Fractionated CO2 laser resurfacing is one of my deeper skin-remodelling treatments.
I use a fractionated CO2 laser to create tiny, controlled columns of heat in the skin, which removes old damaged tissue and stimulates your skin to produce new collagen and elastin.
It's a beautiful treatment for improving skin texture, fine lines, deep lines, the orange peel texture you see on the chin, sun damage, pigmentation, enlarged pores, uneven skin tone and overall skin quality, while also stimulating deeper collagen and elastin production.
Fractionated CO2 laser resurfacing is for someone who really wants to take their skin to the next level.
It can be particularly useful when the skin needs more than a superficial "polish." If you have tougher, thicker or more weathered skin, I can adjust the treatment to work more deeply and aggressively where appropriate. On the other hand, if you have finer, thinner or more delicate skin, I can dial the treatment right back and work much more gently while still stimulating the skin and creating a beautiful result.
That's one of the things I love about my CO2 laser: I can adjust the machine to the person sitting in front of me. I'm not treating every face with the same settings or the same amount of energy. I'm looking at your skin, its thickness, texture, condition, age, previous treatments and what we're actually trying to achieve, and then I can tailor the treatment accordingly.
It's right for someone who wants to seriously look after their skin and is prepared to invest in improving its quality rather than simply covering things up. Whether you're starting to notice fine lines and changes in texture, you've got years of sun exposure showing through, your pores have become more noticeable, or you simply want that smoother, tighter, fresher-looking skin, CO2 can take your skin several steps further.
It's also a great treatment for someone who has already done the more superficial work, perhaps IPL, pigmentation treatments or skin tightening, and now wants to move into deeper skin remodelling.
The beauty of it is that we can meet your skin where it is. My job is to work out how much treatment your skin actually needs to create a beautiful outcome, rather than simply turning the machine up and hoping for the best.
I'd say this isn't right for someone who probably needs to start with Brown Spot Removal or Vascular Removal first. CO2 can indeed remove brown spots but will need to go deeper to get them. And you might consider taking the brown spots off first so that we don't have to go so deep with the CO2.
For example, if you've been looking after your skin and already have a good foundation, you may be able to jump straight into CO2. But if you haven't really looked after your skin and you're thinking, "Let's just go in there and obliterate everything with CO2," that isn't necessarily the right answer. Sometimes we need to clean up the surface first, the pigmentation, vascular irregularities and sun damage, before we start doing the deeper remodelling work.
Remember, even though fractionated CO2 is quite powerful, it isn't going to address everything. In my opinion, it's a stepping stone, and probably one of the last stepping stones you need on your skin journey.
I'll also ask you to wait if your skin is sunburned, recently tanned, irritated, inflamed, broken or still healing from another treatment. And if there's anything about your skin or medical history that makes me think CO2 isn't appropriate at that particular time, I'll tell you.
I'll explain all of this properly during your consultation. I'll tell you what I think your skin needs, what I would do first and why, and then, at the end of the day, it's important that you have everything answered so that you can make the best decision for yourself.
For fractionated CO2 laser resurfacing, I use fractionated CO2 lasers, and I've been using these platforms for years.
I ultimately chose the platforms I use now because I find them exceptionally well suited to my client base and to the results I want to achieve.
The CO2 component allows me to create precise microscopic columns of ablation and heat within the skin. This gives us deeper resurfacing and collagen remodelling, making it particularly useful when we're addressing things like texture, fine lines, sun damage, the look of scarring and laxity.
The erbium component works differently. Erbium is generally a more superficial resurfacing wavelength, allowing me to work more delicately at the surface of the skin with less thermal effect than CO2. That gives me another tool when I want to refine, polish and resurface the skin without necessarily going as deep.
So, in very simple terms, I have the best of both worlds available to me. I can use CO2 when I need deeper remodelling, erbium when I want a more controlled superficial resurfacing effect, or tailor the treatment according to what your skin actually needs.
And that's important because I'm not interested in simply turning a machine up because I can. I want to be able to select the right technology, wavelength, depth, density and energy for the particular skin sitting in front of me.
While the underlying principle is the same, creating controlled microscopic columns of laser energy in the skin to stimulate resurfacing and collagen remodelling, the way the energy is delivered, controlled and adjusted can differ between platforms.
Adjustable depth and density: One of the important advantages is the ability to adjust the depth, density and pattern of the micro-columns. Different skin types, textures, scars and degrees of sun damage can require very different approaches.
Precision and consistency: With a quality fractionated CO2 platform, consistent energy delivery is extremely important. I want to know exactly what I'm delivering to your skin and be able to reproduce that treatment accurately from one session to the next.
For me, the biggest distinction isn't simply that one machine is called CO2 and another is called CO2. The technology, the calibration, the delivery system and, most importantly, the practitioner controlling it all contribute to the treatment.
That's why I'm very particular about the CO2 platform I use.
For me, it's never about buying the newest machine just because something else has appeared on the market. I've seen plenty of new technologies come and go. I look at the engineering, consistency, control, versatility and, most importantly, the results I can achieve predictably.
I'm prepared to look at something new if I genuinely believe it will improve what I can offer my clients. But when you already have access to technology that gives you this level of control and versatility, you don't change machines simply for the sake of having something new. You use the equipment you know, trust and can consistently achieve beautiful results with.
If you've never had a fractionated CO2 laser treatment before, I'd describe the sensation as hot, prickly and quite intense, but it's very manageable. I'm constantly assessing how your skin is responding as I work.
You'll feel the laser making lots of tiny, rapid pulses across the skin. Some areas can feel more sensitive than others, particularly around the mouth, nose and forehead, but the sensation is very short-lived because I'm working in small sections.
It's definitely not a treatment I'd describe as completely painless, but it shouldn't feel unbearable either. We have options to make you comfortable, and my aim is to get the treatment to the level where we're achieving the result we want without making you unnecessarily uncomfortable.
My fractionated CO2 treatment is $1,850 per session, or I offer a 3-treatment series for $3,500.
I space the three treatments approximately three months apart. I deliberately take this approach because I want your skin to have time to recover and remodel between treatments while allowing you to continue with your normal life. The depth and density of treatment have a significant influence on both the result and the recovery period.
I don't particularly like the idea of putting someone through one extremely deep, fully ablative CO2 treatment that can potentially have you out of action for close to two weeks or longer. Deeper ablative resurfacing can involve significant redness, swelling, weeping and peeling, and recovery varies according to how deeply the skin has been treated.
I would much rather work with three carefully planned, medium-depth treatments that progressively remodel the skin and allow you to get on with your life between appointments.
With my recommended ointment and proper aftercare, I generally allow around five days of downtime with my approach.
When you see different prices for "CO2 laser," you aren't necessarily comparing the same treatment. Different manufacturers have different platforms, delivery systems, handpieces and capabilities, and practitioners can use very different depths, densities and treatment protocols.
The price can therefore reflect the technology being used, the area being treated, the depth and density of treatment, the practitioner's experience, consultation, preparation, recommended aftercare and the level of follow-up provided, not simply the name "CO2."
If you have beautiful, well-maintained skin, I don't see the value in unnecessarily traumatising it simply because we can. More aggressive treatment can also carry greater risks, including prolonged redness, pigmentation changes, infection and scarring.
My philosophy is much more measured: I want to give you enough treatment to create a beautiful result, but not so much that we're damaging healthy skin unnecessarily.
One thing I wish people understood before booking CO2 is that what you see on social media isn't necessarily what you need.
A lot of the CO2 treatments you see online are extremely deep.
I take a very different approach.
I prefer to work at a medium depth and deliver the treatment very precisely. I'm not going to publish my exact settings on my website because those are my proprietary treatment settings, developed through years of experience with CO2 and knowing how my clients' skin responds.
And I really want people to understand that you don't have to stop living your life because you've had laser. You simply need to understand how much protection your skin requires during the healing period.
I actually do my own CO2 treatments during summer sometimes. For the first two or three days, I'm absolutely meticulous about protecting my skin. I'm very deliberate about keeping it protected from the sun and following my aftercare. After those first few days, I continue protecting it, of course, but I don't feel that I need to put my entire life on hold.
With all lasers, we need to be mindful in the sun, but you can do this year round. I do it in summer and I am careful to protect my skin extremely well in the first 3 to 5 days. And if I go to the beach, I'm going to have a towel over my face.
That is precisely why I decided to offer my CO2 treatments this way. I want you to be able to have meaningful skin resurfacing and remodelling without feeling that you need to disappear from the world for two weeks.
I've actually gone straight back to work two days after my own treatments. You can have some swelling, and exactly how you respond will depend on your skin, the treatment and a number of other factors, so everyone's recovery is a little different.
But this is the part I really want people to understand: you don't always need to go incredibly deep to get a beautiful CO2 result. It's about being precise, understanding the skin you're treating and knowing how much treatment that particular skin actually needs.
So please don't shop around for the cheapest CO2 treatment. That's not really the way I think you should choose this treatment. Come in, let me look at your skin and explain exactly what I think would be the best way forward for your skin.
Then you can make an informed decision about whether my approach is right for you.
I don't publish my clients' photographs on this website. I can show you before and after photographs, with their permission, at your consultation.
With my medium-depth approach, I generally allow around five days of downtime, although some people can return to work after two days depending on what they do for work and how their skin responds. You're certainly not going to be laid up in bed. Your skin is more likely to feel rough, a little like sandpaper, and have that sunburnt feeling while it settles.
Usually after about five days, and sometimes after two, depending on your occupation, the depth of treatment and how quickly your skin settles.
I use fractionated CO2 for the whole face. Fractionated treatment allows me to create microscopic columns of treatment while leaving healthy skin between those columns. That means I can achieve significant resurfacing and collagen remodelling while preserving more of the surrounding skin and allowing for a much more manageable recovery than a fully ablative treatment.
I do not perform fully ablative CO2 laser. My clinic is not set up for fully ablative CO2, and I don't plan to offer it again.
I have very fine control over how much skin I remove and how much thermal energy I put into the skin, from a more ablative treatment through to a very light, widely spaced pattern where I'm concentrating more on collagen remodelling and less on removing the surface.
Because deeper isn't automatically better.
I also take a very Dermaviduals-style approach to the skin barrier. Those upper layers of the skin are there for a reason. The epidermis and its natural lipid structures help protect the skin, regulate hydration and support the skin barrier, so I don't believe we need to strip away everything just because we have the ability to do so. In most cases, I'd rather preserve as much of that healthy structure as possible and use controlled fractionated treatment to stimulate the deeper remodelling we're actually trying to achieve.
My approach is about being precise and respecting the skin while still creating enough controlled injury to stimulate meaningful remodelling.
And this is where I think the three-treatment series becomes really lovely.
You come in, we do your first treatment, and then you go away and enjoy your skin for three months. During that time, your skin is continuing to remodel. You can support it with things like red light therapy and hydrating facials if appropriate, while maintaining your home skincare and sun protection.
Then, three months later, you come back and we have another look at your skin. By then, I can see what the first treatment has actually achieved, your skin has had time to plump and remodel, and we can give it another deep refresh. It's almost like freshening everything up again, but each treatment is building on the one before it.
Then you do exactly the same thing again with your third treatment.
So rather than one enormous treatment followed by a long recovery and then waiting months to see what happens, I prefer this more progressive approach:
Treat, heal, enjoy your skin, remodel, return three months later, deep refresh, repeat.
There's no need to wonder when you should come back or whether you're finished after one treatment. We simply work through your three treatments progressively and reassess your skin each time.
That's really the philosophy behind my CO2 treatments: I want to remodel your skin, not obliterate it.
Results vary from person to person.
It really is best to keep this up as one of the treatments you give your skin yearly.
Because I perform these at a light-to-medium depth, I can customise the parameters so precisely that, to put it simply, we can take off the skin of a snap pea while leaving the inner casing intact, that's how effective we can be without going too deep.
So, one of these a few times a year, depending on your lifestyle, and then add in some IPL and skin needling between your CO2 treatments to keep your skin on its toes.
I think CO2 is one of those treatments that really rewards consistency rather than excess.
These packages are such a lovely way of keeping your skin in that sweet spot, treating it at a medium depth, allowing it plenty of time to recover, and then giving you the most important part…
Time to enjoy your skin.
When we work with a medium-depth CO2 treatment every three months, we're not constantly chasing the skin. We're giving it a little nudge, then stepping back and allowing it to do what it does best, repair, regenerate and build.
And in those three months between your CO2 treatments, you'll probably find yourself wanting to do something else for your skin.
That might be a hydration facial, LED, IPL, ND:YAG or KTP 532 nm laser, depending on what your skin is asking for at the time.
That's the beauty of having a broader treatment plan. We're not doing the same thing over and over again, we're listening to your skin and giving it what it needs.
Quite often, we'll begin with three treatments, approximately 12 weeks apart. But I don't believe in treating a face simply because the diary says it's time.
Your skin sets the pace. Not the calendar.
And if you have something special coming up…
CO2 is one of my favourite treatments to do before a wedding, holiday, milestone birthday or big event.
Just give me 2 to 3 weeks.
That gives your skin the breathing room it needs to move through the healing phase, settle completely and arrive at that lovely point where you look in the mirror and think,
There I am.
No heavy foundation required.
Just good skin, doing its thing.
That's really what we're working towards with all of this, not endlessly treating your skin, but creating a rhythm that keeps it healthy, responsive, luminous and on its toes.
Eventually, the morning comes around when we look in the mirror and think, I can't walk out the door without foundation. I know it's time for laser. The skin tells us, "I think I need a freshen up."
And usually, that moment comes somewhere around 3 months after your last CO2 treatment, that's if you been following great skincare and wise sun sense.
That's your little reminder that it's time for us to have another look at your skin and decide what it needs next.
The products I recommend aren't chosen because they happen to be fashionable, heavily advertised or sitting on a beauty counter.
I know what skin feels like when the barrier is compromised. I know what it looks like when it's dehydrated, over-treated, congested or simply being given too much. And I know the difference between giving your skin what it needs and giving it what happens to be trending this month.
You don't need everything. You need the right things, at the right time, for your skin.
And that's exactly how I like to approach your skincare.
After all the technology, all the treatments and all the collagen stimulation, it's the everyday care you give your skin between appointments that helps maintain what we've achieved.
| Activity | When |
|---|---|
| Makeup | After 48 hours |
| Gym | After 48 hours |
| Swimming | After a week |
| Sauna | After a week |
| Sun | Ask me first |
| Alcohol | Day 5 |