What is CO2 laser skin resurfacing?

CO2 laser skin resurfacing is a procedure involving the use of carbon dioxide (CO2) and a skin surface-removing laser (ablative laser) to remove scars, warts and deep wrinkles.

How does CO2 laser skin resurfacing work?

Ablative lasers, such as a CO2 laser, work by traumatizing the skin. It removes the thin outer layer of skin (epidermis) and heats the underlying skin (dermis). This stimulates the growth of new collagen fibers. As the epidermis heals and regrows, the treated skin appears clearer, smoother and tighter. 

Non-ablative lasers, such as pulsed light (IPL) devices, do not traumatize the skin, instead they stimulate collagen growth and improve skin tone and texture. This is less invasive and requires less recovery time, but is less effective.

The surgeon chooses the laser type based on the condition being treated and the patient’s cosmetic goals.

What are the uses of CO2 laser skin resurfacing?

CO2 laser skin resurfacing can be used to treat:

• Fine and deep wrinkles
• Age spots
• Uneven skin tone or texture
• Sun-damaged skin
• Mild to moderate acne scars
• Large pores
• Superficial to deep hyperpigmentation

Other uses for carbon dioxide resurfacing include:

• Seborrheic keratosis
• Verruca vulgaris/plana
• Sebaceous gland hyperplasia
• Angiofibroma (fibrous papule of nose)
• Junctional and compound nevi
• Lentigo simplex
• Small syringomas
• Epidermal melasma
• Rhinophyma (potato nose)
• Vocal cord nodules, cysts and tumors

When is CO2 laser skin resurfacing not recommended?

CO2 laser skin resurfacing is not recommended with:

• Active bacterial, viral, or fungal infections
• Unrealistic expectations
• Poor general health
• Oral isotretinoin (Accutane) use within previous six months
• Fitzpatrick skin phototypes 5-6 (very dark skin)
• Other resurfacing procedures within preceding two to three months
• Unwillingness to accept possibility of complications
• Eyelid laxity

• Excessively thick or thin skin
• Collagen vascular disease
• Human immunodeficiency virus (HIV) or systemic infections
• Tendency for keloid or thick scar formation

Is CO2 laser skin resurfacing painful?

CO2 laser skin resurfacing is usually done with anesthesia, so there is minimal discomfort during the procedure.

• Topical anesthetics are common
• Numbing cream may be applied directly onto the skin or sometimes local infiltration (injection)
• Other types of anesthesia are usually performed in individual situations and for skin conditions that need deeper penetration of the laser. These forms of anesthesia include
  • Regional nerve block
  • Intravenous (IV) sedation
  • Laryngeal mask airway
  • Combined techniques

Post-operative pain is minimal and can be managed with oral pain killers.