CO2 laser resurfacing is one of the more significant treatments in cosmetic medicine, and one of the most misunderstood. It is not a facial and it is not a lunchtime option. This article explains how it works, what it is used for, what recovery genuinely involves, and how it compares to the other resurfacing options available in Perth.
We are also pleased to share that the DEKA Tetra CO2 laser is coming to Everything Skin by Dr Salon in Bicton. More detail on that further down.
What CO2 laser resurfacing is
CO2 laser resurfacing uses a carbon dioxide laser to deliver energy at a wavelength of 10,600 nanometres. Water in the skin absorbs that wavelength almost completely, which is what allows the laser to remove tissue precisely rather than heating a broad area.
CO2 laser resurfacing is described as ablative, meaning it removes the outer layers of skin rather than passing through them. Beneath the removed tissue, a controlled zone of heat prompts the fibroblasts in the dermis to produce new collagen over the following months.
Fractional versus fully ablative
Older CO2 lasers treated the entire surface at once, which meant long recovery periods. Fractional systems instead deliver the energy in thousands of tiny columns, leaving untreated skin between them. That surrounding tissue is what drives healing, so recovery is shorter than it was with the older approach.
The DEKA Tetra platform works fractionally and allows the depth and density to be adjusted, which is why a single device can deliver anything from a superficial treatment through to deeper DOT fractional resurfacing.
What CO2 laser resurfacing is used for
CO2 laser resurfacing is generally considered where the concern involves the texture or surface of the skin rather than volume or muscle movement. That includes:
- Acne scarring, particularly rolling and boxcar scarring
- Sun damage and the surface changes that come with long-term ultraviolet exposure
- Fine lines, especially around the mouth and eyes
- Enlarged pores and uneven texture
- Some pigmentation, though this depends heavily on skin type
- Surgical and traumatic scars
Suitability for CO2 laser resurfacing varies a great deal between individuals. Skin type, medical history, medication, tendency to pigment and how much sun exposure the skin has had all affect whether it is appropriate. Some concerns are better addressed with skin needling or with a non-ablative option such as Laser Genesis, and that is a decision for assessment rather than something to settle in advance.
CO2 laser resurfacing compared to erbium
Erbium lasers are the other main ablative option, and the comparison with CO2 laser resurfacing comes up often. Erbium operates at 2,940 nanometres. Water absorbs erbium even more strongly than CO2, so the energy is absorbed in a shallower layer and less heat spreads into the surrounding tissue.
That difference drives everything else about the comparison.
| CO2 | Erbium | |
|---|---|---|
| Wavelength | 10,600 nm | 2,940 nm |
| Depth reached | Deeper | More superficial |
| Residual heat in tissue | More | Less |
| Collagen stimulation | Greater | More limited |
| Typical recovery | Longer | Shorter |
| Bleeding during treatment | Less, heat seals vessels | More |
Neither is better in the abstract. Erbium suits more superficial concerns and a shorter recovery. CO2 reaches deeper and produces more collagen stimulation, which matters for established acne scarring and more significant sun damage, but it asks more of the patient in recovery. A practitioner choosing between them is weighing the depth of the concern against what the person can accommodate.
Why we chose the DEKA Tetra
The reason for selecting this platform is adjustability. The same device covers superficial treatments through to deeper DOT fractional resurfacing, which means the treatment can be matched to the concern and to how much recovery time someone can realistically take, rather than the other way around.
What happens during a treatment
CO2 laser resurfacing begins with a consultation with a registered health practitioner, and here that matters more than for most treatments. It covers skin type, history of cold sores, previous pigmentation problems, current medication, and whether any preparation is needed beforehand. Some people need topical preparation for several weeks before treatment, and some are not suitable candidates at all.
On the day, topical anaesthetic is applied and left to take effect, usually for around 45 minutes to an hour. Depending on the depth being used, additional anaesthetic may be required. Treatment of the full face commonly takes 30 to 60 minutes.
Most people describe the sensation as hot and prickling. It is not a comfortable procedure, and the more superficial settings are considerably more tolerable than the deeper ones.
Recovery and aftercare
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 occlusive and moist, 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. Book nothing socially for at least a week, longer for deeper treatments, and avoid scheduling anything in the lead-up to a holiday or an outdoor summer event.
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 the occlusive aftercare exactly, 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 laser resurfacing in Perth
The DEKA Tetra CO2 laser is arriving at Everything Skin by Dr Salon in Bicton, in Perth’s western suburbs. If you are considering resurfacing, the sensible next step is an assessment rather than a booking, because suitability depends on your skin type, history and how much recovery time you can accommodate. Our practitioners will examine your skin and talk through whether CO2 resurfacing, another option, or a combination makes more sense for you.
You can also read more about our other laser treatments in Perth while you are deciding.
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.
