablative laser vaporises microscopic columns of tissue to a controlled depth, leaving untreated skin between them to speed healing. Wound healing produces new collagen and re-epithelialisation, remodelling scars, wrinkles and texture.

How it's used

One to three sessions depending on aggressiveness. Requires strict pre-treatment preparation and diligent post-care with occlusive healing ointment and absolute sun avoidance. Fitzpatrick IV–VI skin carries substantially higher pigmentation risk and needs an experienced operator and pre-treatment protocol.

Trade-offs

In favour

  • The most effective treatment for acne scarring and deep wrinkles
  • Substantial textural improvement in one to three sessions
  • Long-lasting results
  • Also treats sun damage and pigmentation

Against

  • Genuine downtime of 7–14 days
  • Expensive
  • Higher risk on darker skin tones
  • Requires strict sun avoidance afterwards

Risks and side effects

Read before deciding
  • Post-inflammatory hyperpigmentation, especially in Fitzpatrick IV–VI
  • Prolonged erythema lasting weeks to months
  • Infection including herpes reactivation — antivirals are given prophylactically
  • Scarring if set too aggressively
  • Permanent hypopigmentation with deep treatment — a delayed complication
  • Ectropion if used aggressively near the lower lid

Recovery

Days 1–3: raw, weeping, swollen skin requiring occlusive ointment. Days 4–7: peeling and flaking, skin bright red. Days 7–14: new skin, still pink; makeup usually possible. Weeks 2–8: pinkness fades gradually. Strict SPF for months.

How good is the evidence?

Very strong
Extensive high-quality evidence and guideline support.

Strong evidence base for acne scarring and photoaging, with well-characterised risks.

Sources

Sources point to guideline bodies and literature searches rather than single papers, so they stay accurate as the evidence moves.

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