Fractional CO2 laser skin resurfacing can noticeably improve sun damage, brown spots, fine lines, uneven texture, and mild to moderate acne scarring by stimulating new collagen and healthier skin turnover. At Youthful Reflections Facial Plastic Surgery near Nashville (Brentwood), TN, double board-certified facial plastic surgeon Michael A. Boggess, MD, customizes the laser settings to your skin type, goals, and downtime tolerance for natural-looking improvement.
In this blog post, we’ll answer some of the most commonly asked questions about this treatment and share some of our favorite CO2 Fractional Laser Skin Resurfacing before and after photos.
Fractional CO2 Laser Skin Resurfacing: Quick Facts
| Detail | What most patients can expect* |
|---|---|
| Treatment time | ~20–30 minutes |
| Anesthesia | Often local anesthesia + light sedation |
| Early healing | Light crusting commonly lasts 2 to 3 days |
| Back to many normal activities | Often ~3 to 5 days |
| Makeup | Often after ~1 week (if healing is on track) |
| Redness | Commonly 1 to 3 weeks |
| Results timeline | Early changes ~1 week; more complete results often develop over ~3 months |
*Exact recovery and results vary based on laser settings, skin type, and individual healing.
What is fractional CO2 laser skin resurfacing?
Fractional CO2 laser skin resurfacing uses a carbon dioxide laser to create tiny, controlled treatment zones in the skin rather than treating the entire surface at once. These micro-injuries trigger your body’s healing response—encouraging collagen remodeling, skin tightening and elasticity, and cell turnover—so your skin tone and texture can become smoother and more even over time.
Unlike many lighter “lunchtime” laser treatments, fractional CO2 is typically chosen when you want a more meaningful change in texture, fine lines, sun damage, or certain scars (with a tradeoff of more downtime).
What is laser skin resurfacing good for?
Fractional CO2 laser resurfacing is commonly used to improve texture and tone problems that don’t fully respond to skincare alone. It may help reduce the appearance of:
- Fine lines and wrinkles (especially around the mouth and eyes)
- Sun damage and a rough, crepey surface texture
- Brown spots and uneven tone
- Birthmarks
- Enlarged oil glands on the nose
- Mild to moderate acne scarring (depending on scar type)
- Certain scars in select patients, including chickenpox and burn scars
How long does a laser skin resurfacing treatment take?
Most fractional CO2 laser resurfacing sessions take about 20 to 30 minutes of active laser time. We typically perform this treatment in-office using local anesthesia plus light sedation. This combination helps keep you comfortable and still during the laser passes without the longer setup and recovery time that typically comes with general anesthesia.
What is recovery like after fractional CO2 laser skin resurfacing?
Recovery after fractional CO2 laser resurfacing usually happens in phases: a short early healing period (crusting and sensitivity), followed by redness that fades gradually. While individual experiences vary, a typical timeline looks like this:
- Days 1–3: light crusting and a “raw” sunburn-like sensation are common
- Days 3–5: many people can return to normal daily activities
- After ~1 week: makeup is often possible if healing is progressing normally
- Weeks 1–3: redness gradually diminishes
Even while your skin is in its recovery stage, it will feel smoother, and you will see fewer lines, less blotchiness, and a more radiant glow.
Why downtime varies (and why that’s normal)
Fractional CO2 laser settings are adjusted based on your goals:
- Deeper settings may be used for more advanced sun damage or texture issues and can mean more visible peeling/redness and longer downtime
- More conservative settings may mean shorter downtime but often more subtle change per session
When will I see results from laser skin resurfacing?
Many patients notice smoother texture and more “glow” within about a week, but collagen remodeling takes longer. More complete improvements often develop over several weeks to around 3 months, depending on your skin and treatment depth.
What To Look for in Before and After Photos
When comparing laser skin resurfacing before and photos, focus on changes in:
- Fine lines (especially around the mouth/under-eyes)
- Overall tone evenness and brown spot fading
- Texture (pore appearance, roughness, acne-scar softening)
- How light reflects on the skin (often looks more uniform)
Small differences in lighting, angle, and facial expression can change how skin appears—so the most meaningful comparisons use similar lighting and positioning. Keep in mind that some patient “after” photos may reflect a combination treatment (for example, laser resurfacing plus facial surgery) that offers results beyond what can be achieved with laser skin resurfacing alone.
You can see one of our real patients below, before and after Dr. Boggess’ signature facelift procedure, the Reflection Lift, eyelid surgery, fat transfer, and laser skin resurfacing.
How long does fractional CO2 laser skin resurfacing last?
How long your laser skin resurfacing results last depends on sun exposure, genetics, skin elasticity, and the underlying cause of aging. Although longevity can vary, many patients maintain their improvements for years by protecting their results with:
- Daily broad-spectrum sunscreen
- Sun-smart habits (hats/shade/avoiding peak UV)
- A consistent skincare routine tailored to your skin type
- Periodic maintenance treatments
Laser resurfacing can “reset” a lot of visible damage, but ongoing sun exposure can create new pigment and texture issues over time.
Who is an ideal candidate for laser skin resurfacing?
A good candidate for laser skin resurfacing is someone who wants to improve sun damage, uneven tone/texture, fine lines, or acne scarring and can commit to the recovery period and aftercare. Candidacy also depends on your:
- Skin type and history of pigment changes
- Tendency to scar or develop prolonged redness
- Current medications and medical conditions
- Expectations (improvement vs. perfection)
Some skin types and tones have a higher risk of post-treatment discoloration, which doesn’t automatically rule you out; however, it does mean settings and aftercare should be planned more conservatively.
What are the risks and tradeoffs of fractional CO2 laser resurfacing?
Potential downsides of fractional CO2 laser resurfacing can include:
- Redness, swelling, dryness, and peeling/crusting during healing
- Temporary darkening/lightening of skin (pigment changes), especially in higher-risk skin types
- Prolonged redness (less common but possible)
- Infection or scarring (uncommon, but important to discuss)
Your consultation should include a realistic downtime plan and aftercare steps that match your skin and lifestyle.
When should you see a laser skin resurfacing specialist in Nashville?
If you’re in Brentwood, Nashville, or the surrounding areas, and you’ve tried skincare, peels, or lighter treatments without meaningful improvement in sun damage, brown spots, fine lines, or acne scarring, it may be time to book a consult about fractional CO2 laser resurfacing. You should also consider a specialist consultation if:
- You want a clearer, personalized downtime timeline
- You’re prone to pigment changes or have had discoloration after skin treatments
- You’re considering combining laser resurfacing with facial rejuvenation procedures
Get Started
Youthful Reflections Facial Plastic Surgery in Brentwood, Tennessee, is led by Dr. Michael A. Boggess, a double board-certified facial plastic surgeon with 25+ years of experience in facial rejuvenation. To discuss your laser skin resurfacing and other med spa options, please request a consultation using the online form or call our office at (615) 942-8016 to schedule your appointment.
Originally published July 2017; Updated December 2025
