At a glance
CO2 laser treatment is a skin-resurfacing procedure that uses a precise beam of carbon dioxide laser light to remove damaged or unwanted layers of skin, prompting the body to grow fresher, smoother skin in their place.
The laser delivers short pulses or a continuous beam of light that is absorbed by water in the skin cells. This heats and vaporizes the targeted tissue while also warming the deeper layer called the dermis, which stimulates collagen (the protein that gives skin its firmness) to rebuild over the following weeks and months.
Medical Condition
Dermatologists use CO2 laser for a wide range of skin concerns, from visible signs of ageing to structural irregularities and certain benign (non-cancerous) growths.
- Fine lines and deep wrinkles, especially around the eyes and mouth
- Acne scars and other depressed or pitted scars
- Sun damage and uneven skin tone (including age spots and patches of discolouration)
- Enlarged pores and rough skin texture
- Mild to moderate skin laxity (loose skin) on the face and neck
- Seborrhoeic keratoses (rough, warty patches that appear with age)
- Warts, syringomas (small benign sweat-gland tumours), and similar benign skin lesions
- Rhinophyma (a thickened, bumpy nose condition associated with rosacea)
CO2 laser is not suitable for everyone. Your dermatologist will usually advise against it in these situations:
- Very dark or deeply pigmented skin types, as there is a higher risk of lasting pigment changes
- Active acne breakouts or active skin infections in the treatment area
- Recent use of oral isotretinoin (a strong acne medication), typically within the past 12 to 18 months
- A history of keloid scarring (raised, overgrown scars)
- Pregnancy or breastfeeding
- Certain autoimmune conditions that affect skin healing
Risks & Complications
CO2 laser is generally well tolerated, but like any procedure that intentionally removes skin, it carries real risks that a patient should weigh before going ahead.
- Redness and swelling: expected immediately after treatment and can last several weeks
- Temporary hyperpigmentation (darkening of the skin), particularly common in people with medium to darker skin tones
- Hypopigmentation (permanent lightening of treated skin), more likely with aggressive settings
- Infection, including bacterial skin infections or reactivation of cold sores (herpes simplex virus) in people who carry the virus
- Prolonged oozing or crusting during the healing phase
- Scarring, which is uncommon but possible if the skin does not heal normally
- Changes in skin texture, including milia (tiny white cysts) that may appear as new skin forms
- Eye injury if the area around the eyes is treated without proper eye protection
Preparation & Procedure
Preparation for CO2 laser usually starts several weeks before the procedure, not the night before. Your dermatologist will create a plan based on your skin type and the area being treated.
In the weeks leading up to treatment, you will typically be advised to avoid prolonged sun exposure and to use a broad-spectrum sunscreen daily, as tanned or sun-damaged skin is at higher risk of complications. Your doctor may also prescribe a skin-prepping cream containing retinoids or skin-lightening agents to even out pigmentation beforehand. If you have a history of cold sores, antiviral medication is usually started a day or two before the procedure to prevent an outbreak. Blood thinners and certain supplements such as fish oil or vitamin E are often paused in the days before treatment, but this decision is made by your prescribing doctor.
Depending on the depth of treatment planned, your clinic may request baseline skin photos and a review of your full medication list. Fasting is not usually required for a topical or superficial laser session, but deeper treatments performed under sedation (a relaxing medication given through a drip) may require you to stop eating and drinking for several hours beforehand. Your doctor's team will give you specific instructions.
The procedure itself typically follows these steps:
- The skin is cleansed and any makeup or skincare products are removed
- A topical numbing cream is applied and left for 30 to 60 minutes; for deeper treatments, local anaesthetic injections or sedation may be used instead
- The eyes are protected with special shields or damp gauze
- The laser handpiece is moved systematically across the treatment area, delivering pulses of light in a controlled pattern
- The treated skin appears whitish or grey immediately after each pass, then turns red as it warms
- Cooling or gentle wiping between passes helps manage heat and debris
- A soothing ointment or dressing is applied to the skin when the session is complete
- Total procedure time varies from about 30 minutes for a small area to over two hours for a full face
Aftercare
Recovery from CO2 laser takes longer than many patients expect, and what happens in the first two weeks matters as much as the procedure itself for the final result.
- Immediately after: the skin looks red and raw, similar to a moderate sunburn; most patients go home the same day
- Days 1 to 5: the skin oozes a clear or yellowish fluid and then begins to crust; the treated area must be kept moist with the ointment prescribed by your doctor to prevent the crust from cracking
- Days 5 to 10: crusts shed and new pink skin appears underneath; this is normal and does not mean the healing is complete
- Sun avoidance: the new skin is extremely sensitive to UV light; broad-spectrum sunscreen is used daily and hats or shade are strongly recommended for at least three to six months
- Makeup: most doctors advise waiting until the skin has fully re-epithelialised (formed a new surface layer) before applying any cosmetics, often two weeks or more
- Exercise and heat: activities that raise body temperature, such as vigorous exercise or saunas, are usually avoided for two to four weeks because heat increases swelling and redness
- Skincare products: harsh exfoliants, acids, and retinoids are reintroduced gradually and only when the doctor confirms the skin is ready
- Follow-up appointments: your dermatologist will want to see the skin as it heals, typically at one to two weeks and again at one to three months, to assess the result and check for any pigment changes
- Full results: collagen remodelling continues for three to six months, so the final improvement in skin texture and tone takes time to appear
Cost & What Determines It
The price of CO2 laser treatment varies widely depending on how much of the body is treated, how deep the laser is set, and where in the world the procedure is performed.
- Treatment area and size: a small spot treatment for a single lesion costs much less than a full-face resurfacing session
- Laser depth and technique: ablative fractional laser (which creates tiny columns of damage surrounded by untouched skin) tends to cost differently from fully ablative resurfacing (which removes the entire surface layer), because each has a different recovery demand and equipment setting
- Hospital or clinic class: a private hospital with an accredited dermatology department charges more than a standalone aesthetic clinic; costs also differ significantly between countries
- Anaesthesia type: topical numbing cream adds little to the bill, but sedation or monitored anaesthesia adds the cost of an anaesthesiologist and monitoring equipment
- Number of sessions: some conditions, such as acne scarring, may require more than one session to achieve the desired result
- Pretreatment medications: antiviral medication and prescription skin-prep creams in the weeks before are usually billed separately
- Post-procedure products: prescribed ointments and prescription-grade sunscreens are often charged outside the procedure fee
- Follow-up consultations: review appointments may or may not be included in the quoted package price
A package at a hospital or accredited clinic typically covers the laser session itself, the consumables used during the procedure (such as the handpiece tip and protective eye shields), and sometimes the initial consultation. Pre-procedure blood tests (if required), anaesthesiologist fees, take-home medications, post-care products, and follow-up visits are frequently listed as separate line items on the final bill.
BPJS Kesehatan does not cover aesthetic procedures, and most Indonesian private health insurance policies exclude elective cosmetic treatments as well. Patients travelling abroad for CO2 laser typically pay out of pocket or through a private international health plan that explicitly lists aesthetic dermatology as a covered benefit. Before travelling, ask the clinic for a written itemised cost estimate that includes all the items listed above, so there are no unexpected charges on the day of discharge.
Frequently Asked Questions
How many sessions of CO2 laser do I need?
Most people need between one and three sessions, but your doctor will decide based on what your skin needs. Deeper concerns like scars or significant sun damage may need more sessions spaced several weeks apart, while minor texture issues can sometimes be addressed in a single treatment.
What does CO2 laser feel like, and is it painful?
During the procedure most patients feel a warm, stinging sensation, like a rubber band snapping against the skin. Doctors typically apply a numbing cream beforehand to reduce discomfort, and the intensity you feel depends on how deep the settings are adjusted for your skin condition.
How soon will I see results from CO2 laser, and what should I avoid during healing?
Initial redness and peeling usually settle within one to two weeks, and skin continues to improve over the following months as new collagen forms. During that healing period, most doctors advise avoiding direct sun exposure, heavy exercise that causes sweating, and any skincare products with harsh acids or active ingredients until the skin has fully recovered.
How much does CO2 laser cost?
The cost varies depending on the size of the treatment area, the depth of the laser settings chosen for your skin concern, the number of sessions planned, and the class of clinic or hospital you choose. A written estimate from the hospital is the most reliable way to know the actual figure for your specific case.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
