If you’re thinking about getting a CO2 laser treatment, one of the first questions that probably comes to mind is: “How many sessions will I need to see real results?” It’s a completely normal question, especially because CO2 laser is known for being one of the most powerful skin-resurfacing treatments available today. You don’t want to book an appointment blindly or commit to something without understanding the process, the number of treatments required, or the timeline for your results.
The truth is that CO2 laser isn’t a “one-size-fits-all” treatment. How many sessions you need depends on several factors including your skin concern, its severity, your skin type, and how your skin responds to collagen stimulation. Some people get dramatic results from just one well-performed session. Others do best with two or three spaced sessions. And for some concerns, especially severe acne scarring or deep lines, combination treatments might work even better.
In this guide, I’m going to break down exactly how many CO2 laser sessions you might need depending on your goals. I’ll explain why the number varies from person to person, what results you can expect from each session, how long recovery takes, and why a personalised approach matters so much with CO2 laser resurfacing.
By the end, you’ll know exactly what to expect and feel more confident planning your treatment journey.
What Does a CO2 Laser Actually Do?
Before we dive into session numbers, it helps to understand what makes CO2 laser different from other skin treatments.
A CO2 laser is:
– an ablative laser
– a fractional laser
– a deep resurfacing tool
This means it removes tiny columns of skin while heating the deeper layers. The goal is to:
– trigger collagen remodelling
– rebuild smoother skin
– tighten the surface
– improve texture and tone
Because of its strength, CO2 laser can address issues that milder lasers, peels, and microneedling cannot.
Factors That Determine How Many Sessions You Need
Your session number will depend on:
1. Your skin concern (wrinkles, scars, sun damage, texture)
Each issue requires different depths and intensities.
2. The severity of the problem
Deep lines and severe acne scars need more sessions.
3. Your skin type and thickness
Thicker or oilier skin sometimes responds differently than thin, delicate skin.
4. Your responsiveness to collagen production
Some people produce collagen faster than others.
5. The strength of the laser settings
One strong session can equal several lighter ones.
6. Whether combination treatments are included
Subcision, microneedling RF, or TCA CROSS can reduce the number of CO2 sessions needed.
7. Your tolerance for downtime
You can choose deep or light CO2 resurfacing depending on how much time you can take off.
All of this plays a role in planning your ideal treatment schedule.
How Many CO2 Laser Sessions Do You Need for Different Skin Concerns?
Below is a detailed breakdown of how many sessions you typically need for the most common skin concerns.
1. Acne Scars: Usually 1–3 Sessions
If you’re looking to improve acne scars with CO2 laser, you may need between one and three sessions depending on the type and severity of your scars.
Mild Scarring: 1 Session
If your scars are shallow and mostly textural, one strong session may be enough to give you smoother, fresher-looking skin.
Moderate Scarring: 1–2 Sessions
Rolling and boxcar scars often benefit most from two sessions spaced several months apart.
Severe Scarring: 2–3 Sessions
Deep ice-pick or tethered scars may require three sessions, often combined with:
– subcision
– TCA CROSS
– microneedling RF
– dermal fillers
Results Timeline
You’ll notice initial improvement after healing, but the biggest changes happen over 3–12 months as collagen builds.
2. Wrinkles and Fine Lines: Usually 1–2 Sessions
CO2 laser is extremely effective for treating wrinkles, especially those caused by age or sun exposure.
Mild Ageing: 1 Session
Light lines and early ageing can improve dramatically after a single session.
Moderate Ageing: 1–2 Sessions
If you have deeper wrinkles or a lot of sun damage, a second session may be beneficial.
Severe Wrinkles: 2 Sessions
Especially around the eyes or mouth, a second session can boost tightening and texture improvement.
Results Timeline
You’ll see smoother skin in 2–4 weeks, with continued tightening over several months.
3. Sun Damage and Pigmentation: Usually 1 Session
Sun damage responds extremely well to CO2 resurfacing.
1 Session
Most people only need one session to improve:
– sunspots
– uneven pigmentation
– rough skin
– dullness
– superficial texture
2 Sessions
If the damage is extensive (from decades of sun exposure), a second session may be recommended.
4. Uneven Texture, Pores, and Roughness: 1–2 Sessions
If your main concern is texture or enlarged pores:
1 Session
Often gives a smoother, more refined surface.
2 Sessions
Useful if pores are very large or if you want extra tightening.
5. Deep Resurfacing for Full-Skin Renewal: Usually 1 Session
Some people do CO2 laser as an all-in-one rejuvenation treatment.
A deep resurfacing session can:
– tighten the skin
– reduce lines
– improve texture
– shrink pores
– brighten tone
– stimulate long-term collagen
1 Session
A strong session usually provides transformative results.
2 Sessions
May be recommended for older skin or more serious concerns.
6. Surgical Scar Improvement: 1–3 Sessions
CO2 laser can significantly improve the appearance of surgical scars.
New scars: 1–2 sessions
Older scars: 2–3 sessions
Thick or raised scars: May need additional combination treatments
Results depend on scar type and location.
7. Stretch Marks: 2–4 Sessions
Stretch marks usually require more sessions because they occur in the dermis.
Light marks: 2 sessions
Moderate marks: 3 sessions
Deep or old stretch marks: 3–4 sessions
Combination therapy with microneedling RF is often recommended.
8. Skin Tightening and Long-Term Collagen Boost: 1–2 Sessions
If your goal is tighter skin:
younger skin: 1 session
ageing skin: 1–2 sessions
Collagen levels continue improving for up to a year.
How Far Apart Should CO2 Laser Sessions Be?
Spacing sessions correctly is crucial.
Deep Sessions:
3–6 months apart
Your skin needs time to recover and build collagen.
Mild or Fractional Sessions:
4–8 weeks apart
These are lighter and require less downtime.
Your practitioner will decide the ideal interval based on your skin response.
Why Some People Only Need One Session
There are several reasons why one session can be enough:
1. Strong laser settings
A deep resurfacing session can produce dramatic results.
2. Mild to moderate skin concerns
If you don’t have severe scarring or wrinkles, one treatment may deliver what you want.
3. Young or thick skin
Some skin types respond extremely well to collagen stimulation.
4. High treatment density
The deeper and denser the laser passes, the fewer sessions required.
Why Others Need Multiple Sessions
Sometimes one session isn’t enough especially for:
1. Deep acne scars
These require repeated collagen remodelling.
2. Severe sun damage
Years of UV exposure can make the skin more resistant.
3. Very deep wrinkles
Especially around the mouth or eyes.
4. Mild sessions
If you choose a light resurfacing approach for lower downtime, more sessions will be needed.
5. Combination therapy
Your skin may respond better to repeated, controlled treatments.
How Much Improvement Can You Expect After Each Session?
After 1 Session
You may see:
– smoother texture
– brighter skin
– reduced lines
– shallow scar improvement
– smaller pores
– tighter surface
After 2 Sessions
You’ll likely experience:
– deeper scar improvement
– stronger tightening
– greater clarity
– more even tone
After 3 Sessions
Maximum results typically appear here, especially for:
– deep scarring
– advanced ageing
– stretch marks
Is One Strong Session Better Than Several Mild Ones?
It depends on your goals.
One Strong Session:
– fewer appointments
– more dramatic results
– deeper collagen stimulation
– longer downtime
– more intense peeling
– more early redness
Multiple Mild Sessions:
– less downtime
– gentler on the skin
– safer for darker skin tones
– more total cost
– more visits
– slower results
Your practitioner will help you decide which strategy suits you best.
How Skin Type Influences Session Count
Your skin type plays a big role in how many sessions you need.
1. Lighter Skin (Fitzpatrick I–III)
– Usually tolerates deeper settings.
– Often needs fewer sessions.
– Best results often come from 1–2 sessions.
2. Medium Skin (Fitzpatrick IV)
– May require more conservative settings.
– 2–3 sessions may be recommended.
– Collagen response is still strong.
3. Darker Skin (Fitzpatrick V–VI)
– CO2 laser must be used very carefully.
– Often requires lighter intensity and more sessions.
– Alternative laser options may be safer.
Combination Treatments That Reduce the Number of CO2 Sessions Needed
Many skin concerns respond better when CO2 laser is paired with other treatments.
1. Subcision
– For tethered scars.
– Releases tension so laser can smooth the surface.
– May reduce total CO2 sessions.
2. TCA CROSS
– For ice pick scars.
– Targets depth that lasers can’t reach alone.
3. Microneedling RF
– Improves collagen production at deeper levels.
– Often used between CO2 sessions.
4. Dermal Fillers
Lift depressed scars before laser resurfacing.
5. PRP (Platelet-Rich Plasma)
Enhances healing and results.
Combination therapy can dramatically improve outcomes and reduce the overall number of laser sessions.
How Long Does It Take to See Results?
Immediately After Healing (7–14 days):
– smoother skin
– smaller pores
– reduced surface flaws
4–6 Weeks:
– visible collagen increase
– fading lines
– improving pigmentation
3–6 Months:
– major scar improvement
– tighter, firmer skin
6–12 Months:
– full collagen remodelling
– long-term tightening
Your results continue improving long after your session.
How to Make Your Results Last Longer
To reduce the number of CO2 sessions you’ll need, you can support your skin in several ways:
– avoid sun exposure
– use SPF daily
– follow a tailored skincare routine
– avoid smoking
– stay hydrated
– use retinoids if recommended
– maintain healthy collagen with nutrition
– avoid picking or squeezing skin
Good habits can slow ageing and help your results last years.
Who Should Not Have Multiple CO2 Laser Sessions?
CO2 laser is not suitable for everyone.
You should avoid it if you:
– have very dark skin
– are prone to hyperpigmentation
– have active acne
– have certain medical conditions
– are pregnant
– cannot tolerate downtime
– have unrealistic expectations
Your practitioner will advise you honestly during consultation.
How Many Sessions Do Experts Recommend Overall?
– Mild ageing usually needs 1 session.
– Moderate ageing typically needs 1–2 sessions.
– Deep wrinkles often need 2 sessions.
– Mild acne scars generally need 1 session.
– Moderate acne scars usually need 1–2 sessions.
– Severe acne scars may need 2–3 sessions.
– General texture issues commonly need 1–2 sessions.
– Sun damage typically needs 1 session.
– Stretch marks often require 2–4 sessions.
– Full-face renewal usually needs 1–2 sessions.
These are broad guidelines, and your exact treatment plan will always be personalised based on your skin, goals, and how you respond to each session.
FAQs:
1. How long does CO2 laser recovery really take?
Recovery varies depending on how deep the treatment is, but most people experience about one to two weeks of visible healing. In the first few days, the skin may feel warm, tight, and raw, followed by peeling and redness. By the second week, most of the surface healing is complete, although some lingering redness can persist for several weeks, especially after deeper sessions. Makeup can usually be worn after 7–10 days, and the skin continues to strengthen for months as collagen forms underneath.
2. Do CO2 laser results last permanently?
The improvements from CO2 laser are long-lasting, especially for scars and deep lines, because the collagen created is permanent. However, the natural ageing process, sun exposure, and lifestyle habits continue to affect the skin over time. This means that while scars or wrinkles corrected by the laser will not suddenly return, new signs of ageing can eventually appear. Many people repeat the treatment years later to maintain freshness, but the original results do not disappear suddenly.
3. Is CO2 laser painful?
Most people describe the treatment as uncomfortable rather than unbearable. A strong numbing cream is applied before the procedure, and in some cases, local anaesthetic injections or cooling devices are used to reduce discomfort. During the treatment, you may feel a warm or prickling sensation as the laser works on the skin. Afterward, the face can feel like a strong sunburn for several hours, gradually settling as healing begins. By the next day, most of the discomfort is replaced by tightness rather than pain.
4. Can CO2 laser be done on darker skin tones?
It can be performed, but only in very controlled and mild settings. Darker skin tones have a higher risk of post-inflammatory hyperpigmentation, which means too much heat can trigger darkening rather than improvement. Because of this, practitioners usually opt for lighter resurfacing, more sessions at lower intensity, or alternative treatments such as microneedling RF or non-ablative lasers. A skilled practitioner will assess whether CO2 is suitable by examining your skin tone’s response to injury and heat.
5. What’s the difference between fractional CO2 laser and fully ablative CO2 laser?
Fractional CO2 laser treats only a fraction of the skin at a time, leaving tiny intact bridges of skin between treated zones. This allows faster healing, less downtime, and a lower risk of complications, which is why it’s the most commonly used method today. Fully ablative CO2 resurfacing treats the entire surface, offering more dramatic results in a single session, but with significantly more downtime and a higher risk of pigment changes. Most modern clinics prefer fractional because it strikes a safer balance between results and recovery.
6. When will I see the full results of my CO2 laser treatment?
You’ll notice early improvements within the first two weeks as the skin heals and becomes smoother and brighter. Over the next one to three months, you’ll begin to see deeper changes as collagen builds in the dermis, gradually tightening the skin and softening scars or wrinkles. The most dramatic improvements usually appear between three and six months, and collagen can continue to remodel for up to a year. This long-term improvement is why CO2 laser is considered one of the most powerful anti-ageing treatments available.
7. Can CO2 laser help with pigmentation issues like melasma?
CO2 laser is usually not the first choice for melasma because the heat can sometimes make the condition worse. Melasma is very sensitive to inflammation, and the strong thermal effect of CO2 may trigger pigmentation instead of reducing it. Non-ablative lasers, chemical peels, and topical treatments are generally safer options. However, for pigmentation caused by sun damage rather than hormonal factors, CO2 laser can be very effective when used correctly.
8. Is CO2 laser safe around the eyes?
It can be used safely around the eyes, but only by an experienced practitioner. The skin in this area is extremely delicate, so special eye shields are placed to protect the eyes during the procedure. When performed properly, CO2 laser can significantly tighten eyelid skin, smooth crow’s feet, and improve crepey texture without surgery. Many people choose this as a non-surgical alternative to eyelid rejuvenation, although healing may involve more swelling in this area.
9. Can CO2 laser treat active acne?
CO2 laser is not used on active acne because the heat can irritate the skin and potentially spread bacteria. Instead, acne must be stabilised first with topical treatments, oral medication, or other therapies. Once the acne is under control and no new breakouts are forming, CO2 laser becomes an excellent option for improving the scars left behind. Treating both conditions separately ensures safer results and reduces the chance of complications.
10. What should I avoid after a CO2 laser treatment?
For several weeks after treatment, it’s important to avoid direct sun exposure, vigorous exercise, hot showers, steam rooms, and anything that may irritate or overheat the skin. Makeup should only be applied once the skin has fully re-epithelialised, usually after a week. Harsh skincare like retinoids, acids, scrubs, or exfoliants must be paused until your practitioner approves their reintroduction. Following aftercare carefully helps prevent complications such as infection, dark marks, or delayed healing.
Final Thought: Your Path to Smoother, Healthier Skin
CO2 laser resurfacing is one of the most effective ways to rejuvenate your skin, whether your goal is to soften acne scars, reduce deep wrinkles, repair sun damage, or improve rough texture. Even a single session can create a noticeable transformation, while additional sessions can enhance and deepen your results, especially for more stubborn concerns.
Your final outcome will always depend on factors like the treatment intensity, the number of sessions, and how carefully you follow aftercare instructions. Protecting your skin from the sun, avoiding irritation during recovery, and maintaining a supportive skincare routine all play an important part in achieving smooth healing and long-lasting benefits.
If you’re looking for CO2 laser clinic in London, you can get in touch with us at the London Medical & Aesthetic Clinic. Our team offers personalised treatment plans designed to give you safe, effective, and long-lasting results.
References:
1. Avdulaj, A. et al., 2025. Fractional CO2 Laser for Acne Scar Treatment. Journal of Skin and Laser Therapy, 1(1). Available at: https://www.mdpi.com/3042-6774/1/1/2
2. Pan, Z. et al., 2023. A Novel Treatment Modality of Facial Atrophic Acne Scars: CO2 Fractional Laser in 121 Cases. Journal of Clinical Medicine, 12(13), 4388. Available at: https://www.mdpi.com/2077-0383/12/13/4388
3. Majid, I., 2014. Fractional CO2 Laser Resurfacing as Monotherapy in the Treatment of Atrophic Acne Scars. Dermatologic Surgery, 40(1), pp. 31–36. https://pmc.ncbi.nlm.nih.gov/articles/PMC4134658/
4. Petrov, A. et al., 2015. Fractional Carbon Dioxide Laser in Treatment of Acne Scars. Journal of Dermatologic Treatment, volume & issue unspecified. https://pmc.ncbi.nlm.nih.gov/articles/PMC4884248/
5. Hedelund, L. et al., 2012. Fractional CO2 Laser Resurfacing for Moderate to Severe Atrophic Acne Scars: A Randomized Controlled Trial. Lasers in Surgery and Medicine, 44(5), pp. 547–553. PubMed indexed. https://pubmed.ncbi.nlm.nih.gov/22766970/
