Face
September 23, 2024

What Is a CO2 Facial Laser? Uses, Recovery and Risks

A CO2 facial laser is a carbon dioxide laser used for skin resurfacing. It removes thin layers of skin and heats the layer beneath, which prompts new collagen so that the skin heals smoother and firmer. It is used for wrinkles, scars and sun damage. It is one of the more intensive skin treatments: recovery takes up to two weeks, redness can last for months, and people with darker skin have a higher risk of pigment changes.

This guide explains how a CO2 facial laser works, who it suits, recovery and risks.

How a CO2 facial laser works

Cleveland Clinic describes laser resurfacing as directing short, concentrated beams of light at the skin to remove it precisely, layer by layer. The laser removes the outer layer and heats the layer underneath, which stimulates new collagen fibers.

There are two approaches:

Full CO2 resurfacing treats the whole surface of the area evenly.
Fractional CO2 resurfacing delivers many narrow columns of laser light and leaves the skin between them untouched. Less skin is injured, but the light goes deeper, which Cleveland Clinic says brings a greater risk of complicated healing and scarring.

What a CO2 facial laser is used for

Cleveland Clinic lists the people who may be good candidates as those with:

fine lines or wrinkles around the eyes, forehead or mouth;
scars from acne or chickenpox;
sun-damaged skin, age spots or uneven pigmentation;
enlarged oil glands on the nose.

The American Academy of Dermatology (AAD) describes laser resurfacing as the most effective procedure for tightening loose skin, better than other skin-tightening procedures, with the tradeoff of downtime and a greater risk of side effects such as scarring.

Who may not be suited to it

Cleveland Clinic says you may not be a good candidate if you have active acne, very dark skin, deep wrinkles, or excessive or sagging skin.

Skin tone matters because of pigment. A darker skin tone carries a greater risk of healing with darker patches. Cleveland Clinic notes that an erbium laser may be a better choice for darker skin. Other options with less pigment risk include microneedling; see microneedling or RF microneedling.

Recovery after a CO2 facial laser

This is not a lunchtime treatment. Cleveland Clinic describes the usual course:

Straight after: the skin is red and feels sunburned. It may look raw, ooze and blister.
First days: a dressing for 24 hours, then cleansing two to five times a day and an ointment to prevent scabs.
Days 5 to 7: the skin dries and peels. New skin is pink.
Healing: treated areas heal in 5 to 21 days. Recovery with a CO2 laser is up to two weeks.
Afterwards: redness usually fades in two to three months but can take six months to a year.

Do not scratch or pick at crusting skin, as this can cause scarring or infection.

Risks and side effects

Cleveland Clinic lists:

small white bumps called milia during healing;
darker patches, and more rarely lighter patches;
reactivation of cold sores, especially after treatment around the mouth;
swelling;
bacterial infection;
scarring, which is very rare.

If you get cold sores, tell your provider. An antiviral medicine is usually started before treatment.

How to prepare

Cleveland Clinic’s instructions include:

avoiding tanning and heavy sun exposure, and using a broad-spectrum sunscreen daily, for four weeks beforehand;
avoiding deep peels and other resurfacing for four weeks beforehand;
stopping medicines that cause sensitivity to light at least 72 hours beforehand, as directed.

You may also be asked to apply a retinoid to the skin for about four weeks before the procedure.