CO2 laser resurfacing is the most powerful non-surgical option for deep wrinkles, significant sun damage, and scarring. It is also the one with the most demanding recovery.
Dr Ritu and her clinical staff usually combine fractionated CO2 laser with full Erbium laser resurfacing to best target wrinkles and scarring with less downtime. She will advise you as to whether the Refresh 5 or the Refresh 10 depth is the best option for you. These will rejuvenate you by five to ten years, respectively.
CO2 Laser Resurfacing: The Short Answer
A fractional CO2 laser vaporises microscopic columns of skin while heating the deeper dermis, prompting the skin to regenerate and lay down new collagen. It addresses deep lines, acne and surgical scarring, sun damage and texture in a way lighter treatments cannot.
Expect seven to ten days of visible recovery, several weeks of residual pinkness, and results that continue developing over three to six months.
How It Works
The 10,600nm wavelength is absorbed by water in the skin. Because skin is largely water, that energy converts to heat almost instantly, vaporising tissue in precisely controlled columns.
Fractional delivery is what makes modern CO2 tolerable. Rather than removing the entire surface, the laser treats microscopic zones and leaves untreated bridges of skin between them. Those bridges act as reservoirs of healthy cells, so the surface heals in days rather than weeks.
Two things happen at once. Damaged surface cells are removed, and heat delivered to the deeper dermis triggers a remodelling response. That second process runs for months, through changes in gene expression within the skin, which is why the final result is not visible when the redness settles.
The Treatment Day
Topical anaesthetic is applied for 30 to 60 minutes beforehand, and nerve blocks may be used for deeper settings.
During treatment, you will feel heat and a prickling or snapping sensation, managed with cooling. It is uncomfortable rather than painless, and deeper settings are more so.
Immediately afterwards, the skin feels hot, comparable to a significant sunburn, and looks red and swollen.
To reduce post-treatment redness and to improve results, we pre-treat your skin with medical-grade skincare and also perform LED light treatments in the first few weeks.
Day-by-Day Recovery
- Days 1 to 2. The most intense stage. Marked redness, swelling that is often worst on the second morning, a persistent burning sensation, and pinpoint oozing. Sleeping propped up helps. Occlusive ointment is applied continuously.
- Days 3 to 5. Skin darkens to a bronzed appearance, tightens, and begins flaking. Itching is common and normal. This is the stage people find hardest to leave alone, and picking at this point is how scarring happens.
- Days 6 to 7. Peeling finishes and fresh pink skin appears. Swelling largely resolves. Mineral makeup is usually permitted once the surface is intact.
- Weeks 2 to 4. Pinkness fades gradually. Skin may feel sensitive and dry. Sun exposure at this stage risks lasting pigmentation.
Aftercare is not optional. Gentle cleansing, heavy occlusive ointment, no picking, no active ingredients, and absolute sun avoidance. Our post-resurfacing care guide covers the details, and daily sun protection becomes permanent rather than temporary.
Healing timelines vary between individuals.
Risks Worth Knowing
Beyond expected redness, swelling and peeling:
- Infection, including reactivation of cold sores, which is why antiviral cover is often prescribed
- Post-inflammatory hyperpigmentation, more common in deeper skin tones
- Prolonged redness lasting months rather than weeks
- Scarring, uncommon but possible, and more likely where the skin is picked or infected
- Delayed hypopigmentation: permanent loss of pigment appearing months to years afterwards. Rare, but it does not resolve and cannot be reversed
That last one is rarely mentioned in clinical marketing and is the reason settings, skin type assessment and operator experience matter more here than with any other resurfacing treatment. Dr Ritu has spoken about the dangers of the cosmetic laser industry on 9 News.
What Results to Expect
Improvement in deep lines and wrinkles, particularly around the mouth and eyes. Meaningful reduction in acne and surgical scarring. Clearing of sun damage and rough precancerous patches. Improved texture and firmness as new collagen matures.
Surface changes appear once healing completes. Collagen remodelling continues for three to six months, so the result at four weeks is not the final one. Individual results vary, and existing sun damage will accumulate again without protection.
Frequently Asked Questions
How many sessions will I need?
Many people achieve their goal in one treatment. Deeper wrinkles or scarring may need two or three, spaced months apart.
Who is not a candidate?
Contraindications include active infection or acne, recent use of certain oral acne medications, a history of keloid scarring, and some autoimmune or healing disorders. Deeper skin tones carry higher pigmentation risk and generally require pre-conditioning and conservative settings rather than exclusion. Matching settings to skin type is central to a safe outcome.
When can I return to work?
Depending upon depth of treatment, plan four to seven days away from the office and social commitments. Residual pinkness continues afterwards and is manageable with mineral makeup.
Is there a lower-downtime alternative?
For pigmentation and moderate texture concerns, non-ablative and picosecond options achieve a great deal with far less recovery, though across several sessions rather than one. For deep scarring and significant photoageing, CO2 does what they cannot.
Our comparison of skin tightening and resurfacing options sets out the differences.
Find Out Whether CO2 Suits Your Skin
You deserve a clear picture of both the results and the recovery before committing to a treatment that requires a week away from normal life.
Whether CO2 is the right choice depends on your skin type, what you are treating and whether the downtime is workable for you.
Book a consultation with Dr Ritu or her clinically trained team at Dr Refresh to discuss suitability and preparation. Please make an enquiry online, WhatsApp us at 0493 766 096, or call (02) 8014 6505.
