Recovery is the part of CO2 laser resurfacing most people want to understand before they book, and reasonably so. It is the main practical difference between this treatment and a peel or a non-ablative laser, and it is the thing most likely to decide whether the treatment suits your life at the moment.
This article covers how long downtime lasts at each treatment depth, what your skin does day by day, the aftercare that supports healing, and the signs that mean you should call the clinic. If you are after what the treatment does, which settings we offer and what it costs, that is on our CO2 laser resurfacing page.
How long is CO2 laser downtime?
It depends almost entirely on how deeply the skin is treated. At Everything Skin the DEKA SmartXide Touch C60 is used at three depths, and each carries a different recovery.
- Lighter resurfacing. Approximately 1 to 2 days of visible redness.
- Moderate depth. Approximately 2 to 3 days.
- Deeper fractional resurfacing. Approximately 5 to 7 days, with residual redness that can persist for several weeks afterwards.
These are typical ranges rather than guarantees. Healing varies between individuals, and factors including skin type, age, medical history, smoking and how closely aftercare is followed all affect it.
It is worth being clear about what downtime means here. It refers to the period when the skin is visibly red, swollen or shedding. It is not the same as time off work, which depends on the depth treated, what you do and how comfortable you are being seen mid-healing. Your clinician will tell you which depth is planned and what to expect before you commit to a date.
What recovery actually involves
Recovery from CO2 laser resurfacing deserves the most honesty of anything here, because it is the main reason people either choose the treatment or decide against it.
Expect the skin to feel hot and appear red and swollen for the first 48 hours, similar to significant sunburn. Over the following days, it becomes dry and rough as the treated tissue sheds, and a bronzed or gridded appearance is common. Depending on depth, visible healing generally takes anywhere from three days for superficial treatments to two weeks or more for deeper work. Redness can persist for several weeks after the surface has healed.
During recovery, you will need to keep the skin well moisturised using your recommended aftercare, avoid all active skincare, avoid makeup until your practitioner clears it, and avoid swimming, saunas and strenuous exercise. Sun avoidance is not optional. Sun exposure on healing skin is the most common cause of pigmentation problems afterwards, and in Perth that requires real planning.
Plan the timing deliberately, and plan it around the depth you are having. After DOT Fractional, book nothing socially for at least a week. After the two lighter settings a long weekend is often enough, though redness can last longer than you expect. Whatever the depth, avoid scheduling treatment in the lead-up to a holiday or an outdoor summer event.
CO2 laser recovery, day by day
The pattern below is what most patients experience after a moderate to deep treatment. Lighter treatments compress the same sequence into a shorter window.
- Day 1. Skin feels hot and tight and looks red, comparable to significant sunburn. Swelling is common and is usually most noticeable around the eyes on waking.
- Day 2 to 3. Swelling settles. The skin starts to feel dry and rough, and a bronzed or gridded appearance develops as treated tissue prepares to shed.
- Day 3 to 5. Peeling and flaking. This is the stage people find hardest to leave alone. Do not pick, scrub or exfoliate; interfering with shedding tissue is one of the more avoidable causes of scarring.
- Day 5 to 7. Most surface shedding has finished after lighter and moderate treatments. New skin underneath is pink and sensitive.
- Week 2 to 4. Pinkness fades gradually. Makeup is usually tolerated again once the skin has fully closed and your practitioner has cleared it.
- Month 2 to 6. Collagen remodelling continues beneath the surface. Changes in texture and firmness develop over this period rather than appearing at once.
Aftercare that supports healing
Aftercare is not optional here. The skin barrier is open during healing, and how it is looked after materially affects both the result and the risk of complications.
- Keep the skin moist and occluded with whatever your clinician provides or recommends. Do not let it dry out and crust.
- Stop all active skincare. No retinoids, vitamin C, exfoliating acids or scrubs until you are cleared to restart.
- Cleanse with lukewarm water and the cleanser you are given, using light pressure. No hot water.
- Avoid sun exposure completely while healing, and use high protection daily once the skin has closed. Fresh skin pigments readily, and sun exposure during this window is a common cause of post-inflammatory pigmentation.
- Sleep slightly elevated for the first few nights if swelling bothers you.
- Do not pick, peel or help the shedding along.
- If you have a history of cold sores, tell the clinic beforehand. Preventive antiviral treatment is recommended and may be prescribed if appropriate.
Getting back to exercise, makeup and normal skincare
Recovery is very different between treatment depths, so the guidance below is given by treatment rather than as one rule. In each case the deciding factor is the same: the skin must have fully closed and your clinician must have cleared you. That point is typically reached after around 1 to 2 days for CoolPeel Essential, 2 to 3 days for CoolPeel Elite, and 5 to 7 days for DOT Fractional. Your clinician will confirm what applies to you.
- Strenuous exercise, saunas and swimming. Avoided until the skin has closed, so around 1 to 2 days after CoolPeel Essential, around 2 to 3 days after CoolPeel Elite, and at least the first week after DOT Fractional. Heat, sweat and chlorine all irritate healing skin, and sweat on an open barrier raises infection risk.
- Makeup. Once the skin has fully closed and your practitioner has cleared it. After the two lighter settings that is usually within a few days. After DOT Fractional it is commonly around day 7 to 10.
- Active skincare. Retinoids and acids are reintroduced gradually once the skin has settled, earlier after the lighter settings and from around the four week mark after DOT Fractional, on your clinician’s advice.
- Social downtime. CoolPeel Essential usually means around 1 to 2 days of visible redness, CoolPeel Elite around 2 to 3 days, and DOT Fractional around 5 to 7 days of visible healing, which is why most people keep that week clear. Residual redness can continue for several weeks at any depth, and is generally coverable once makeup has been cleared.
- Sun. Daily protection indefinitely. It affects how long your result lasts as well as your pigmentation risk.
When to contact the clinic
Most of what happens during recovery is expected. Some things are not. Contact the clinic rather than waiting if you notice:
- Increasing rather than decreasing pain after the first 48 hours
- Spreading redness, heat, yellow crusting, pus or an unusual odour, which can indicate infection
- Clustered blisters or tingling that may suggest a cold sore outbreak
- Fever
- Any area that has not begun to heal in the timeframe you were given
- Anything that concerns you and that you were not told to expect
Raising something early is always better than waiting to see. Infection and delayed healing are far more manageable when they are caught quickly.
Risks and who it is not suitable for
CO2 laser resurfacing carries more risk than most non-surgical treatments, and those risks should be understood before booking a consultation, not after.
Recognised risks include prolonged redness, post-inflammatory hyperpigmentation, hypopigmentation (which can be permanent), infection (including reactivation of cold sores), delayed healing, and scarring. The risk of pigmentation problems is higher in deeper skin tones, which is why skin typing is part of the assessment rather than a formality.
It is generally not appropriate if you:
- Have taken oral isotretinoin recently, timing to be confirmed with your practitioner
- Have an active skin infection, including a cold sore outbreak
- Have a history of keloid or hypertrophic scarring
- Are pregnant or breastfeeding
- Have recent sun exposure or a tan on the area to be treated
- Have certain autoimmune or connective tissue conditions
This list is not exhaustive, and some of these are timing issues rather than permanent exclusions. A proper assessment exists to identify what a general article cannot.
Frequently asked questions
What is a CO2 laser?
In cosmetic medicine, a CO2 laser is an ablative resurfacing device that uses a carbon dioxide beam at 10,600 nanometres to remove the outer layers of skin and prompt collagen production underneath. The same underlying technology is used industrially for cutting and engraving, which is why a general search on the term returns a mix of the two.
Does CO2 laser resurfacing hurt?
Most people find it uncomfortable. Topical anaesthetic is applied beforehand and reduces the sensation considerably without removing it, and additional anaesthetic options can be discussed at consultation. The deeper the treatment, the more sensation is involved.
How long does healing take, and can it be sped up?
Visible healing commonly runs from around three days for superficial treatments to two weeks or more for deeper work, with redness lingering beyond that. What genuinely helps is following your recommended aftercare exactly and keeping the skin well moisturised, keeping the skin out of the sun, not picking at shedding skin, and avoiding heat and exercise for the period your practitioner specifies.
Can CO2 laser be used on darker skin tones?
It can be, but it requires more caution. Deeper skin tones carry a higher risk of post-inflammatory hyperpigmentation, so settings are usually conservative, preparation beforehand is more important, and other options may be more appropriate. This is assessed individually.
Can CO2 laser make melasma worse?
It can. Melasma is heat sensitive and can be aggravated by ablative resurfacing, so it is generally approached cautiously and often managed with other methods first. If you have melasma, raise it specifically at your consultation.
How many treatments are needed?
That depends on the concern and the depth used. Superficial treatments are often done as a series, while deeper resurfacing is sometimes a single treatment with a long recovery. Your practitioner will set out what they anticipate at the consultation.
Book a consultation about CO2 laser resurfacing in Perth
If you are weighing up whether the recovery fits your circumstances, that is exactly the conversation to have at a consultation. Treatment depth can often be adjusted to the downtime you can realistically accommodate, and your suitability needs assessing before anything is booked.
Read more about CO2 laser resurfacing at Everything Skin, or book a consultation with our Perth team.
Important information
This information is general in nature and is not medical advice. It is not a substitute for a consultation with a registered health practitioner. Outcomes vary between individuals and no result is guaranteed. Some treatment options can only be discussed during a consultation with a registered health practitioner. All procedures carry risks, which will be explained to you during your consultation. Always seek advice from a qualified health practitioner about your individual circumstances.
