CO2 Laser

CO2 laser treatment is a skin resurfacing procedure that uses a focused beam of carbon dioxide light to remove damaged outer layers of skin and stimulate the growth of fresh, healthier skin underneath.

The laser delivers short pulses of concentrated light energy to the skin. This energy vaporises (turns into steam) the outermost skin cells layer by layer, removing wrinkles, scars, or other surface irregularities. At the same time, the controlled heat triggers the body's natural healing response, boosting collagen (the protein that keeps skin firm and plump) production in the deeper layers. Over the following weeks, new skin grows back smoother and more even in tone.

CO2 laser is used to improve a wide range of skin concerns, particularly those caused by ageing, sun exposure, scarring, or abnormal skin growths. A dermatologist will assess the skin carefully before recommending this treatment.

• Fine lines and wrinkles, especially around the eyes and mouth
• Deep wrinkles and skin laxity (looseness) on the face
• Acne scars and other types of atrophic scars (scars that create a sunken or pitted appearance)
• Uneven skin tone, including dark spots (hyperpigmentation) from sun damage or ageing
• Enlarged pores and rough skin texture
• Superficial skin lesions such as seborrheic keratoses (harmless warty growths) and syringomas (small benign sweat-gland bumps)
• Mild to moderate skin sagging, particularly around the lower face
• Rhinophyma (thickened, bumpy skin on the nose caused by a long-standing skin condition)

CO2 laser is not suitable for everyone. The doctor will usually advise against it in the following situations:

• Very dark skin tones, because there is a higher risk of long-lasting changes in skin colour after the procedure
• Active acne breakouts or active skin infection in the treatment area
• A history of forming keloid scars (thick, raised overgrown scar tissue)
• Recent use of certain oral acne medications (the doctor will check this and may ask for a waiting period)
• Pregnancy or breastfeeding
• Certain autoimmune conditions (diseases where the immune system attacks the body's own tissues) that slow wound healing
• Unrealistic expectations about what the treatment can achieve

CO2 laser is generally considered safe when performed by a trained dermatologist, but like any procedure that intentionally removes layers of skin, it carries recognised risks that patients should understand beforehand.

• Redness, swelling, and a raw or sunburned feeling in the treated skin — this is expected and usually fades over days to weeks
• Prolonged redness (erythema) that can last several weeks or, in some cases, months
• Changes in skin colour: the treated area may become lighter (hypopigmentation) or darker (hyperpigmentation) than the surrounding skin, especially in people with medium to dark skin tones
• Infection: because the outer skin barrier is temporarily removed, bacteria or the herpes simplex virus (the virus that causes cold sores) can enter and cause an infection; doctors often prescribe preventive antibiotics or antiviral medicines
• Scarring, including hypertrophic scars (raised, thick scars) in a small number of cases
• Milia (small white cysts, or closed bumps under the skin) that can appear during healing
• Acne flares during the healing period
• Eye injury if the laser is used very close to the eyes without proper protective shields
• Incomplete improvement, meaning some wrinkles or scars may not fully resolve and a repeat treatment may be discussed

Good preparation helps the skin heal better and lowers the chance of complications. The steps below are typical, but your doctor's instructions will be tailored to your skin type, health history, and the depth of treatment planned.

Before the procedure, the doctor will usually ask about current medications, skin conditions, and any history of cold sores, because the herpes simplex virus can reactivate after laser treatment. Common preparatory steps include:

• Stopping certain skin-care products — such as retinoids (vitamin A-based creams) and exfoliating acids — usually one to two weeks before, to reduce skin sensitivity
• Applying a skin-lightening cream for several weeks beforehand if the doctor considers there to be a risk of post-treatment darkening, particularly for medium to dark skin tones
• Completing a course of antiviral medicine before the procedure if there is a history of cold sores, to prevent an outbreak triggered by the laser
• Avoiding prolonged sun exposure and using a broad-spectrum sunscreen (one that blocks both UVA and UVB rays) consistently in the weeks leading up to treatment
• Stopping blood thinners (medicines that reduce clotting) if medically safe to do so — the doctor will advise on this
• Stopping smoking as far in advance as possible, because smoking slows skin healing
• Fasting is not always required for superficial treatments but may be necessary if sedation (medicine to make you drowsy and relaxed) is planned — the doctor will specify

Pre-procedure assessments typically include a close examination of the skin under a special light, a review of skin type using a classification scale, and in some clinics, standardised photographs to track before-and-after changes. Blood tests are not routinely needed unless sedation is planned or a health condition requires it.

On the day of the procedure, the typical sequence of steps is as follows:

• 1. The treatment area is thoroughly cleaned to remove all make-up, oils, and skin-care products.
• 2. A topical anaesthetic cream (numbing cream applied to the surface of the skin) is spread over the area and left for a set time — usually around thirty to sixty minutes — to reduce discomfort during the laser passes.
• 3. If deeper treatment is planned, the doctor may also inject a local anaesthetic (a numbing injection into the skin) or arrange sedation.
• 4. Protective shields or damp gauze are placed over or near the eyes.
• 5. The laser handpiece is moved methodically across the treatment area. The doctor adjusts settings — such as pulse depth and density — depending on the area being treated and the skin concern.
• 6. A gentle stream of cool air or a cooling device is often used alongside the laser to improve comfort.
• 7. Immediately after the laser passes are complete, the skin is cleaned and a soothing ointment (a thick, protective cream) or a special dressing is applied.
• 8. The doctor or nurse reviews the treated area and gives written aftercare instructions before the patient leaves.

Recovery from CO2 laser varies considerably depending on how deeply the skin was treated. A superficial (light) treatment may mean only a few days of redness and peeling, while a deeper treatment can involve a healing period of one to three weeks or more before the skin is fully closed and comfortable. Most patients are monitored briefly at the clinic on the day of treatment and are then cared for at home, with clear instructions from the medical team.

• Keep the treated skin moist: the doctor will typically prescribe a plain, fragrance-free ointment or healing cream to apply regularly — dryness can delay healing and increase discomfort
• Gently cleanse the area with cool or lukewarm water and mild, unscented cleansers as directed; avoid scrubbing or rubbing the skin
• Do not pick, pull, or peel the skin that is flaking — this can cause scarring or infection
• Avoid direct sun exposure completely while the skin is healing, and continue to use a broad-spectrum sunscreen every day for at least several months after healing is complete, because newly formed skin is more vulnerable to sun damage and discolouration
• Avoid make-up and skin-care products (especially those with active ingredients such as retinoids, acids, or alcohol) until the doctor confirms the skin has healed sufficiently
• Avoid strenuous exercise, steam rooms, saunas, and swimming pools during the healing period, as heat and moisture can irritate the skin and raise infection risk
• Attend all scheduled follow-up appointments — the doctor will check healing, assess the result, and decide if any additional treatment sessions are needed
• Report any signs of infection promptly: increasing pain, spreading redness, yellow or green discharge, fever, or cold-sore blisters appearing in the treated area
• In the longer term, protecting the skin from the sun and maintaining a good skin-care routine helps preserve the results of the treatment