Can CO2 Laser Get Rid of Deep Wrinkles? A Complete Guide

Key Takeaways

• The CO2 laser is an advanced skin resurfacing treatment highly effective for deep wrinkles and scars.
• This ablative laser treatment encourages collagen renewal and promotes new skin formation.
• By removing the damaged outer layers, the treated skin appears smoother and more youthful.
• Understanding how deep wrinkles form helps you select the right type of laser resurfacing.
• Setting realistic expectations ensures satisfaction following the treatment and throughout the post-treatment recovery.

Understanding Deep Wrinkles and What Causes Them

Deep wrinkles represent one of the most visible signs of skin ageing. To know whether CO2 laser resurfacing or another type of laser is right for you, it’s essential to understand how these wrinkles form and what causes them to deepen over time.

How Wrinkles Form Over Time

Wrinkle formation begins gradually. With each passing year, collagen production declines, and the skin’s ability to retain moisture and repair damage diminishes.

The heat from the laser used in ablative laser resurfacing mimics a controlled injury that stimulates the same repair process your body uses naturally, only more effectively.

As the healing process unfolds, new skin replaces the old, damaged layers, restoring smoother texture and minimising the look of wrinkles and scars. Controlled thermal injury from the CO2 laser activates fibroblasts and induces new collagen formation, closely mimicking the body’s natural wound-repair process.

The laser may also target small areas of skin for localised resurfacing around problem zones, such as wrinkles around the eyes or mouth, providing customisable care depending on your needs.

Factors That Accelerate Skin Ageing

Certain factors can make wrinkles appear more quickly or deepen over time, even before ageing becomes advanced. These include:

• Prolonged sun exposure, which breaks down collagen and damages surrounding skin.
• Smoking, which restricts circulation and accelerates cellular breakdown.
• Pollution, introducing free radicals that stress skin tissue and impair regeneration.
• Dehydration and poor nutrition, which limit the skin’s natural repair capacity.

In these cases, CO2 laser skin treatments or fractional laser resurfacing can help reduce wrinkles and correct uneven skin tone caused by environmental and lifestyle damage.

These procedures reach deep into the dermis to encourage new skin while leaving skin with minimal downtime when performed with modern non-ablative laser treatment systems.

How to Identify Deep Wrinkles vs Fine Lines

Before choosing a resurfacing treatment, it’s helpful to distinguish between fine lines and deeper wrinkles.

• Fine lines are shallow and surface-level, often linked to mild dehydration or early collagen loss. They respond well to non-ablative laser treatment, moisturisers, or topical products.
• Deep wrinkles, on the other hand, extend into the dermal layers and are best addressed through ablative laser resurfacing or fractional CO2 laser skin treatments that penetrate deeper into the skin.

When you see your skin losing elasticity or notice pronounced wrinkles around the eyes or mouth, it may be time to discuss a CO2 laser skin resurfacing treatment plan with a qualified specialist. The treatment is best for moderate to severe wrinkles and can dramatically tighten the skin while improving tone and texture across a range of skin types.

During the weeks following treatment, maintaining hydration and using approved skin products will help the treated skin heal efficiently. As collagen rebuilds, results continue to improve, leaving your skin looking smoother and more refined immediately after treatment and in the months ahead.

How CO2 Laser Resurfacing Works for Deep Wrinkles

CO2 laser resurfacing smooths and rejuvenates the skin by targeting deep wrinkles, uneven tone, and other signs of ageing.

This ablative laser resurfacing procedure uses a precise carbon dioxide beam to remove the outer layers of damaged skin and stimulate the growth of new skin that appears firmer, brighter, and more youthful.

The Science Behind Fractional CO2 Laser Treatment

Fractional CO2 laser resurfacing is a modern, refined version of traditional CO2 laser skin treatments, offering greater precision and faster healing. 

Instead of removing the entire surface, the fractional laser creates microscopic treatment zones that penetrate deep into the dermis, treating small areas of skin while leaving surrounding skin intact to speed recovery.

This type of laser resurfacing enhances collagen remodelling and smooths texture with minimal downtime compared to a full ablative laser treatment. It’s especially effective for wrinkles around the eyes, mouth, and forehead, making it a popular choice for those seeking visible rejuvenation without the extended downtime of a full-face treatment.

How Laser Energy Stimulates Collagen Regeneration

The key to CO2 laser resurfacing treatment is how it activates the skin’s natural repair process. During the resurfacing procedure, the laser energy penetrates deep into the dermis, where fibroblasts, cells that create collagen, are stimulated to produce new collagen and elastin. 

The heat from the laser breaks down damaged tissue, triggering renewal and improving skin strength and elasticity. A 2023 Medicina study found that combining CO2 with a 1540 nm wavelength further improved dermal collagen remodelling and hydration compared with single-wavelength CO2 treatments. Benefits of this process include:

• Stronger, smoother, and more hydrated treated skin.
• Gradual reduction of deep wrinkles and fine lines.
• Noticeably improved tone, firmness, and clarity.

As the new skin forms, texture and resilience improve over time. Whether used as a resurfacing for deep wrinkles treatment or combined with other laser skin treatments, CO2 resurfacing delivers scientifically proven, long-lasting rejuvenation.

How CO2 Laser Differs from Fractional CO2 Laser

While both CO2 laser skin and fractional CO2 laser systems work on the principle of skin resurfacing, they differ in how the energy is delivered and how the skin tissue heals. 

Traditional CO2 laser resurfacing uses a uniform beam to treat the entire surface area, making it suitable for severe wrinkles and scars or those seeking comprehensive facial laser rejuvenation. However, it involves longer recovery and may require more careful post-treatment care to manage redness and sensitivity.

Fractional CO2 laser resurfacing, by contrast, focuses on microscopic zones, treating small areas of skin while leaving untouched portions intact. This allows for quicker recovery and reduced discomfort while still achieving excellent results for deep wrinkles and uneven skin tone.

The table below highlights the key differences between traditional CO2 and fractional CO2 laser resurfacing:

• Traditional CO2 Laser: Delivers a uniform beam that treats the entire skin surface, offering deeper penetration ideal for advanced wrinkles and scars. Healing typically takes 10–14 days, with extended downtime involving redness and peeling. The procedure causes moderate to high discomfort but produces more dramatic results, making it best suited for severe ageing concerns and lighter skin tones.
• Fractional CO2 Laser: Uses a fractionated beam that targets microscopic zones for controlled treatment depth, suitable for moderate resurfacing. Healing occurs within 5–7 days, and downtime is minimal, allowing for faster recovery. It generally causes mild to moderate discomfort and provides gradual, natural-looking results, making it ideal for mild-to-moderate skin issues and a broader range of skin types, including sensitive skin.

Understanding these distinctions helps you and your practitioner tailor your treatment plan to your individual goals and tolerance for downtime. Both methods encourage new skin growth and tighten the skin, but fractional laser resurfacing offers faster healing with minimal downtime.

Can CO2 Laser Really Remove Deep Wrinkles Permanently?

While the CO2 laser resurfacing treatment is among the most effective methods to reduce wrinkles, it’s important to set realistic expectations. 

The type of laser used, your skin tissue characteristics, and the healing process all influence results.

Clinical Results and What Studies Show

Clinical research supports the efficacy of CO2 laser resurfacing as a top-tier skin resurfacing treatment for age-related changes. Numerous peer-reviewed studies demonstrate significant improvement in wrinkles around the eyes and mouth, enhanced tone, and reduction in uneven skin texture.

Patients frequently report their skin is looking smoother and more radiant after the healing process, with continued improvement over the weeks following treatment as collagen continues to rebuild.

High patient satisfaction rates also highlight that CO2 laser skin treatments deliver predictable, long-term results when part of a comprehensive post-treatment care routine.

How Many Sessions Are Needed for Deep Wrinkle Reduction

The number of recommended CO2 laser sessions depends on the severity of wrinkles and overall skin condition. Most individuals notice substantial improvement after just one CO2 laser skin resurfacing session, though deeper wrinkles or extensive damage may require multiple treatments. On average, one to three sessions spaced several months apart yield optimal results.

Your provider will assess your skin and design a treatment plan suited to your specific needs, considering factors like wrinkle depth, range of skin tone, and previous laser skin treatments. 

Following the practitioner’s advice and maintaining gentle skincare immediately after treatment are crucial for ensuring safe recovery and optimal outcomes.

Realistic Expectations: How Much Improvement Can You Expect?

After a CO2 laser resurfacing session, most patients see a visible reduction in wrinkles, improved firmness, and smoother texture. The skin will become more refined as the healing process unfolds, with ongoing improvements for several months due to collagen regeneration.

While results can be transformative, complete elimination of deep wrinkles isn’t guaranteed for every patient. Factors such as genetics, age, and environmental exposure affect final results. 

Proper post-treatment care, hydration, sun protection, and the use of recommended skin products, can extend the longevity of results and help you maintain a smoother, rejuvenated complexion for years to come.

CO2 Laser vs Other Wrinkle Treatments

When considering how to reduce the appearance of wrinkles, it’s important to understand the strengths and differences between various laser skin treatments and non-laser options. 

The CO2 laser resurfacing treatment is widely regarded as one of the most effective resurfacing procedures for deep wrinkles, thanks to its ability to penetrate deeper into the skin and promote significant collagen regeneration.

CO2 Laser vs Erbium Laser: Which Is Better for Deep Wrinkles?

Both CO2 laser and Erbium laser treatments aim to rejuvenate the skin, but they differ in depth, intensity, and recovery.

• The CO2 laser skin resurfacing procedure is an ablative laser treatment, meaning it removes the outer layers of skin while stimulating collagen production in deeper layers. This makes it ideal for resurfacing for deep wrinkles, wrinkles and scars, and uneven skin tone. 
• The Erbium laser is a milder type of laser resurfacing, removing thinner layers and causing less thermal damage. It’s suitable for patients seeking a non-ablative laser treatment or those with sensitive or drier skin. 

Comparative trials in JAMA Dermatology show CO2 lasers yield greater wrinkle depth reduction than Er:YAG systems, though recovery time is longer.

If your goal is to tighten the skin and correct severe wrinkles or sagging, CO2 resurfacing generally offers more dramatic and durable results. The healing process may take longer, but the outcome, smoother, rejuvenated skin tissue, is worth it.

CO2 Laser vs RF Microneedling and Chemical Peels: Key Differences

RF microneedling and chemical peels are popular non-surgical treatments, but they differ from CO2 laser skin resurfacing in both mechanism and depth of action.

• RF microneedling combines fine needles with radiofrequency energy to heat deeper layers of the skin. While it boosts collagen like CO2 lasers, it’s less intense and may require multiple sessions for visible results. 
• Chemical peels resurface the top layer of your skin, making them useful for mild fine lines and pigmentation, but they cannot reach the dermal depth necessary to reduce deep wrinkles. 

In contrast, CO2 laser resurfacing delivers focused ablative energy into deeper dermal layers, producing a more dramatic tightening and wrinkle reduction effect.

The Journal of Cosmetic Dermatology (2023) reported that fractional CO2 laser resurfacing stimulates stronger collagen remodelling and skin tightening than RF microneedling or peels, achieving more significant wrinkle reduction in fewer sessions.

Because the CO2 laser targets both the epidermis and dermis, it is especially effective for advanced signs of ageing, including deep periorbital and perioral lines, where other resurfacing treatments reach their limits.

When to Choose CO2 Laser Over Non-Ablative Options

You should consider CO2 laser skin resurfacing treatment if your concerns include pronounced wrinkles, uneven skin tone, or skin laxity that milder options cannot address.

The ablative laser energy stimulates collagen repair at a deeper level, allowing the skin to become smoother and tighter during the weeks following treatment.

On the other hand, non-ablative laser treatments, RF microneedling, and chemical peels are better suited for mild ageing, early prevention, or maintenance between more intensive procedures.

In short, CO2 laser resurfacing is ideal for those ready to commit to a more powerful resurfacing procedure that produces lasting improvements across the range of skin concerns.

What to Expect During and After CO2 Laser Resurfacing

Understanding the CO2 laser resurfacing treatment process helps you prepare for every stage, from the procedure itself to the healing process that follows.

This advanced laser skin resurfacing method precisely targets deep wrinkles, uneven skin tone, and skin laxity, helping to tighten the skin and promote long-term rejuvenation.

While highly effective, it also involves distinct recovery stages that are essential for achieving safe and beautiful results.

The Treatment Process: Step by Step

Your journey begins with a pre-treatment preparation phase. Before the procedure, a topical anaesthetic or local numbing cream is applied to ensure comfort throughout your CO2 laser skin resurfacing session.

• Duration: A typical full-face treatment lasts 45 to 60 minutes, though smaller areas, like resurfacing around the eyes or mouth, take less time.
• Laser application: During the resurfacing procedure, the laser energy penetrates deeper into the skin, using an ablative laser beam to remove the outer layers of damaged tissue. This stimulates collagen and elastin production within the dermis, triggering the body’s natural repair process.
• Surface renewal: As the heat from the laser activates fibroblasts, it encourages new skin to form, resulting in smoother texture and visibly reduced wrinkles.

Depending on your treatment goals, your practitioner may use fractional CO2 laser resurfacing for a more controlled approach, treating small areas of skin while leaving portions of surrounding skin intact to speed up recovery.

Downtime, Healing, and Recovery Stages

Immediately following laser treatment, your treated skin will appear red, warm, and slightly swollen, signs that the healing process has begun. These effects are part of the skin’s natural regeneration and vary depending on the depth and intensity of the resurfacing treatment.

Here’s what to expect in the weeks following treatment:

• Days 1–5: Redness, swelling, and mild discomfort are common. The skin will begin to peel, revealing new skin underneath.
• Weeks 2–3: The treated skin starts to smooth out, and pinkness gradually fades as collagen production increases.
• Months 1–3: Collagen remodelling continues beneath the surface, helping to tighten the skin and improve tone and elasticity.

Adhering to your practitioner’s post-treatment instructions is critical. Use gentle, fragrance-free skin products, avoid sun exposure, and keep the area moisturised to protect the new skin barrier. Proper care helps prevent infection, minimise scarring, and promote optimal healing.

A prospective  study published in the Journal of Drugs in Dermatology evaluated 100 patients who underwent fractional CO2 laser resurfacing. The results showed a significant reduction in periorbital wrinkles and noticeable brow elevation. Patients also reported smoother overall skin texture within just a few weeks of treatment.

Before the Procedure: How to Prepare for CO2 Laser Treatment

Preparation for your CO2 laser skin treatment starts well before you sit in the chair. A thorough pre-treatment consultation ensures that the chosen type of laser resurfacing, whether ablative or fractional, is best suited for your skin’s needs and condition. 

During this consultation, your practitioner will:

• Assess your skin tissue and identify areas that require resurfacing for deep wrinkles or other concerns like scars or uneven tone.
• Create a personalised treatment plan, outlining the expected downtime, healing process, and care regimen.
• Recommend which skin products to pause before treatment and provide guidance for immediately after treatment care.

This stage ensures your resurfacing procedure is tailored to your skin’s characteristics for maximum effectiveness and safety.

Pre-Treatment Consultation and Skin Assessment

The pre-treatment consultation is a vital step for success. During this session, the practitioner examines your skin type, thickness, and elasticity to determine the most effective laser skin resurfacing approach.

If your skin is more sensitive or you have a darker complexion, fractional CO2 laser resurfacing or a gentler non-ablative laser treatment may be recommended.

You’ll also receive a detailed checklist of how to prepare your skin with minimal risk, such as avoiding retinoids, stopping blood-thinning medications, and protecting your skin from UV exposure before the procedure.

Do’s and Don’ts Before Your Session

Proper preparation plays a significant role in ensuring safe and successful results from your CO2 laser skin treatments. Follow these simple yet essential guidelines to optimise your results and minimise complications:

Do:

• Follow all pre-procedure instructions provided by your practitioner.
• Keep your skin well-hydrated and nourished in the days before treatment.
• Attend your pre-treatment consultations for accurate planning and skin assessment.

Don’t:

• Use retinoids, exfoliating acids, or strong skin products a week before treatment.
• Expose your skin to direct sunlight; always wear SPF 30 or higher.
• Schedule chemical peels or other invasive laser skin treatments too close to your session.

By following these steps, you’ll ensure that your treated skin responds well to the CO2 resurfacing procedure, healing efficiently and revealing smoother, healthier new skin in the weeks following treatment.

Long-Term Results: How Long Do CO2 Laser Wrinkle Results Last?

CO2 laser outcome longevity largely depends on individual skin type, age, and post-treatment care. The rejuvenating effects of CO2 laser resurfacing can last for several years, especially when supported by consistent skincare and healthy lifestyle habits.

Because the ablative laser stimulates deep collagen remodelling and encourages new skin formation. Research published in JAMA Dermatology (2004) found that collagen production remains elevated for up to six months post-resurfacing, with visible skin improvements lasting 12 to 24 months in most patients.

Maintenance Treatments and Skin Care Tips

To sustain and enhance your results after CO2 resurfacing, it’s vital to adopt a consistent, restorative skincare routine. As the healing process settles and collagen continues to rebuild, maintaining your skin’s health will help extend the life of your results. Here are key recommendations for ongoing care:

• Protect your skin daily: Use a broad-spectrum SPF 30+ sunscreen to guard against UV damage and prevent the breakdown of collagen in your new skin. 
• Hydrate and nourish: Apply skin products rich in hyaluronic acid, ceramides, and antioxidants to support moisture retention and protect against free radicals. 
• Schedule maintenance sessions: Periodic fractional CO2 laser resurfacing, non-ablative laser treatment, or gentle chemical peels every 12–18 months can help reduce the appearance of wrinkles that may return with time. 
• Be gentle with the skin: Avoid harsh exfoliants or overuse of retinoids immediately after treatment to protect your treated skin barrier. 

A disciplined skincare routine ensures that the resurfacing for deep wrinkles results remain consistent and that your complexion stays firm, luminous, and balanced well into the future.

Lifestyle Habits That Extend Results

Your everyday habits play a major role in maintaining the benefits of CO2 laser skin resurfacing. Since this resurfacing treatment works at both the surface and deeper dermal layers, your skin’s long-term health depends on how well you care for it after the healing process is complete. 

Follow these lifestyle practices to extend results:

• Stay hydrated: Drinking adequate water supports skin elasticity and enhances nutrient delivery to regenerating tissues. 
• Maintain a balanced diet: Eat foods rich in vitamins A, C, and E to support collagen renewal and protect skin tissue from oxidative stress. 
• Exercise regularly: Improved circulation from physical activity boosts oxygen flow, promoting continued skin rejuvenation. 
• Avoid smoking and excess alcohol: These habits slow healing, deplete collagen, and accelerate ageing, leading to faster wrinkle recurrence. 

Adopting these habits not only supports your treated skin but also ensures that the results of your laser resurfacing treatment last as long as possible.

What to Do If Wrinkles Reappear Over Time

Even with diligent care, deep wrinkles may gradually reappear due to ongoing collagen loss from natural ageing. When this happens, reassessing your treatment plan and skincare approach is key.

If you begin noticing fine lines or the return of deeper creases, consider the following steps:

• Consult your practitioner: A follow-up skin assessment will help determine whether additional CO2 laser sessions or alternative laser skin treatments, like fractional CO2 laser resurfacing, are appropriate. 
• Evaluate your skincare routine: Identify any gaps in hydration, sun protection, or post-treatment maintenance that could affect your results. 
• Explore combination options: Pairing CO2 resurfacing with treatments like RF microneedling, PRP therapy, or dermal fillers may enhance collagen stimulation and prolong your youthful look. 

By staying proactive and maintaining consistent post-treatment care, you can ensure your CO2 laser resurfacing results continue to deliver smoother, firmer, and healthier-looking skin for years to come.

Risks, Side Effects, and Who Should Avoid CO2 Laser

Before opting for CO2 laser resurfacing, it's essential to be informed about the potential risks and side effects. While this treatment can significantly reduce the appearance of deep wrinkles, complications such as post-inflammatory hyperpigmentation and prolonged redness may occur. 

To minimise these risks, consulting with an experienced practitioner is crucial. Experts, like those at the Institute of Medical Physics, can provide a comprehensive assessment of your skin type and medical history, allowing for a more tailored treatment approach.

Certain skin types warrant special consideration when it comes to CO2 laser treatments. Individuals with darker skin may be at a heightened risk of complications due to increased pigmentation sensitivity. This makes it even more vital for such individuals to seek experienced professionals who understand the intricacies of treating diverse skin tones safely.

Identifying a good candidate for laser treatment involves evaluating skin condition and overall health. Those in good health without active skin conditions typically respond better to the procedure, leading to optimal results with minimal side effects. 

A thorough pre-treatment consultation can help determine if you fall into this favourable category, ensuring you take informed steps in your skin care journey.

Before You Go…

Deciding if CO2 laser resurfacing is right for you begins with a detailed skin assessment and medical review. This advanced laser skin treatment can deliver remarkable rejuvenation for deep wrinkles, but results depend on expert application and proper post-treatment care.

A consultation with a qualified practitioner will help determine which type of laser resurfacing, from fractional CO2 to ablative CO2 laser, best suits your skin. During this session, your specialist will evaluate your skin tissue, discuss goals, and explain the healing process and expected results.

Every skin type responds differently, so a tailored plan is key. With professional guidance and consistent care, you can confidently achieve smoother, firmer, and more youthful skin that lasts.

About the Institute of Medical Physics

Founded by Dr. Emanuel Paleco, the Institute of Medical Physics (IMP) is a leading UK centre for medical and aesthetic laser treatments, with its main clinic in King’s Cross and additional locations across North London and Essex.

IMP is renowned for combining scientific precision with personalised care. Dr. Paleco and his team specialise in CO2 laser skin resurfacing, Erbium laser rejuvenation, and fractional laser treatments, all tailored to individual skin profiles for safe, natural results.

Experience advanced skin transformation through evidence-based laser science. Book a consultation with Dr. Emanuel Paleco to discover how modern laser expertise can help you achieve radiant, healthy, and confident skin.