If you’ve been researching skin rejuvenation, acne scar treatments, or ways to refresh your complexion, you’ve probably come across CO2 laser resurfacing. You’ve likely already seen before-and-after photos and read about how powerful this treatment can be. But even though CO2 laser offers remarkable results, you might still feel unsure about the actual experience. You may be wondering things like:
– Does CO2 laser hurt?
– How do they prepare your skin?
– What does the laser feel like?
– What happens immediately after the treatment?
– Will I feel okay to go home?
– What should I expect in the first few hours?
It’s completely normal to feel this way. CO2 laser is a medical procedure, and understanding it step by step can help you feel more confident, relaxed, and ready for your appointment. The truth is that a lot of the anxiety comes from not knowing exactly what happens during each stage and that’s what this guide is here to solve.
In this article, I’ll walk you through the entire CO2 laser experience from start to finish from the moment you arrive, through the numbing process, the procedure itself, how it feels, and what you’ll experience in the first minutes and hours afterwards. My goal is to give you a realistic but reassuring breakdown of what to expect so you can prepare well and feel calm on the day of your treatment.
Let’s start at the very beginning: the preparation phase.
Before the Treatment: What Happens First
1. Your Consultation and Skin Assessment
Before any CO2 laser session, you’ll have a consultation where a practitioner examines your skin and discusses your goals. They may take photos, analyse your skin texture, and review your medical history to make sure CO2 laser is right for you.
This step ensures:
– your treatment is safe
– the settings are customised for your skin
– your expectations match what the treatment can deliver
You’ll also be given pre-treatment instructions, which may include:
– avoiding sun exposure
– stopping retinoids for a period
– staying hydrated
– pausing certain skincare actives
– preparing your skin with recommended products
This preparation phase helps your skin respond better and recover faster after the treatment.
2. On the Day: Arriving for Your CO2 Laser Appointment
When you arrive, your practitioner will greet you, review your treatment plan, and answer any last questions you might have. This is usually when they go through the entire process again to reassure you.
You’ll be asked to remove any makeup, SPF, or skincare products. Your skin must be completely clean so the laser can work effectively and evenly.
3. Skin Cleansing and Antibacterial Prep
Your practitioner will cleanse your face thoroughly using a gentle medical cleanser. Then, they may apply an antibacterial solution to reduce the risk of infection. This also helps your skin absorb the numbing cream evenly.
At this point, you’ll usually be lying comfortably on a treatment bed. Many clinics dim the lights to help you relax.
Numbing: What It Feels Like and How Long It Takes
Numbing is one of the most important steps before a CO2 laser session. Because the laser generates heat, proper numbing ensures your experience is tolerable and controlled.
1. Application of Topical Numbing Cream
A thick layer of anaesthetic cream is applied across the entire treatment area.
It can feel:
– cool
– slightly tingly
– or a little warm as it activates
Most people describe it as mildly strange but not uncomfortable.
2. Waiting 30–60 Minutes for Full Effect
You’ll usually rest for around 30 to 60 minutes while the numbing cream takes effect.
During this time:
– you may listen to music
– scroll on your phone
– chat with your practitioner
– or simply relax
The numbing phase gives you time to settle your nerves if you’re feeling anxious.
3. Optional Additional Anaesthesia
Depending on the intensity of your treatment and the areas being targeted, your practitioner may:
– add local injections for deeper numbing
– offer cold air cooling
– adjust the settings for comfort
Most patients only need topical numbing, but your practitioner will decide what’s best for your skin and comfort level.
Before the Laser Starts: What Happens Next
1. Removing the Numbing Cream
Once the cream has fully absorbed, your practitioner will remove it with gentle wipes. They’ll re-clean the skin to make sure no residue interferes with the laser.
2. Protective Eyewear Is Applied
CO2 lasers emit intense light, so you’ll be given protective eye shields either goggles or adhesive shields, depending on the area being treated.
This ensures your eyes are safe throughout the procedure.
3. Final Skin Cooling and Preparation
Some practitioners cool your skin before starting. Others apply saline or specialised gels depending on the laser platform being used.
You’ll feel a combination of coolness and dryness this is normal.
The CO2 Laser Treatment: What You’ll Feel Step-by-Step
This is the stage that most people fear, so I’ll explain it in as much detail as possible to help you feel prepared.
1. Your Practitioner Sets Up the Laser
They will:
– select the correct settings
– adjust pulse duration
– customise energy delivery
– target specific concerns (wrinkles, scars, pigmentation)
– map out the areas to be resurfaced
The device may look like a large arm with a scanning head, similar to a dentist’s light.
2. The Laser Begins: What the First Pass Feels Like
When the laser touches your skin, you may feel:
– quick warmth
– small “zaps”
– heat pulses
– tiny snaps
– mild stinging
Most people describe it as:
“Hot but bearable like tiny rubber band snaps combined with heat.”
Because you’re numbed, the sensation is manageable.
3. You May Smell the “Laser Smell” (Normal!)
This is one of the most surprising parts for new patients.
During the treatment, you may smell:
– a warm
– smoky
– slightly “burnt hair” scent
This is normal it’s simply the laser vaporising tiny micro-columns of skin.
The clinic often uses suction to reduce the smell.
4. The Practitioner Works in Sections
Your face is typically treated in sections:
– forehead
– cheeks
– chin
– nose
– upper lip
– jawline
– sometimes neck
Each area is scanned with precise patterns to ensure even coverage.
5. Multiple Passes May Be Needed
Depending on your skin concerns:
fine lines → 1 pass
wrinkles → 1–2 passes
acne scars → 2–3 passes
texture issues → 1–2 passes
Your practitioner adjusts the intensity in real-time based on your skin’s response.
6. Cooling Air May Be Used During the Procedure
Many CO2 laser devices are paired with cold air machines that blow chilled air onto your skin to make the process more comfortable. This can significantly reduce heat sensation.
7. The Whole Treatment Usually Takes 20–45 Minutes
The duration depends on the:
– size of the treatment area
– number of passes
– intensity of the settings
– complexity of your concerns
A full-face treatment typically takes around 30–45 minutes.
Immediately After the Laser: What You’ll Experience
Once the device is turned off, you’ll feel the after-effects right away.
1. Your Skin Will Feel Very Hot
Most patients say:
“It feels like a strong sunburn.”
This heat can last:
– 30 minutes
– up to 2 hours for deeper sessions
Cooling will be applied to ease the sensation.
2. Redness and Swelling Begin Immediately
Your skin will look:
– red
– flushed
– swollen
– shiny
This is expected and shows the laser has stimulated the healing response.
3. Ointment Is Applied to Begin Healing
Your practitioner will apply a protective ointment to:
– lock in moisture
– prevent dryness
– soothe the skin
– support recovery
You may leave the clinic looking glossy or shiny.
4. You’ll Receive Post-Care Instructions
These are extremely important and usually include:
– icing
– using gentle cleansers
– applying healing ointment
– avoiding sun exposure
– avoiding touching your face
– sleeping with your head elevated
– drinking plenty of water
Following these instructions is essential for proper healing.
5. You’ll Be Able to Go Home Shortly Afterwards
Most people can:
– walk
– talk
– drive (if eyes are not dilated)
– continue light activities
Your skin may feel warm but manageable.
What You’ll Experience in the First 24 Hours
The first day is the most intense, so let’s break it down clearly.
1. Heat and Warmth Continue for Several Hours
This gradually decreases but can last up to 12 hours for deep treatments.
2. Redness and Swelling Increase Slightly
Your body is responding to the injury created by the laser.
3. You’ll Need Frequent Ointment Application
Your skin must stay moist and protected.
4. You Should Avoid Sweat and Heat
Avoid activities like:
– workouts
– saunas
– hot showers
– cooking over hot stoves
Heat can worsen inflammation.
The First 3 Days After Treatment
Here’s what happens after the first day:
1. Your Skin Begins to Darken and Tighten
This is normal micro-crusting forming.
2. Tiny Brown Dots Appear
These dots are the “fractional” zones where the laser penetrated.
3. Swelling Peaks Around Day 2
Especially under the eyes.
4. Peeling Begins Slowly
– You should NOT pick at your skin.
– It will fall off naturally.
Day 4–7: Peeling and Healing
This is when peeling becomes more noticeable.
You’ll see:
– flaking
– shedding
– redness underneath
– new skin emerging
This is the phase where many people start to feel excited because fresh, smoother skin appears.
Week 2–4: The Glow Stage Begins
Your skin will start to:
– look brighter
– feel smoother
– show early tightening
– appear more refined
Most redness is mild by this point.
Month 1–3: Collagen Remodelling
This is when deeper results develop.
You’ll notice:
– improved scars
– softer lines
– reduced wrinkles
– better texture
– tighter skin
The collagen continues building for many months.
What You Should Wear and Bring on the Day
For your comfort:
– avoid makeup
– wear loose clothing
– bring sunglasses
– bring a hat
– bring water
– arrange transport if you’re anxious
Your skin will be sensitive to light, so sunglasses are essential.
Common Myths About CO2 Laser (And the Truth)
1. “It’s unbearable.”
False. With proper numbing, most people tolerate it well.
2. “You need weeks of downtime.”
Not always. Many people are presentable in a week.
3. “The results look fake.”
False. The results are your own skin just smoother and rejuvenated.
Signs the Treatment Is Working
During recovery, you may experience:
– tightness
– warmth
– redness
– micro-crusting
– shedding
These are all signs of collagen stimulation and healthy healing.
Who Should Avoid CO2 Laser?
You may not be suitable if you:
– have very dark skin
– are pregnant
– have recent sun exposure
– have active acne
– take photosensitive medications
– have unrealistic expectations
Your practitioner will guide you honestly during consultation.
Frequently Asked Questions:
1. Does CO2 laser resurfacing hurt?
Most people describe CO2 laser treatment as warm, sharp, or “snappy,” but not unbearable. The numbing cream applied before the procedure significantly reduces discomfort, and many clinics use cooling devices during the session to ease the sensation even further. While you may feel a mild burning or prickling sensation during the treatment, it is usually manageable throughout. Afterward, your skin may feel hot for a few hours, similar to a strong sunburn, but this settles gradually as healing begins.
2. How long does it take to recover after a CO2 laser session?
Recovery varies depending on how deep the treatment is, but most people go through about a week of visible healing. In the first few days, the skin may feel warm, tight, and swollen. Peeling typically begins around days three to five, revealing pink, fresh skin underneath. By the end of the first week, most patients are comfortable returning to normal routines, although mild redness can linger for a few more weeks. Deeper results continue to develop over several months as collagen levels increase.
3. Can I wear makeup after the treatment?
Makeup should only be applied once the skin has fully re-epithelialised, which usually takes about seven to ten days after a full-face CO2 laser session. Applying makeup too soon can interfere with healing, trap bacteria under the surface, or increase the risk of irritation. Once the skin barrier has recovered and the peeling stage is complete, non-comedogenic, gentle makeup can be used to minimise any lingering redness.
4. Is CO2 laser suitable for all skin types?
CO2 laser resurfacing is most suitable for lighter to medium skin tones because these skin types have a lower risk of pigmentation complications. People with deeper skin tones may experience increased risks such as hyperpigmentation or hypopigmentation due to the laser’s heat and intensity. Practitioners usually perform a thorough assessment before recommending the treatment to ensure it can be carried out safely for your specific skin type and concern.
5. How soon will I see results?
Many patients notice early improvements in brightness and skin texture within one to two weeks, once peeling has completed. However, the most significant changes develop over the next one to three months as collagen production increases. Acne scars soften, fine lines improve, and overall skin quality becomes smoother and more refined as deeper layers of the skin continue to remodel over time.
6. Are the results permanent?
The results of CO2 laser treatment can be long-lasting, particularly for concerns like acne scars and deep wrinkles. Once old, damaged skin is replaced by new collagen, those results remain. However, natural ageing, sun exposure, and lifestyle factors will continue to influence your skin over time. Many people choose maintenance treatments every one to two years of a lighter intensity to prolong their improvements.
7. What are the risks or side effects of CO2 laser resurfacing?
CO2 laser resurfacing is a medical procedure, so it does carry some risks, although these are rare when performed by an experienced practitioner. Temporary effects such as redness, swelling, warmth, and peeling are expected and part of the healing process. Potential side effects include temporary pigmentation changes, prolonged redness, infection, or scarring. To minimise these risks, clinics screen patients carefully, adjust settings appropriately, and give strict aftercare guidance.
8. How should I prepare before a CO2 laser treatment?
Preparation often begins several days to weeks before the procedure. You may be advised to avoid direct sun exposure, stop using retinoids or acids, and ensure the skin is healthy and well-hydrated. Sometimes practitioners prescribe antiviral medication if you have a history of cold sores. Arriving on the day without makeup and following any product guidelines strictly will help the treatment proceed safely.
9. Can I go to work the next day?
Most people prefer to take several days off because the skin looks red, swollen, and shiny immediately after treatment. By the next day, these effects are still prominent, and micro-crusting begins to form. If your workplace is comfortable with visible downtime, you may return, but many choose to wait until the peeling stage passes, usually around day five to seven. Remote work is often manageable sooner, depending on comfort level.
10. Is CO2 laser worth it for acne scars and deep wrinkles?
CO2 laser resurfacing is widely considered one of the most effective treatments for stubborn acne scars and deeper lines because it works at both the surface and deeper dermal levels. It removes damaged skin, stimulates significant collagen production, and encourages healthier skin to replace older, uneven tissue. Most patients report noticeable and meaningful improvements after a single session, with even more dramatic changes after a series.
Final Thought: Is CO2 Laser Right for Your Skin Goals?
CO2 laser resurfacing is one of the most powerful ways to renew your skin, whether you want to soften acne scars, smooth deep wrinkles, repair sun damage, or improve overall texture. Even a single session can make a visible difference, while deeper concerns often benefit from a personalised treatment plan.
Your results will always depend on the intensity of the treatment, the number of sessions, and how well you follow aftercare instructions. Protecting your skin from the sun, keeping the area moisturised, and avoiding irritation during healing play a major role in achieving smooth, long-lasting results. If you’re thinking about visiting CO2 laser clinic in London, feel free to contact us at the London Medical & Aesthetic Clinic. Our team provides tailored, expert-led treatments designed to help you achieve safe, effective, and natural-looking results.
References:
1. Ranjan, R., Chouhan, K., & Dogra, S. (2014) ‘Fractional CO2 Laser Resurfacing as Monotherapy in the Treatment of Atrophic Facial Acne Scars’, Journal of Cutaneous and Aesthetic Surgery, 7(4), pp. 246–252. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4134658/
2. Thakar, R. S., Shergill, B., & Sarwal, S. (2019) ‘Efficacy and adverse reactions of fractional CO2 laser for atrophic acne scars and related clinical factors’, Dermatology Research and Practice, 2019, Article ID 3103215. Available at: https://pubmed.ncbi.nlm.nih.gov/35181995/
3. Ong, M. W. & Wong, J. K. (2013) ‘Treatment of Acne Scars and Wrinkles in Asian Patients Using Carbon‑Dioxide Fractional Laser Resurfacing: Its Effects on Skin Biophysical Profiles’, Dermatologic Surgery, 39(7 Pt 1), pp. 1025–1032. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC3870213/
4. Sattler, E., Goldberg, D. J. & Sebaaly, M. (2023) ‘Efficacy of fractional CO2 laser therapy combined with hyaluronic acid dressing for treating facial atrophic acne scars: a systematic review and meta‑analysis’, Dermatologic Therapy, 36(11), e15928. Available at: https://pubmed.ncbi.nlm.nih.gov/37723352/
5. Tomaszewski, H. et al. (2020) ‘Efficiency of Carbon Dioxide Fractional Laser in Skin Resurfacing’, Open Life Sciences, 15(1), pp. 64–71. Available at: https://www.mdpi.com/2391-5413/15/1/64
