The Ultimate Guide to Lasers — and How to Find the Right One For You

What is Fractionated CO2?

Laser Treatment: Fractionated CO2, like Fraxel
Best For: acne scars, deeper wrinkles, sun damage
Downtime: swelling, scabbing, crusting, and peeling for at least a week

First off, a fractionated CO2 laser is an ablative laser, so it targets the top layer of skin. According to Jennifer Herrmann, MD, FAAD, the fractionated CO2 laser works by focusing microscopic beams of light into the skin in a grid pattern. Because the laser targets water, a major component of the skin, it immediately vaporizes tissue when fired.

“The fractionated CO2 laser is best for removing significant sun damage or treating textural acne scars,” says Dr. Herrmann. “By helping your skin grow its own new collagen, it can very effectively reduce lines around the eyes and mouth. It is also great for removing brown spots in a single treatment and improving the overall health of the skin because it physically removes damage.” Because there are small areas of “normal” skin between the micro wounds, healing is accelerated.

Dr. Herrmann also notes that because of the heat generated by the laser, people with darker skin tones may not be the right candidate. She also says that people with melasma (not to be confused with hyperpigmentation) should be very careful with heat-based lasers as they can actually backfire and cause the melasma to spread.

In terms of downtime, you should expect a pretty red face (like the worst sunburn you’ve ever had) for about 7 to 10 days with some peeling and scabbing. You will likely also need to use some ointment to help the healing process.

When you’re on the hunt for a laser treatment, it’s important that you research what type of laser is used — for example, Fraxel, which is the most common device used for fractionated CO2 treatments, has three different settings. Fraxel Re:pair, which is the most aggressive of the three, is a fractional CO2, ablative laser. Fraxel Re:store is actually a fractional Erbium laser (more on that later), while Fraxel Dual uses two non-ablative laser frequencies.

Since the fractionated CO2 laser is quite strong, your doctor will apply a medical-grade numbing cream to your skin, and you may even be given a low dose of Xanax or Valium beforehand. You may still feel some heat and stinging both during and after the treatment.

The takeaway? Fractionated CO2 lasers are great for anyone with acne scarring, fine lines, wrinkles, dark spots, and sun damage, but you should expect a longer amount of time to heal (think: swelling, scabbing, crusting, and peeling for at least a week). Your skin will look tighter and smoother after about a week after the procedure, but the final results usually take around 3 to 6 months to really appear since it takes time for new collagen to synthesize.