CO2 Laser
Resurfacing

CO2 laser resurfacing is most effective in patients with Fitzpatrick skin types I to III — fair to medium skin tones with visible photodamage, fine lines, uneven pigmentation, acne scarring, or loss of skin radiance and texture. Patients with darker skin types (IV–VI) require careful evaluation, as CO2 laser carries a higher risk of post-inflammatory hyperpigmentation in these skin tones, and an alternative approach may be recommended. Active skin infections, isotretinoin use within the past year, and a history of keloid scarring are important contraindications discussed at consultation.

Full ablative CO2 removes the entire surface of the treated skin — producing the most dramatic results but requiring a longer, more demanding recovery. Fractional CO2 delivers energy in microscopic columns with untreated skin between them, allowing faster healing and greater safety while still achieving substantial collagen remodelling and surface improvement. At The Face Institute, we use fractional technology with parameters adjusted to the patient's needs — allowing us to dial between a lighter, lower-downtime treatment and a more aggressive resurfacing depending on the clinical goal.

In the first 24 to 48 hours, the skin will be red, swollen, and weeping — requiring careful wound care with gentle cleansing and barrier ointments. By days three to five, the skin begins to peel and bronzed crusting develops as the treated tissue sheds. By day seven to ten, the new skin underneath is revealed — pink, smooth, and sensitive. Redness gradually fades over two to six weeks, and full skin settling — including final pigmentation normalisation — takes three to six months. Strict sun avoidance during recovery is essential.

For lighter fractional treatments, a topical anaesthetic cream applied before the session provides sufficient comfort. For more aggressive parameters — or when treating the full face — oral sedation or intravenous sedation may be offered to ensure the patient is fully comfortable throughout. The post-treatment period involves a burning, sunburnt sensation for the first 24 to 48 hours, which is managed with cooling, emollients, and prescribed medications.

Results from a CO2 resurfacing session typically last three to five years before patients notice significant recurrence of photodamage and texture changes — though this depends heavily on post-treatment sun protection habits and the natural pace of individual ageing. The collagen stimulated by treatment continues to improve the skin for up to six months after the procedure, and the quality of the skin surface is reset to a genuinely younger baseline. Maintenance treatments can be performed every three to five years to sustain the result.

Yes — and this combination is one of the most powerful in all of facial rejuvenation. CO2 resurfacing performed on the day of a deep plane facelift addresses both the structural and surface dimensions of ageing simultaneously. The important caveat is that the laser is applied only to areas where the skin's blood supply has not been disrupted by the surgical dissection — a constraint that requires careful surgical planning and expert judgement. When performed safely and correctly, the combined result is transformative.

Pre-treatment preparation typically begins four to six weeks before the procedure and may include a course of topical retinoids to prime the skin and improve healing speed, a hydroquinone-based brightening agent in patients with pigmentation concerns, and strict sun avoidance. Antiviral prophylaxis is prescribed routinely before treatment to prevent herpes simplex reactivation, which can be triggered by laser energy even in patients with no active cold sore history. A full pre-treatment protocol is provided at consultation.