Dr Mark Griffiths

West London Dermatologist


Royal Free 020 7317 7751
Syon Clinic 020 8322 6000
Independent Laser Unit 020 7435 7521
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Conditions & Treatments > Fractional CO2 Laser

The following guide contains information about fractional CO2 laser. If you would like to consider this treatment further please get in touch with the Independent Laser Unit at the Royal Free Hospital to arrange a consultation.

If you are already a private patient of Dr Griffiths please make the booking office aware when you book in so they can better assist you.

What is fractional CO2 laser?

Fractional carbon dioxide (CO2) laser is an intense laser energy used in minute pulses to induce changes in the skin.

What is fractional CO2 laser used for?

Fractional CO2 laser is used to improve skin texture and the appearance of scars. Scars that have appeared due to acne, trauma or surgery may be suitable for treatment. Scars which are raised cannot be treated with fractional CO2 laser but may be suitable for pulsed-dye laser.

In addition to treating scars, the laser can also be used as a way of rejuvenating skin to give it a more youthful appearance.

How does fractional CO2 laser work?

It works by creating multiple minute zones of thermal injury in the skin. This stimulates new collagen formation. When used to treat scars it helps to regenerate and restructure the collagen making up the scar to help improve appearance and texture. When used to rejuvenate the skin the new collagen contributes to a mesh-like network of collagen in the skin resulting in improved skin tightness and texture.

What does the treatment involve?

The treatment involves passing a laser over the skin using a small hand-held device. Prior to the procedure a local anaesthetic cream is applied to the surface of the skin for one hour. During the procedure you will be provided with protective eyewear. Cool air will be circulated over the treatment areas for comfort.

How long does the treatment take? Will I need more than one session?

You will be asked to attend about one hour prior to your laser treatment so that we can address any further questions that you may have and so that a local anaesthetic cream can be applied to the skin. After one hour the laser treatment will start and will take about one hour. In total, the treatment from start to finish takes about two to three hours.

Do I need to take any special precautions before my treatment?

Yes, you should avoid excessive sun exposure for at least four weeks prior to treatment. You should also discuss whether any of your medicines or herbal therapies will need to be stopped prior to treatment. Usually, you will be given a prescription for acyclovir to take twice a day starting on the day before treatment and continuing for a total of eight days.

What should I expect following the treatment?

Following treatment there is a warming sensation and the skin will be red. An ointment is applied to the treated skin to help healing. In addition to redness there may be some swelling and crusting or weeping. You will be given a cream to apply every few hours to help with this (not needing during sleeping hours). Ice packs can also be used if needed to cool the areas. Sun exposure should be avoided during the first three days. Three days after treatment any swelling and crusting should have subsided and a peeling effect is seen which settles over a week to 10 days. This is much like a sunburn-type peel. Face creams, sunscreens, make-up and cosmetics can be applied from day three onwards.

What are the risks of treatment?

Fractional CO2 laser is used because its favourable safety profile. However, there are a number of risks to consider when deciding if this treatment is right for you.

  • Persistent redness: sometimes the redness can last longer than 7-10 days. It is fine to use creams or cosmetics to cover this and it will usually settle after a few weeks or a couple of months.
  • Infection: the risk of infection is small, however, usually it is recommended that you take acyclovir 400mg twice a day starting the day before treatment and continuing for a period of eight days. Antibiotics are not routinely prescribed but if you develop an area which is more red or crusty this could indicate infection. If you are concerned about infection please get in touch with the laser unit or my office for further advice.
  • Pigmentation: this is a risk particularly for people who have had recent sun exposure. Areas of increased or decreased pigmentation can occur as a result of this treatment.
  • Scarring: this is a rare complication of treatment but is possible depending on your skin’s reaction to treatment.
Please note:
This is only a guide and is by no means comprehensive.