Dermatology
CO2 Laser Resurfacing Recovery: Day-by-Day
Published · Haute MD Editorial Team
Recovery from CO2 laser resurfacing happens in stages. For the first few days the treated skin is swollen, raw and oozing, like a bad sunburn, and needs gentle cleansing and a thick ointment several times a day. Around days 5 to 7 it dries and peels. New skin usually covers the area within about 1 to 2 weeks (Mayo Clinic says 7 to 10 days; Cleveland Clinic says 10 to 21 days at stronger settings), and many people return to normal activities then with makeup. Full recovery takes longer: Mayo Clinic says at least a month, and pink or red skin can take 2 to 3 months, sometimes up to a year, to fade. Fractional CO2 usually heals faster than traditional, fully ablative CO2. The main risks are infection (including cold-sore flares), acne and milia, prolonged redness, darker or lighter patches, and rarely scarring.
At a glance
What CO2 lasers treat: Wrinkles, scars (including acne scars), sun damage, uneven tone and texture, warts and some other skin conditions. Procedure length: 30–45 minutes for part of the face; 1½–2 hours for the full face. Raw, oozing, crusting stage: First several days. Dry, peeling stage: Around days 5–7. New skin covers the area: About 7–10 days (Mayo); up to 2 weeks (ASPS); 10–21 days at stronger settings (Cleveland Clinic). Full recovery: At least a month (Mayo); ablative healing can take 4–6 weeks (Johns Hopkins). Pink or red skin: Usually fades over 2–3 months; can last 6 months to a year. Back on retinoids/acids: Around 4–6 weeks, as directed. Main risks: Infection (including cold sores), acne and milia, prolonged redness, darkening or lightening of skin, rare scarring. FDA status: CO2 lasers are FDA-cleared (510(k)) Class II medical devices, not "FDA-approved". Sources: Mayo Clinic; Cleveland Clinic; Johns Hopkins Medicine; ASPS; ASDS; FDA. Checked Oct. 28, 2026.
What CO2 laser resurfacing does
A carbon dioxide (CO2) laser is an ablative laser: it destroys the outer layer of skin (the epidermis) and heats the layer beneath (the dermis), which stimulates new collagen. As the wound heals and skin regrows, the treated area is smoother and tighter (Mayo Clinic). Cleveland Clinic says CO2 lasers treat sun damage, wrinkles, scars, warts, birthmarks and other skin conditions. There are two main approaches, and they recover differently: Traditional (fully ablative) CO2 treats the whole surface of the treated area. It has the longest recovery. Fractional CO2 delivers the laser in narrow columns and leaves the skin between them untreated, which shortens recovery and reduces the risk of side effects (Mayo Clinic; Johns Hopkins). Mayo Clinic says fractional devices have become "the widely preferred method." A 2014 review says these micro-columns re-epithelialize (grow new surface skin) in 2 to 3 days (Omi and Numano). Fractional treatment may take more than one session. FDA status. CO2 lasers are regulated as Class II "powered laser surgical instruments" and reach the market through 510(k) clearance, not FDA approval. For example, one CO2 system cleared in December 2023 is indicated for "laser skin resurfacing" to treat "wrinkles, rhytids, and furrows (including fine lines and texture irregularities)" and acne scars, among other uses (FDA 510(k) K233301).
The recovery timeline, stage by stage
These are typical ranges from the sources cited, not a fixed schedule. How deep and dense the treatment is matters most: "The stronger the settings, the longer the recovery time" (Cleveland Clinic). Fractional treatments usually sit at the shorter end; fully ablative treatments at the longer end. Follow your own doctor's plan. ### Procedure day (day 0) It's usually an outpatient procedure. The skin is numbed, and you may be given sedation for a full face, or general anesthesia (Cleveland Clinic; Mayo Clinic). If you're sedated, arrange a ride home (Mayo Clinic). Treating part of the face takes 30 to 45 minutes; a full face takes 1½ to 2 hours (Cleveland Clinic). Afterward, the care team applies a thick ointment and may cover the skin with a dressing (Mayo Clinic). Cleveland Clinic describes a non-stick dressing for 24 hours. Clear drainage and tiny spots of bleeding may appear on the day of treatment and the day after (Cleveland Clinic). ### Days 1 to 2 Expect swelling, itching, and skin that feels sunburned and sensitive (Mayo Clinic; Cleveland Clinic). Use a cool compress or wrapped ice pack for 15 minutes every one to two hours as needed during the first 24 to 48 hours (Cleveland Clinic). Sleep with your head raised on an extra pillow; Cleveland Clinic advises this for the first four days. Wound care starts: gentle cleansing two to five times a day with saline or a diluted vinegar solution, as your doctor directs, then a layer of ointment (ASPS; Cleveland Clinic). The ointment keeps scabs from forming, which can raise the chance of scarring and slow healing (Cleveland Clinic). ### Days 2 to about 5: raw, oozing and crusting Depending on the treatment, the skin may look like a severe sunburn: raw and oozing, sometimes with blisters. A yellow fluid may ooze and form a crust (ASPS; Cleveland Clinic). Don't scratch or pick at crusts; it can cause scarring or infection (ASPS; Cleveland Clinic). Swelling is expected. For treatment around the eyes, doctors may prescribe oral steroids for swelling (ASPS; Cleveland Clinic). If your doctor prescribed an antiviral or antibiotic, keep taking it as directed. Cleveland Clinic describes continuing them for seven to 10 days after treatment. AAD says that after laser resurfacing "you'll need to stay home for 5 to 7 days." ### Days 5 to 7: drying and peeling About five days to a week after treatment, the skin becomes dry and peels (ASPS; Cleveland Clinic). New skin underneath is pink at first. Keep up the cleansing and ointment routine until the skin has healed; Johns Hopkins describes ointment for seven to 10 days. ### About week 1 to week 2 (or 3): new skin covers the area "New skin usually covers the area in 7 to 10 days" (Mayo Clinic). ASPS and Cleveland Clinic put CO2 recovery at "up to two weeks." Cleveland Clinic's CO2 page says treated areas heal in 10 to 21 days, depending on the condition and laser intensity. ASDS says healing takes three to 10 days, depending on depth and laser type. Once healed, oil-free makeup can cover the pink to red color; green-based makeup helps neutralize redness (ASPS; Cleveland Clinic). Start daily broad-spectrum sunscreen with SPF 30 or higher once the skin has healed, or when your doctor says to (ASPS; Cleveland Clinic; Mayo Clinic). Avoid activities that make you flush for two weeks (Cleveland Clinic). Mayo Clinic advises avoiding situations that raise infection risk, such as public whirlpools, and not using products that may irritate the face, such as cosmetics, during recovery. ### Weeks 2 to 6 Full recovery takes at least a month (Mayo Clinic). Johns Hopkins says healing after ablative treatment can take four to six weeks. Small white bumps (milia) can appear during healing, up to about a month after treatment (Cleveland Clinic). Retinoids and acids: Cleveland Clinic advises avoiding tretinoin or glycolic acid for four weeks and other irritating topical products for six weeks; ASPS says Retin-A and glycolic acid products can usually be restarted around six weeks, or as your doctor directs. AAD says that after healing, you'll see tightening and fewer wrinkles within 2 weeks. ### Months 2 to 12 Pink or red skin usually fades over two to three months but can take six months, and sometimes up to a year (Cleveland Clinic; ASPS). Redness tends to last longer in people with blonde or red hair. Mayo Clinic notes skin may look inflamed for several months after ablative treatment. Skin may keep improving for up to a year, and the improvement may last for several years (Cleveland Clinic; Mayo Clinic). New sun damage and normal aging will still add lines over time, so daily sun protection matters (Mayo Clinic).
Risks and side effects
Sources list these risks of ablative laser resurfacing: Infection. Bacterial, viral or fungal. The most common is a flare of the herpes virus that causes cold sores (Mayo Clinic). Tell your doctor if you get cold sores; an antiviral before and after treatment can prevent reactivation (ASPS; Cleveland Clinic). Acne flares and milia, partly from the thick ointments and dressings (Mayo Clinic; ASPS). Prolonged redness. Color changes. Skin can heal darker (hyperpigmentation) or, less often, lighter (hypopigmentation). Darker skin tones carry a higher risk of darkening and of long-term color changes (Mayo Clinic; Cleveland Clinic). Johns Hopkins notes CO2 lasers can cause light spots, especially in darker skin, and are most often recommended for lighter skin. With traditional, fully ablative CO2, permanent lightening is the main long-lasting side effect, and it can appear late (Preissig et al.; Tierney et al.). Scarring. Rare, but possible (ASPS; Cleveland Clinic). Mayo Clinic says ablative treatment carries a slightly higher risk. How often, in studies: In one practice's review of 490 fractional CO2 treatments (deep, or deep plus superficial; face and body) in 374 patients with skin types I–IV, 13.6% of treatments led to an adverse event. The most common were acne-like breakouts (5.3%), cold-sore outbreaks (2.2%), bacterial infections (1.8%), yeast infections (1.2%), darkening (1.2%) and redness lasting beyond a month (0.8%). There was no scarring or lightening in that series (Shamsaldeen et al., 2011). In a small study of 9 patients with skin types III–IV, darkening after fractional CO2 occurred in 55.5% at one month and 11.1% at six months (Chan et al., 2010). A review of fractional resurfacing complications found them more likely in sensitive areas and in people with darker skin types or medical risk factors, and less common overall than with traditional ablative resurfacing (Metelitsa and Alster, 2010). Call your doctor if you notice fever, bleeding or excessive pain (Johns Hopkins), or signs of infection or a cold-sore outbreak on the treated skin.
Aftercare checklist
1. Clean the treated skin gently as directed, usually two to five times a day with saline or a dilute vinegar solution (ASPS; Cleveland Clinic). 2. Keep it covered with the ointment your doctor recommends so scabs don't form (Cleveland Clinic; Mayo Clinic). 3. Don't pick, scratch or rub crusts (ASPS; Cleveland Clinic). 4. Use cool compresses during the first 24 to 48 hours, and sleep with your head raised (Cleveland Clinic). 5. Take any prescribed antiviral or antibiotic for the full course (Cleveland Clinic; ASPS). 6. Don't smoke. Mayo Clinic advises not smoking for at least two weeks before and after treatment. 7. Stay out of the sun while healing, then wear SPF 30+ every day (Mayo Clinic; Cleveland Clinic). (In a small split-side trial in Thailand, 26 patients, a broad-spectrum sunscreen with anti-inflammatory ingredients started the day after ablative fractional CO2 led to less darkening at one week; ask your doctor when to start.) 8. Wait about four to six weeks before going back to retinoids or acids, unless your doctor says otherwise (Cleveland Clinic; ASPS).
Who is a good candidate?
Likely good candidates (Cleveland Clinic) have: acne or chickenpox scars fine lines or wrinkles around or under the eyes, forehead or mouth sun-damaged skin, age spots or uneven pigment enlarged oil glands on the nose May not be good candidates: active acne or very dark skin (ASDS; Cleveland Clinic) deep wrinkles or excessive, sagging skin (Cleveland Clinic). Mayo Clinic says laser resurfacing "can't fix sagging skin." AAD calls it the most effective non-surgical option for tightening loose skin, but non-surgical tightening can't match a facelift. an open wound or active infection (Johns Hopkins) Mayo Clinic says you may be cautioned against laser resurfacing if you: took isotretinoin in the past year have a connective tissue or autoimmune disease or a weak immune system have a history of keloid scars had radiation therapy to the face have had laser resurfacing before are prone to cold sores or had a recent outbreak have brown skin or are very tan are pregnant or breastfeeding have a history of an outward-turning eyelid (ectropion) If you have darker skin, ask about other options. Mayo Clinic names radiofrequency microneedling as one less likely to cause color changes; see What Is RF Microneedling?
Preparing for treatment
Avoid unprotected sun: Mayo Clinic says too much sun up to two months before can cause a permanent change in skin color; Cleveland Clinic advises daily broad-spectrum sunscreen for four weeks before. Your doctor may ask you to use a topical retinoid for about four weeks beforehand (ASDS; Cleveland Clinic) and may prescribe an antiviral and an antibiotic (ASDS; Mayo Clinic). Tell your doctor about all medicines and supplements. Cleveland Clinic says to avoid photosensitizing medications such as doxycycline or minocycline for at least 72 hours before treatment. Plan your time off around the stages above.
Questions to ask at your consultation
1. Will you use fractional or fully ablative CO2, and why, for my skin? 2. How deep and dense will the treatment be, and what recovery should I plan for? 3. What is my risk of darkening or lightening, given my skin tone? 4. Will I need an antiviral or antibiotic? 5. What's my wound-care routine, and when can I wear makeup and sunscreen? 6. Who performs the treatment, and how many CO2 resurfacing treatments have you done?
Who should perform it?
AAD says the results of a laser procedure "depend largely on the skill of the person performing that procedure" and warns that the limited training, supervision and equipment in non-medical settings like spas and shopping malls "may jeopardize your health and safety." Because darker skin is more prone to burns and dark marks after laser treatments, AAD advises working with a board-certified dermatologist experienced in treating darker skin with lasers. ASPS warns that "in the wrong or inexperienced hands, laser resurfacing can be dangerous" and advises making sure the physician has specific experience with this procedure.
Find a doctor
Browse Dermatology, Plastic Surgery or Facial Plastic Surgery in the Haute MD directory, or start at Find a Doctor. Featured doctors: Dr. Daniel Scott Karempelis, a board-certified dermatologist and founding partner of Dermatology Associates of Atlanta in Atlanta, Georgia, where he is Medical Director of the practice's Laser Institute of Georgia; and Dr. Lisa Airan, a board-certified cosmetic dermatologist in New York City whose aesthetic dermatology practice includes laser surgery with fractionated CO2 laser. Haute MD members are featured through paid membership. Membership is not an endorsement or a ranking.
Sources
1. Mayo Clinic Staff, "Laser resurfacing" (Oct. 26, 2024). https://www.mayoclinic.org/tests-procedures/laser-resurfacing/about/pac-20385114 (fetched 2026-10-28). 2. Cleveland Clinic, "Carbon Dioxide Laser Resurfacing" (last updated 11/20/2020). https://my.clevelandclinic.org/health/treatments/8314-carbon-dioxide-laser-resurfacing (fetched 2026-10-28). 3. Cleveland Clinic, "Laser Skin Resurfacing" (last updated 03/22/2021). https://my.clevelandclinic.org/health/treatments/11015-laser-skin-resurfacing (fetched 2026-10-28). 4. Johns Hopkins Medicine, "Laser Skin Resurfacing and Other Rejuvenation Treatments." https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/laser-skin-resurfacing (fetched 2026-10-28). 5. American Society of Plastic Surgeons, "Laser Skin Resurfacing" (recovery, safety and candidates pages). https://www.plasticsurgery.org/cosmetic-procedures/laser-skin-resurfacing/recovery ; https://www.plasticsurgery.org/cosmetic-procedures/laser-skin-resurfacing/safety ; https://www.plasticsurgery.org/cosmetic-procedures/laser-skin-resurfacing/candidates (fetched 2026-10-28). 6. American Society for Dermatologic Surgery, "Laser Resurfacing." https://www.asds.net/skin-experts/skin-treatments/laser-resurfacing (fetched 2026-10-28). 7. American Academy of Dermatology, "Many ways to firm sagging skin." https://www.aad.org/public/cosmetic/younger-looking/firm-sagging-skin/ (fetched 2026-10-28). 8. American Academy of Dermatology, "Skin conditions that lasers can treat" (last updated 8/31/21). https://www.aad.org/public/diseases/a-z/skin-conditions-lasers-treat (fetched 2026-10-28). 9. U.S. Food and Drug Administration, 510(k) K233301, ULTRApulse Alpha CO2 Laser System (cleared Dec. 1, 2023), Indications for Use. https://www.accessdata.fda.gov/cdrh_docs/pdf23/K233301.pdf (fetched 2026-10-28); openFDA device classification, product code GEX (21 CFR 878.4810, Class II). https://api.fda.gov/device/classification.json?search=product_code:GEX (queried 2026-10-28). 10. Omi T, Numano K. "The Role of the CO2 Laser and Fractional CO2 Laser in Dermatology." Laser Ther. 2014;23(1):49. doi:10.5978/islsm.14-RE-01. https://pmc.ncbi.nlm.nih.gov/articles/PMC3999431/ (full text fetched 2026-10-28). 11. Preissig J, Hamilton K, Markus R. "Current Laser Resurfacing Technologies: A Review that Delves Beneath the Surface." Semin Plast Surg. 2012;26(3):109. doi:10.1055/s-0032-1329413. https://pmc.ncbi.nlm.nih.gov/articles/PMC3580982/ (full text fetched 2026-10-28). 12. Shamsaldeen O, Peterson JD, Goldman MP. "The adverse events of deep fractional CO(2): a retrospective study of 490 treatments in 374 patients." Lasers Surg Med. 2011;43(6):453–456. doi:10.1002/lsm.21079. https://pubmed.ncbi.nlm.nih.gov/21761414/ (abstract fetched 2026-10-28). 13. Chan NP, Ho SG, Yeung CK, Shek SY, Chan HH. "Fractional ablative carbon dioxide laser resurfacing for skin rejuvenation and acne scars in Asians." Lasers Surg Med. 2010;42(9):615–623. doi:10.1002/lsm.20974. https://pubmed.ncbi.nlm.nih.gov/20976801/ (abstract fetched 2026-10-28). 14. Metelitsa AI, Alster TS. "Fractionated laser skin resurfacing treatment complications: a review." Dermatol Surg. 2010;36(3):299–306. doi:10.1111/j.1524-4725.2009.01434.x. https://pubmed.ncbi.nlm.nih.gov/20100273/ (abstract fetched 2026-10-28). 15. Tierney EP, Eisen RF, Hanke CW. "Fractionated CO2 laser skin rejuvenation." Dermatol Ther. 2011;24(1):41–53. doi:10.1111/j.1529-8019.2010.01377.x. https://pubmed.ncbi.nlm.nih.gov/21276157/ (abstract fetched 2026-10-28). 16. Wanitphakdeedecha R, Phuardchantuk R, Manuskiatti W. "The use of sunscreen starting on the first day after ablative fractional skin resurfacing." J Eur Acad Dermatol Venereol. 2014;28(11):1522–1528. doi:10.1111/jdv.12332. https://pubmed.ncbi.nlm.nih.gov/24320057/ (abstract fetched 2026-10-28).
Medical disclaimer
This page is for general education and is not medical advice. Talk with a board-certified dermatologist or plastic surgeon about laser resurfacing.
Frequently Asked Questions
How long is CO2 laser recovery?
New skin usually covers the treated area in about 7 to 10 days (Mayo Clinic), and ASPS puts CO2 recovery at up to two weeks; stronger settings can take 10 to 21 days (Cleveland Clinic). Full recovery takes at least a month, and redness can take 2 to 3 months or longer to fade.
What does skin look like day by day after CO2 laser?
For the first several days it's swollen, raw and may ooze and crust. Around days 5 to 7 it dries and peels. New pink skin then shows, and the pink fades over months.
When can I wear makeup after CO2 laser?
Once the skin has healed. Oil-free, green-based makeup can help hide redness (ASPS; Cleveland Clinic). Ask your doctor first.
Is fractional CO2 recovery shorter?
Usually. Fractional CO2 leaves untreated skin between tiny treated columns, which speeds healing (Mayo Clinic; Cleveland Clinic). Cleveland Clinic puts fractional recovery at about one week. You may need more than one session.
When can I go back to work?
Plan around the stages: AAD says to expect to stay home 5 to 7 days after laser resurfacing, and many people use makeup once new skin has formed. Deeper treatments take longer.
How long does redness last after CO2 laser?
Usually 2 to 3 months, sometimes 6 months to a year. It tends to last longer in people with blonde or red hair.
Can CO2 laser cause dark spots?
Yes. Darkening is a known risk, and it's higher in darker skin tones. Lightening can also occur, more often after traditional fully ablative CO2. Sun protection and choosing an experienced doctor help.
When should I call my doctor after CO2 laser?
For fever, bleeding, excessive pain, signs of infection, or blisters that look like cold sores.
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