CO2 Laser Resurfacing: Cost, Recovery, Results and Risks

Cleveland Clinic describes laser resurfacing as a treatment that removes the outer layer of skin — the epidermis — while heating the underlying dermis, the layer beneath it.

The heat stimulates the growth of new collagen fibers, and the skin that grows back is smoother and firmer, in the clinic's description.

Other names for the procedure include laser peel, lasabrasion and laser vaporization.

CO2 lasers are one of the two resurfacing lasers the American Society for Dermatologic Surgery (ASDS) names as most common.

ASDS counts CO2 among the laser options for wrinkles, scars, warts and other conditions.

The other common type is the erbium laser, used for superficial and moderately deep lines on the face, hands, neck and chest — and, ASDS notes, causing fewer side effects than CO2.

A regulatory point worth knowing before you read any ad: CO2 resurfacing lasers are FDA-cleared devices, not FDA-approved drugs.

As an example, FDA's 510(k) database lists Candela/Syneron's CO2RE fractional CO2 system (K181523, cleared 2018) for dermatological procedures requiring ablation, coagulation and resurfacing of soft tissue, including skin.

That is one device's clearance; another practice's CO2 system carries its own, so which system a practice uses, and what that system is cleared for, is a fair question to ask.

How the energy is delivered changes the treatment.

Cleveland Clinic explains that traditional CO2 and erbium resurfacing injure the whole treatment area uniformly, while fractional CO2 drills numerous narrow columns into the skin and leaves the surrounding skin untreated and intact.

That one design difference is behind the trade-offs in recovery, number of sessions and effect covered later in this guide.

Cleveland Clinic lists the concerns that make someone a candidate for laser resurfacing as acne or chickenpox scars, uneven pigmentation, age spots, sun damage, and fine lines around the eyes, forehead or mouth.

The same sources are specific about who usually is not a candidate.

ASDS and Cleveland Clinic both say people with active acne, or with very dark skin, usually are not good candidates for ablative laser resurfacing.

Cleveland Clinic adds that darker skin carries a greater risk of healing with hyperpigmentation — and that erbium may be a better choice for darker skin — and lists deep wrinkles and excessive or sagging skin among the reasons someone may not do well with resurfacing.

That second point is worth restating, because ads sometimes flatten it: nothing in this guide's research supports calling ablative CO2 resurfacing safe for every skin type.

ASDS says very dark skin usually makes someone a poor candidate, and a 2026 systematic review of facial laser complications found post-inflammatory hyperpigmentation was the most common complication, particularly in people with Fitzpatrick skin types IV to VI (darker skin tones).

Preparation starts weeks before a session.

Cleveland Clinic's pre-treatment guidance overlaps with the American Academy of Dermatology's (AAD) advice for laser scar treatment, which covers similar ground:

Lists like these are a starting point for a conversation, not a protocol.

The right preparation depends on your skin, your medicines and the depth of treatment planned, and the practice's own instructions take precedence over any generic list.

The cleanest national number comes with caveats attached.

The American Society of Plastic Surgeons' (ASPS) cost page puts the average cost of skin resurfacing procedures like laser skin resurfacing at $1,829, according to its latest statistics.

The figure covers skin resurfacing in general: the page does not separate CO2 from other lasers, or ablative from non-ablative treatment.

It is also a plastic-surgeon fee, not a med spa price, and it excludes related costs: facility fees, anesthesia and prescriptions.

The page does not date its statistics; MedSpaStandard read it in October 2026.

We could not confirm a national med spa price for CO2 laser resurfacing, and how practices price the treatment — by session, by area, or as a package — is not something this guide's research established.

Local prices belong to local listings, so treat the ASPS figure as a named reference point from the surgical side, not as a quote you should expect to match.

What you can pin down in advance is the shape of the bill.

The area treated changes how long the procedure takes — Cleveland Clinic times a partial face at 30 to 45 minutes and a full face at 1.5 to 2 hours.

The mode matters too: a fractional plan built on multiple sessions is more than one appointment — the lower-eyelid study covered below treated people with 2 to 3 sessions.

And the ASPS figure's own exclusions are a ready-made checklist for any quote: ask whether facility, anesthesia and prescriptions are included.

Cleveland Clinic's page adds one more line to the budget: insurance does not cover cosmetic resurfacing.

No source in this guide's research gives a fixed session count for CO2 resurfacing — the number depends on the mode and the target.

The published studies are small, but they give a sense of scale.

In a randomized split-face trial of 28 people treated around the eyes, a single fractional session — fractional CO2 on one side, fractional erbium on the other — reduced wrinkle depth by about 20%, with no meaningful difference between the two lasers.

The authors concluded that multiple sessions may be needed for full effect.

In a 25-patient study of the lower eyelids, 2 to 3 sessions of ablative fractional CO2 — an average of 2.44 — produced a mean improvement of about 62 to 66% in texture, laxity and wrinkles at 6 months.

Redness and swelling in that study resolved by 1 week, with crusting and oozing within 48 to 72 hours.

On how long results last, Cleveland Clinic says skin may continue to improve for up to a year after resurfacing and that the improvement may last for several years.

The same source gives the limit: normal aging continues and brings new wrinkles, so the improvement is not permanent.

On pain, the published sources describe the anesthesia rather than pain scores.

Cleveland Clinic describes resurfacing as an outpatient procedure done with local anesthesia, often plus oral or IV sedation, with general anesthesia possible for a full-face treatment.

By its timing, a partial-face treatment takes 30 to 45 minutes and a full-face treatment 1.5 to 2 hours.

ASDS describes topical anesthetics used to numb small treatment areas, with a nerve block or conscious sedation for larger treatments.

The numbing plan a practice offers is worth asking about, since the sources describe different numbing for small areas than for larger treatments.

Recovery figures differ by source, because they measure different lasers and different depths.

Take each with its source rather than blending them into one average:

The AAD adds that after ablative resurfacing, tightening and fewer wrinkles appear within 2 weeks after healing.

Day to day, Cleveland Clinic describes the course after resurfacing this way: treated skin is red, sensitive and sunburn-like at first, and may be raw, ooze yellow fluid and blister.

Around days 5 to 7 it becomes dry and peels.

New skin appears pink and lightens over the following 2 to 3 months.

Cleveland Clinic's aftercare instructions:

• Sleep with an extra pillow for the first 4 days to help reduce swelling.
• Use cool compresses for the first 24 to 48 hours.
• Apply petroleum jelly or a similar ointment until the skin heals.
• Avoid activities that cause flushing for 2 weeks.
• Avoid tretinoin or glycolic acid for 4 weeks.
• Do not pick at crusts, and do not smoke.

Redness is the longest tail.

Cleveland Clinic says redness in the treated sites generally fades in 2 to 3 months but may take as long as 6 months to a year to disappear, and that it lasts longer in people with blonde or red hair.

Makeup can go back on once the areas have healed; the clinic notes green-based, oil-free makeup helps hide redness.

Cleveland Clinic lists the possible complications of laser resurfacing as milia, which the clinic says can appear up to a month after treatment, hyperpigmentation and, rarely, hypopigmentation, reactivation of herpes cold sores (especially after treatment around the mouth), bacterial infection, swelling and, very rarely, scarring.

The clinic notes antivirals are often started before treatment.

ASDS's list of potential complications overlaps: swelling, burning sensation, itching, scarring, pigmentation issues, infection, and bumps caused by blocked sweat glands.

The broadest recent picture comes from a 2026 systematic review of facial laser complications covering 13 studies and 2,010 cases treated from 2019 to 2025.

It found post-inflammatory hyperpigmentation was the most common complication, particularly in people with Fitzpatrick skin types IV to VI.

Ablative lasers — CO2 and Er:YAG — carried the highest risks of scarring and infection.

Eye injuries were less common but among the most severe complications.

For a sense of scale in one setting: among 424 patients who had ablative CO2 resurfacing of the lower eyelids with a single oculoplastic surgeon — most with Fitzpatrick type II or III skin, and most having simultaneous blepharoplasty — post-inflammatory hyperpigmentation occurred in 9.4%, herpes outbreaks in about 0.9%, atypical mycobacterial infection in 0.5% and a small scar in 0.9%.

All of these resolved, and no persistent scarring or ectropion (lid malposition) occurred.

One surgeon's figures do not transfer to other practices; they show what complications looked like in an experienced, physician-led setting.

Infection and other healing problems are on the complication lists above.

If treated skin looks worse rather than better as the days pass, contact the treating provider.

Within CO2, the first fork is traditional versus fractional.

Traditional resurfacing treats the whole area uniformly; fractional drills narrow columns and leaves the surrounding skin intact, in Cleveland Clinic's description.

The trade-off runs in both directions: fractional recovery is shorter — one full week against up to two weeks for traditional CO2, by Cleveland Clinic's figures — but a single fractional session has limited effect in trials, and the authors of the 28-person split-face trial concluded multiple sessions may be needed.

Fractional is not a shortcut to a fully ablative result without the recovery.

The second fork is ablative versus non-ablative.

ASDS defines non-ablative laser rejuvenation as using a laser to create heat without injuring the skin surface — used for age spots, scars, sun damage and wrinkles — while ablative resurfacing removes layers of skin.

On timing, the AAD says non-wounding lasers used for tightening may need 3 to 5 treatments, with results appearing gradually 2 to 6 months after the last one.

For loose skin specifically, the AAD puts ablative resurfacing at the top of the non-surgical field, calling it the most effective procedure for tightening loose skin — while noting it requires staying home for 5 to 7 days and carries greater risk of side effects such as scarring.

The AAD's broader ranking: creams give subtle results; non-invasive devices (ultrasound, radiofrequency, certain lasers) give modest tightening; minimally invasive procedures, including laser resurfacing, give the most tightening without surgery; and none of them matches a facelift, eyelid surgery or neck lift.

The erbium laser is the other resurfacing option ASDS names: superficial to moderately deep lines on the face, hands, neck and chest, with fewer side effects than CO2 by ASDS's description.

These comparisons describe what each modality does, not what anyone should choose.

The right option depends on the concern being treated, the skin's type and color, and the recovery time a person can take — which is the consultation's job, not a guide's.

Choosing a provider for CO2 resurfacing starts with two questions that are legal rather than cosmetic: who will operate the laser, and who handles it if healing goes badly.

On the first, there is no national rulebook.

Who may perform CO2 or other ablative resurfacing in a med spa is set state by state, through state medical and nursing boards — FDA clearance of a device is not permission for any one profession to use it.

In researching this guide we could not confirm a national answer to which CO2 treatments med spas may offer and which are physician-only, so treat it as a direct question for each practice, and check the answer against your state's rules.

With that settled, the questions below cover what this guide's sources flag as the decisions that matter:

Before-and-after galleries deserve their own kind of skepticism.

Under the FTC's endorsement guides, a before-and-after photo paired with a results claim conveys that the result is typical — and an ad is deceptive if consumers generally cannot expect that result.

So ask a practice what results patients in general can expect, rather than reading a gallery as your own likely outcome.

And if a practice wants to use your photos afterward, HIPAA requires your written authorization before protected health information is used for marketing, for providers HIPAA covers — whether a given med spa is one can depend on whether it conducts standard electronic transactions such as insurance billing.

Full-face photographs are specifically listed among the identifiers of protected health information.