Fractional CO2 Laser: Treatment, Recovery & Results

Treatment type: Fractional laser skin resurfacing

Common concerns treated: Acne scars, fine lines, enlarged pores, sun damage, uneven skin texture

Procedure length: Typically 30–60 minutes depending on the treatment area

Anaesthetic: Topical numbing cream applied 30–60 minutes before treatment

Recovery time: 3–7 days of redness and peeling, with gradual improvement over following weeks

Results visible: Initial improvement within 1–2 weeks, with continued collagen production over 3–6 months

Fractional CO2 laser treatment is a form of laser skin resurfacing that treats the skin in thousands of tiny microscopic columns, leaving surrounding skin intact. Unlike fully ablative CO2 laser resurfacing which removes the entire outer layer of skin, fractional CO2 laser targets only a fraction of the skin’s surface at one time. This approach stimulates collagen production and encourages new skin cell growth while preserving healthy surrounding tissue, which significantly speeds up the healing process.

Because fractional CO2 laser penetrates the deeper layers of the skin while leaving surrounding tissue untouched, it can produce meaningful improvements in skin texture, acne scars, fine lines and pigmentation with a shorter recovery period than fully ablative treatment. The procedure is typically performed as a day procedure in a clinic setting, with patients returning home shortly after treatment.

Fractional and fully ablative CO2 laser both use carbon dioxide laser technology to resurface the skin and stimulate collagen production, but they differ significantly in how much skin is treated at one time and how long recovery takes. Understanding the difference helps patients choose the most appropriate treatment for their skin concerns and lifestyle.

For a detailed side-by-side comparison of fractional and ablative CO2 laser including recovery time, cost and suitability, see our Fractional vs Ablative CO2 Laser comparison table.

Fractional CO2 laser treatment can improve a wide range of skin concerns by stimulating new collagen production and encouraging healthy skin cell regeneration. Because the laser targets the deeper layers of the skin while leaving surrounding tissue intact, it is particularly effective for improving skin texture and tone with manageable downtime.

Common skin concerns treated with fractional CO2 laser include:

• Acne scars and surgical scars
• Fine lines and early wrinkles
• Sun damage and uneven skin tone
• Enlarged pores and rough skin texture
• Pigmentation and age spots
• Mild skin laxity and crepey skin

Fractional CO2 laser can be used on a range of skin types, though careful patient assessment is essential before treatment. Because the laser creates controlled micro-injuries in the skin, patients with darker or olive skin tones require particular care as there is a higher risk of post-inflammatory hyperpigmentation following treatment.

Skin type is commonly assessed using the Fitzpatrick scale, which classifies skin from Type I (very fair) to Type VI (very dark). Fractional CO2 laser is most commonly recommended for Fitzpatrick Types I to IV, though experienced practitioners may treat darker skin types using adjusted laser settings and a more conservative approach.

During a consultation, a qualified practitioner will assess skin type, medical history and treatment goals to determine whether fractional CO2 laser is the most appropriate option, or whether an alternative treatment may be more suitable.

Fractional CO2 laser is one of the most widely used treatments for acne scarring, particularly for atrophic scars including boxcar scars, rolling scars and shallow ice pick scars. By removing damaged skin cells and stimulating new collagen production in the deeper layers of the skin, fractional CO2 laser can significantly improve the texture and appearance of acne scarred skin.

Because acne scarring varies considerably between patients in terms of depth, type and distribution, treatment settings are carefully adjusted by the practitioner to target each patient’s specific concerns. Some patients achieve significant improvement with a single fractional CO2 laser session, while others benefit from two or three sessions spaced several weeks apart.

During a consultation, the practitioner will assess the depth and type of scarring and recommend whether fractional CO2 laser resurfacing is the most appropriate option, or whether a combination approach including fully ablative CO2 laser or other treatments may produce better results. For deeper or more complex acne scarring, your practitioner may recommend fully ablative CO2 laser resurfacing as an alternative.

Fractional CO2 laser resurfacing can produce visible improvements in skin texture, tone and overall quality. Before treatment, patients typically present with concerns such as acne scars, fine lines, sun damage or uneven skin texture. After the skin heals, most patients notice smoother skin, reduced scarring, softer lines and a more even complexion.

Results from fractional CO2 laser develop gradually over several weeks and months as new collagen forms beneath the skin. Because the treatment stimulates the skin’s natural healing response, improvements continue long after the initial recovery period has ended. Most patients see meaningful improvement within 4 to 6 weeks, with continued enhancement over 3 to 6 months.

Common improvements seen in fractional CO2 laser before and after results include:

• Smoother overall skin texture
• Reduced appearance of acne scars
• Softer fine lines and early wrinkles
• More even skin tone and reduced pigmentation
• Smaller appearing pores
• Improved skin radiance and quality

Results vary depending on the depth of treatment, the concerns being addressed, and the patient’s skin type and aftercare. For more dramatic single-session before and after results, some patients consider fully ablative CO2 laser resurfacing.

The cost of fractional CO2 laser treatment varies depending on the clinic, the practitioner’s experience, the treatment area, and the number of sessions required. In the UK, fractional CO2 laser resurfacing typically costs between £500 and £2,500 per session. Smaller treatment areas such as under-eyes or specific scar areas may cost less, while full-face fractional CO2 laser performed by an experienced practitioner will be towards the higher end of this range.

Because fractional CO2 laser often requires more than one session to achieve optimal results, particularly for acne scarring, patients should factor in the total cost of their treatment plan when budgeting.

Factors that influence fractional CO2 laser cost include:

• Treatment area size and complexity
• Number of sessions required
• Clinic location and practitioner experience
• Type of fractional CO2 laser technology used
• Aftercare products and follow-up appointments

When comparing prices, it is important to consider both cost and practitioner expertise. Fractional CO2 laser is an advanced medical procedure that should always be performed by a qualified and experienced practitioner. You can verify a practitioner’s credentials through the Joint Council for Cosmetic Practitioners (JCCP) or Save Face.

One of the key advantages of fractional CO2 laser over fully ablative treatment is the shorter recovery period. Because the laser leaves surrounding skin intact, the healing process is faster and side effects are generally less intense than with fully ablative resurfacing.

In the first few days after fractional CO2 laser treatment, patients commonly experience redness, mild swelling and peeling as the skin begins to regenerate. Most patients find that the visible signs of recovery resolve within 5 to 7 days, though some redness may persist for a week or two depending on the treatment depth.

Proper aftercare is essential to support healing and achieve the best possible results from fractional CO2 laser treatment. During the recovery period the skin is more sensitive and requires gentle, consistent care.

Practitioners commonly recommend the following aftercare guidelines after fractional CO2 laser:

• Keep the skin clean and moisturised using gentle products recommended by your practitioner
• Avoid direct sun exposure and apply a high-SPF sunscreen once the skin has healed
• Do not pick or peel the skin during recovery — allow it to shed naturally
• Avoid harsh skincare products including retinoids, exfoliating acids and scrubs until the skin has fully healed
• Avoid excessive heat including saunas, steam rooms and intense exercise during the first week of recovery
• Attend all follow-up appointments so your practitioner can monitor healing and results
• Follow your practitioner’s specific aftercare instructions — these may vary depending on the depth of treatment used

Most patients can return to their normal skincare routine within 2 to 3 weeks following fractional CO2 laser treatment.

Fractional CO2 laser is considered a safe and effective treatment when performed by an experienced medical practitioner, and carries a lower risk profile than fully ablative CO2 laser resurfacing due to the preservation of surrounding healthy tissue. However, as with any skin procedure, there are potential risks and side effects that patients should be aware of before treatment.

Most patients experience temporary redness, mild swelling and skin peeling during the healing period. These effects are a normal part of the skin’s regeneration process and typically resolve within one to two weeks.

Less common side effects can include prolonged redness, changes in skin pigmentation, infection or delayed healing. Patients with darker skin tones have a higher risk of post-inflammatory hyperpigmentation following fractional CO2 laser treatment, which is why thorough skin assessment before treatment is essential.

Possible fractional CO2 laser side effects include:

• Redness and mild swelling
• Peeling or flaking during healing
• Temporary skin sensitivity
• Hyperpigmentation or hypopigmentation — particularly in darker skin types
• Infection — rare when proper aftercare is followed
• Scarring — very rare when performed by an experienced practitioner

Choosing a qualified and experienced practitioner significantly reduces the risk of complications. For doctor-led clinics, verify GMC registration. For nurse-led clinics, look for membership with the British Association of Medical Aesthetics Nurses (BAMAN) or the British College of Aesthetic Medicine (BCAM). You can also check accreditation with the Joint Council for Cosmetic Practitioners (JCCP) or Save Face.

Choosing the right clinic for fractional CO2 laser treatment is important to achieve safe, effective results. Because fractional CO2 laser is an advanced medical procedure that affects the deeper layers of the skin, patients should look for practitioners with specific experience in laser resurfacing and a thorough understanding of different skin types.

During a consultation, a qualified practitioner should assess your skin condition, discuss your treatment goals, explain the expected recovery process and provide a clear overview of potential risks and costs.

When choosing a fractional CO2 laser clinic, consider:

• The practitioner’s specific experience performing fractional CO2 laser resurfacing
• Whether the clinic carries out a thorough skin consultation before treatment
• The type of fractional CO2 laser technology used
• Whether the clinic holds voluntary Care Quality Commission (CQC) registration — note that CQC registration is not currently mandatory for cosmetic laser clinics in England, but demonstrates a higher level of clinical governance where held
• Professional body membership such as the Joint Council for Cosmetic Practitioners (JCCP), General Medical Council (GMC) for doctor-led clinics, or British Association of Medical Aesthetics Nurses (BAMAN) for nurse-led clinics
• Membership with the British College of Aesthetic Medicine (BCAM) or Save Face as additional trust indicators
• Clear guidance on aftercare, recovery and follow-up appointments

Patients looking for fractional CO2 laser treatment can find experienced clinics across major UK cities. The Aesthetic Standard has reviewed and verified clinics offering fractional CO2 laser resurfacing in the following locations:

• Fractional CO2 Laser Clinics in London
• Fractional CO2 Laser Clinics in Manchester
• Fractional CO2 Laser Clinics in Birmingham

For a full overview of CO2 laser resurfacing including fractional and fully ablative options, visit our CO2 laser treatment guide.

Fractional CO2 laser is suitable for patients who want to improve skin texture, reduce acne scarring, treat fine lines or address sun damage, and who prefer a shorter recovery period than fully ablative resurfacing. The treatment is particularly well suited to patients who cannot take extended time off for recovery but still want meaningful improvement in their skin quality.

Good candidates for fractional CO2 laser typically:

• Have acne scars, fine lines, enlarged pores or uneven skin texture
• Have fair to medium skin tones, though darker skin types can be treated with careful assessment
• Are in good general health with no active skin infections
• Have realistic expectations about the gradual nature of results
• Can commit to proper aftercare including sun protection

Patients with active skin infections, certain medical conditions, a history of keloid scarring, or those who are pregnant may not be suitable candidates. A thorough consultation with a qualified practitioner is essential to determine suitability.

For patients with deeper wrinkles, severe acne scarring or significant sun damage who want more dramatic results from a single session, fully ablative CO2 laser resurfacing may be a more appropriate option.