Laser Skin Resurfacing: Types, Benefits, Risks, Recovery and Results
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is laser skin resurfacing?
Laser skin resurfacing is a treatment that uses concentrated light beams to remove or heat skin layers and stimulate new collagen. It may reduce wrinkles and scars, even pigmentation, tighten skin or remove lesions. Common approaches are CO2, erbium and fractional resurfacing. [6] Recovery ranges from about one to two weeks, and a qualified clinician should assess candidacy first.
What the research says
Ultra-pulse fractional CO2 laser improved depressed acne scars more than other treatments in a pooled analysis. A meta-analysis of 6 articles (467 patients with depressed acne scars) found higher skin-smoothness scores with the ultra-pulse CO2 fractional laser than with other methods (SMD 0.49; 95% CI 0.13–0.84; P = 0.008) (Lin et al., Ann Palliat Med, 2022). [4]
Pigment change was the most frequently reported facial laser complication, especially in darker skin types, and ablative lasers carried the highest risks of scarring and infection. A PRISMA systematic review of 13 studies (2,010 cases) found post-inflammatory hyperpigmentation was the most commonly reported complication, particularly in Fitzpatrick IV–VI skin types, while ablative lasers (CO₂, Er:YAG) carried the highest risks of scarring and infection (Zhorov et al., Lasers Med Sci, 2026). [5]
Ablative lasers had fewer lasting complications than nonablative lasers in a review of 34 studies. Across 1,093 patients, adverse events were reported in 106 (9.7%). Excluding transient events, complications were 2.56% with ablative lasers versus 7.48% with nonablative lasers (Mirza et al., Dermatol Ther, 2021). [7]
What is laser skin resurfacing?
Laser skin resurfacing is a procedure that uses laser light to improve the appearance and texture of skin. It may reduce the appearance of wrinkles and scars, even out skin coloring, tighten skin and remove certain lesions, including benign and malignant lesions. [6]
The laser directs short, concentrated, pulsating beams at irregular skin. It removes the outer layer, called the epidermis, and heats the underlying layer, called the dermis. This process stimulates new collagen fibers. As the skin heals, the new surface may look smoother and firmer. [3][6]
Laser skin resurfacing is also called a laser peel, laser vaporization or lasabrasion. [3][6] These names describe the same general family of treatments, but the depth, device, settings and recovery can differ.
What can laser resurfacing treat?
The treatment may be considered for several cosmetic or skin-related concerns. Examples include acne or chickenpox scars, uneven pigmentation, skin scars, birthmarks, age spots, sun-damaged skin, fine lines and wrinkles, and enlarged oil glands on the nose. [3][6]
A clinician may also consider resurfacing for skin that has not responded as expected after a facelift or for certain lesions. [3][6] The treatment is not automatically appropriate for every concern, and the clinician must assess what is causing the visible change before choosing a procedure.
Who may or may not be a candidate?
Candidacy is not determined by one symptom or one skin characteristic. A clinician evaluates the medical history, current physical condition, treatment area, skin response to sun exposure and desired results.
The clinical information notes that active acne, very dark skin, deep wrinkles, or excessive or sagging skin may make laser resurfacing less suitable. [2][6] This does not mean that a person should self-exclude from dermatology care. It means the possible benefits, risks and alternatives need to be discussed with an experienced clinician.
Darker skin tones have a greater risk of healing with darker pigmentation, known as hyperpigmentation. [6] Ask how the planned laser and settings may affect pigment, whether the clinician has experience treating a range of skin tones and what alternatives may be available if pigment change is a concern.
What are the main types of laser resurfacing?
The main approaches described here are CO2, erbium and fractional resurfacing. They vary in how much skin is treated, how deeply the laser reaches and how long healing may take. [6]
Approach | What it does | Recovery described | Key discussion |
CO2 laser resurfacing | Precisely removes thin skin layers; used for wrinkles, scars and some skin growths or conditions. [6] | Up to two weeks. [6] | It can be more intensive; discuss healing, pigment change and scarring risks. |
Erbium laser resurfacing | Treats superficial to moderately deep lines and wrinkles with less surrounding-tissue injury. [6] | About one full week. [6] | It may cause fewer swelling, bruising and redness side effects than CO2; the clinician assesses fit. |
Fractional CO2 resurfacing | Treats narrow columns while leaving surrounding skin untreated and intact. [6] | About one full week. [6] | Less total skin is injured, but deeper reach can raise the risk of complicated healing and scarring. |
The best treatment is not selected from a chart alone. The doctor chooses the approach after evaluating medical history, current physical condition and desired results. [6]
How does laser skin resurfacing work?
Laser resurfacing changes the skin in a controlled way. Ablative treatment removes the epidermis and heats the dermis. This deliberate injury encourages new collagen growth as the skin heals. [1][3]
Fractional CO2 resurfacing treats many narrow columns rather than the entire surface at once. The untreated skin between the columns remains intact, which is the reason less total skin is injured. However, the laser can penetrate more deeply, and the deeper treatment may increase the risk of complicated healing and scarring. [6]
The goal is not simply to use the strongest laser. The clinician balances the condition being treated, the depth needed, the treatment area, recovery expectations and the person’s risk factors.
What happens during the procedure?
Laser resurfacing is generally performed on an outpatient basis. The treatment area is numbed with a local anesthetic, and oral or intravenous sedative medication may be used. General anesthesia may be used when the entire face is treated. [6]
The face or selected area is thoroughly cleaned before treatment. Wrinkles around the eyes, mouth or forehead may be treated individually, or a full-face laserabrasion may be performed. [6]
A partial-face treatment may take about 30 to 45 minutes. A full-face treatment may take about 1.5 to 2 hours. [6] The actual time depends on the treatment area and the approach selected.
How should someone prepare?
Preparation is individualized. The clinician may ask a person to avoid tanning or heavy sun exposure and use broad-spectrum sunscreen for four weeks before treatment. Deep facial peels and other aggressive facial procedures may also need to be avoided for four weeks. [6]
Some medicines can make skin more sensitive to light. The clinical information specifically mentions doxycycline and minocycline and advises not using photosensitizing medicines for at least 72 hours before treatment. [6] Do not stop a prescription medicine without speaking with the prescribing clinician or treatment team.
Tell the clinician about a history of oral cold sores, genital herpes or shingles in the treatment area. An antiviral may be prescribed when appropriate. Some people may also be asked to use a topical retinoid for about four weeks before the procedure. [2][6]
A consultation should also cover treatment goals, the expected recovery, the possibility of pigment change, the risk of scarring, and whether another approach may be safer or more suitable.
What is recovery like?
Immediately after treatment, skin may be red, sensitive and sunburn-like. Swelling, itching or stinging may last for several days. Depending on the treatment, the skin may look raw, ooze a yellow liquid or blister. [6]
Five to seven days after treatment, skin may become dry and peel. New skin may first appear pink and gradually lighten over the following two to three months. The treated areas generally heal in five to 21 days, depending on the condition treated and the type of laser used. [6]
Redness commonly fades over two to three months but may take six months to a year to disappear. The redness may persist longer in people with blonde or red hair. [6] These are broad time ranges, not promises; the clinician should explain what is realistic for the planned treatment.
What aftercare may be discussed?
The treating clinician provides the aftercare plan. The clinical information describes gentle cleansing, ointments or moisturizing products, sun protection and avoiding actions or products that irritate healing skin. It also cautions against scratching or picking crusted skin because this can cause scarring or infection. [6]
A clinician may also discuss how to manage swelling, how to position the head during early recovery, when makeup may be used, and when to return to regular skin-care products or activities. These details depend on the treatment and should not be copied as a one-size-fits-all protocol.
After healing, daily broad-spectrum sunscreen and moisturizer may be recommended. Sun avoidance and sun protection help reduce the chance of pigment changes. [1][6]
What are the risks and complications?
Laser resurfacing creates a controlled skin injury, so side effects are possible. The treatment area may swell, itch, sting, peel or feel sensitive. Milia, or small white bumps, may appear during healing. [1][6]
Pigment changes can include hyperpigmentation, in which treated skin becomes darker, or hypopigmentation, in which it becomes lighter. Darker skin tones have a greater risk of hyperpigmentation. Reactivation of a herpes simplex cold sore may occur, especially when the area around the mouth is treated. [1][6]
Other possible complications include bacterial infection, swelling and rare scarring. [6] Deeper or more extensive treatment may affect healing time and risk. Ask the clinician which complications are most relevant to the planned laser and treatment area.
Possible risk or change | What to discuss with the clinician |
Redness, swelling, itching or stinging | How long these effects may last for the selected treatment. |
Milia | Whether small white bumps are expected during healing and how the team wants them managed. |
Hyperpigmentation or hypopigmentation | The person’s risk of pigment change and how skin tone, sun exposure and laser choice affect that risk. |
Cold-sore reactivation | Whether a history of herpes or shingles changes preparation. |
Infection | Which symptoms should prompt a call and which aftercare instructions reduce irritation or contamination. |
Scarring | Whether the treatment depth or skin history increases risk. |
Prolonged redness | Whether color change may last months and how it will be monitored. |
What results can someone expect?
A visible difference may appear as the treated skin begins to heal. Improvement may continue for up to a year and may last several years. [1][6] The result depends on the laser, the skin concern, the treated area and the person’s healing.
Normal aging can lead to new wrinkles over time. Laser resurfacing may be repeated in the future, but the decision belongs with a qualified clinician after reassessing the skin. [6]
Results are not guaranteed. A consultation should address what the treatment can realistically improve, what it cannot correct, how long recovery may take and what alternatives may be available.
Is laser skin resurfacing covered by insurance?
The clinical information describes laser resurfacing as elective cosmetic surgery and states that insurance does not cover it. [6] Coverage rules vary, especially when a laser is used for a medical lesion rather than cosmetic resurfacing. Confirm the expected cost and coverage directly with the clinician’s office and insurer before scheduling treatment.
What questions should you ask before laser skin resurfacing?
Topic | Questions to discuss |
Goal | Which concern is the treatment intended to improve, and what change is realistic? |
Laser type | Why is CO2, erbium or fractional treatment being considered? |
Treatment depth | How much skin will be treated, and how might depth affect healing and scarring? |
Skin tone | What is the risk of hyperpigmentation or hypopigmentation for this skin? |
Medical history | Do acne, cold sores, shingles, scarring, sun exposure or previous procedures change the plan? |
Medicines | Could any medicine increase light sensitivity, and who should advise on changes? |
Anesthesia | Will local anesthetic, sedation or general anesthesia be used? |
Recovery | When might peeling, redness and pink new skin be expected to improve? |
Aftercare | Which cleansing, ointment, sunscreen, activity and product instructions apply? |
Warning signs | Which changes should prompt a call to the treatment team? |
Cost | Is the procedure considered cosmetic, and what will insurance cover? |
When should someone contact the treatment team?
Contact the treating clinician if recovery seems different from the expected plan, if irritation is worsening or if there are concerns about infection, pigment change or scarring. The treatment team can decide whether the skin needs to be examined.
Seek urgent medical attention for severe symptoms or an emergency. Do not use this article to decide whether a blister, drainage, swelling or color change needs treatment; ask the clinician who performed or supervised the procedure.
Conclusion: Match the laser to your skin, your goal and your care plan
Laser skin resurfacing uses concentrated light to change selected skin layers and stimulate collagen. It may improve wrinkles, scars, pigmentation, sun damage and certain lesions, but the best treatment depends on the person’s skin, medical history, treatment area and goals.
CO2, erbium and fractional approaches differ in depth, treatment pattern, surrounding-tissue injury, recovery and risk. Skin may be red, sensitive, swollen or peeling during healing, and redness or pigment changes may persist for months. Darker skin tones have a greater risk of hyperpigmentation, so careful planning is important.
A qualified clinician can explain which laser is being considered, what recovery may look like, how aftercare will be managed, which warning signs matter and whether the expected benefit justifies the risks and cost.
Frequently Asked Questions
What is laser skin resurfacing?
Laser skin resurfacing is a procedure that uses laser light to remove or heat selected skin layers, stimulate collagen and improve the appearance or texture of skin. [3][6]
What does laser resurfacing treat?
Laser skin resurfacing may reduce wrinkles and scars, even out pigmentation, tighten skin and remove certain benign or malignant lesions. It may also be considered for acne or chickenpox scars, age spots, sun-damaged skin, birthmarks and enlarged oil glands on the nose. [6]
What is the difference between CO2 and erbium laser resurfacing?
CO2 resurfacing can remove thin layers of skin and may treat wrinkles, scars and several skin conditions. Erbium resurfacing is designed for superficial and moderately deep lines and wrinkles and may cause less surrounding-tissue injury and fewer side effects such as swelling, bruising and redness. [2][6] A clinician chooses the approach after evaluation.
What is fractional laser resurfacing?
Fractional resurfacing creates many narrow columns of laser treatment while leaving surrounding skin untreated and intact. Less skin is injured, but deeper penetration can increase the risk of complicated healing and scarring. [6]
How long does laser resurfacing take?
A partial-face treatment may take 30 to 45 minutes. A full-face treatment may take about 1.5 to 2 hours. [6] The duration depends on the area and treatment approach.
How long does laser resurfacing recovery take?
Recovery varies. The types described include about one full week for erbium or fractional resurfacing and up to two weeks for CO2 resurfacing. The treated areas may heal in five to 21 days, and redness or color changes can last much longer. [6]
Is laser resurfacing painful?
The treatment area is numbed with local anesthetic, and oral or intravenous sedative medication may be used. General anesthesia may be used for treatment of the entire face. [6] Ask the clinician what will be used for the planned procedure.
Is laser resurfacing safe for darker skin tones?
Darker skin tones have a greater risk of hyperpigmentation after resurfacing. [6] A qualified clinician should assess the skin and explain whether the planned laser, settings or an alternative treatment is appropriate.
Can laser resurfacing cause scarring?
Scarring is rare but possible. The risk can vary with treatment depth, laser type, skin history and healing. Fractional treatment may injure less total skin but can still have a greater risk of complicated healing and scarring because the laser penetrates more deeply. [6]
When can someone wear makeup after laser resurfacing?
Makeup may be worn once the treated areas have healed, but the treating clinician should confirm when it is appropriate. Healing skin may remain pink or red for months. [6]
What should someone avoid before laser resurfacing?
The care team may recommend avoiding tanning or heavy sun exposure, using broad-spectrum sunscreen, avoiding deep facial peels and discussing photosensitizing medicines before treatment. [6] Do not stop prescription medication without medical advice.
What should someone avoid after laser resurfacing?
Follow the clinician’s individualized plan. The clinical information cautions against scratching or picking crusted skin and describes avoiding irritating products, aggressive facial treatments, activities that cause flushing and smoking during recovery. [6]
Does insurance cover laser skin resurfacing?
The clinical information describes it as elective cosmetic surgery that insurance does not cover. [6] Coverage can vary when treatment is for a medical lesion, so confirm directly with the insurer and clinician’s office.
What is another name for laser skin resurfacing?
It is also known as lasabrasion, laser peel or laser vaporization. [6]
Will my face be red afterward?
Redness is expected. It generally fades in two to three months but may take six months to a year to disappear. [6]
What are milia?
Milia are small white bumps that may appear in laser-treated areas during healing, up to a month after treatment. They may be removed by gentle cleansing with a washcloth. [6]
Can cold sores return after resurfacing?
Yes. A herpes simplex cold sore may be reactivated, especially after treatment around the mouth. Tell your doctor about any history and ask about antiviral medicine. [6]
Related guides
Related guides on laser skin resurfacing cover acne scars, wrinkles, age spots and scar revision.
Related Reading
Breast Reduction Scars: Healing Timeline, Types and Treatment explains how breast reduction scars heal.
CO2 Laser Resurfacing: Uses, Procedure, Recovery and Risks explains CO2 laser resurfacing for skin.
References
Mayo Clinic Staff. Laser resurfacing. Mayo Clinic. October 26, 2024. https://www.mayoclinic.org/tests-procedures/laser-resurfacing/about/pac-20385114
American Society for Dermatologic Surgery. Laser Resurfacing. American Society for Dermatologic Surgery (ASDS). Accessed October 30, 2026. https://www.asds.net/skin-experts/skin-treatments/laser-resurfacing
American Society of Plastic Surgeons. Laser Skin Resurfacing. American Society of Plastic Surgeons. Accessed October 30, 2026. https://www.plasticsurgery.org/cosmetic-procedures/laser-skin-resurfacing
Lin L, Liao G, Chen J, et al. A systematic review and meta-analysis on the effects of the ultra-pulse CO2 fractional laser in the treatment of depressed acne scars. Ann Palliat Med. 2022;11(2):743-755. PMID 35249351. https://doi.org/10.21037/apm-22-70
Zhorov I, Goldstein M, Hasa A, et al. Facial laser complications (a five year review). Lasers Med Sci. 2026;41(1):69. PMID 41968192. https://doi.org/10.1007/s10103-026-04862-z
Cleveland Clinic. Laser Skin Resurfacing: Lasers Types, Skin Conditions, What to Expect. Cleveland Clinic. Last updated March 22, 2021. https://my.clevelandclinic.org/health/treatments/11015-laser-skin-resurfacing
Mirza HN, Mirza FN, Khatri KA. Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: a systematic review of 1093 patients. Dermatol Ther. 2021;34(1):e14432. PMID 33084193. https://doi.org/10.1111/dth.14432
Disclaimer
This article is for general educational purposes and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional with any questions about a medical condition or treatment.
A qualified clinician should tailor laser choice, preparation and aftercare to the person’s skin, health, medicines, healing and goals, and evaluate concerning changes. Do not stop a prescribed medicine or decide how to treat a blister, drainage, swelling or color change based only on this article.
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