How Many CO2 Laser Sessions Do I Need?

Key Takeaways

• CO2 laser sessions often range from three to five for best results.
• Your specific skin type and concerns impact the number of sessions needed.
• Frequency of sessions is crucial in maximising treatment effectiveness.
• Individual treatment goals can dictate your personalised session plan.
• Each CO2 laser treatment contributes to progressive skin improvements.

Understanding How CO2 Laser Resurfacing Works

CO2 laser skin resurfacing is a powerful laser procedure that uses carbon dioxide (CO2) laser beams to resurface the skin, promoting smoother, more even texture and tone. The laser beam delivers controlled energy into the facial skin, precisely targeting the outer layer of skin where damage, discolouration, and wrinkles form.

This process triggers the body’s natural healing response, encouraging the growth of new skin and collagen in deeper layers. The result is noticeably smoother, firmer, and more radiant skin,  a true reset for anyone seeking facial rejuvenation. The benefits of CO2 laser resurfacing include significant improvement in:

• Fine lines and wrinkles 
• Acne scars and pitted texture 
• Sun damage and pigmentation 
• Age spots and dullness 
• Uneven tone or enlarged pores 

These resurfacing treatments are clinically proven to deliver lasting results, especially when performed as a series of treatments under professional supervision.

How CO2 Laser Stimulates Skin Renewal

During fractional CO2 laser treatment, microscopic laser beams penetrate the skin to create thousands of controlled micro-injuries, stimulating the skin’s natural regeneration process. This approach treats only a fraction of the skin, leaving surrounding tissue intact to accelerate healing.

The fractional CO2 laser skin resurfacing method is especially effective for treating acne scars, fine lines, and mild to moderate sun damage. Patients typically notice improvements within days after their laser treatment, as the new skin emerges smoother and brighter.

Unlike traditional CO2 lasers, the fractional CO2 laser handpiece provides precision control, reducing downtime while maintaining the deep rejuvenating effects of ablative laser treatments. As collagen continues to form in the months following treatment, the skin’s firmness and clarity continue to improve.

Types of CO2 Laser Treatments (Fractional vs Fully Ablative)

There are various types of CO2 laser treatments designed to meet different skin needs. Fractional CO2 lasers, such as ActiveFX and DeepFX, are less invasive than fully ablative lasers.

Fully ablative lasers remove entire layers of skin, effectively treating deeper scars and wrinkles but requiring longer recovery times. In contrast, fractional treatments target a fraction of the skin, making them ideal for those looking for a balance of efficacy and minimal downtime.

• Fractional CO2 Laser: A less invasive option that requires around 1–2 weeks of recovery. It’s best suited for treating uneven skin tone, mild wrinkles, and early signs of ageing.
• Fully Ablative Laser: A more intensive treatment with a longer recovery period of 2–4 weeks. It is ideal for deep scars, pronounced wrinkles, and advanced skin damage.

Typical Number of CO2 Laser Sessions Needed

The average number of CO2 laser skin resurfacing sessions depends on your unique skin type, treatment goals, and the specific concerns being addressed. Whether you’re targeting wrinkles, acne scars, or pigmentation issues, your journey with CO2 laser treatments is highly individualised.

Most patients notice visible improvements after just one treatment, but for full and lasting results, a series of three to five CO2 laser sessions is typically recommended. This ideal session count for CO2 laser helps stimulate collagen progressively, improving both surface texture and deeper dermal layers for smoother, firmer skin.

Average Sessions for Wrinkles, Scars, and Pigmentation

Different skin conditions respond differently to CO2 fractional laser treatments, and the total number of sessions required reflects the complexity of the issue being treated:

• Wrinkles and Fine Lines: Patients seeking to smooth fine lines and tighten facial skin often benefit from three to five sessions. Each treatment helps resurface the outer layer of skin and stimulate new collagen, resulting in firmer, smoother skin over time.
  
• Scars and Acne Scarring: When treating acne scars or post-surgical scarring, the CO2 laser can treat deeper layers of the skin more aggressively. In such cases, five to seven fractional CO2 laser skin resurfacing sessions may be required to remodel collagen and improve skin texture effectively.
  
• Pigmentation and Sun Damage: For sun damage, age spots, or uneven skin tone, results typically emerge after three to four sessions. The laser beam gently removes pigmented cells while encouraging new skin formation. Darker skin tones require extra care and often lower-energy treatments to avoid post-inflammatory pigmentation.
  

For example, a retrospective review found that fractional CO2 laser treatment of depressed acne scars used anywhere from 1 to 7 sessions, tailored to the patient’s response and skin type.

Why Some Patients Need Multiple Treatments

The need for multiple CO2 laser sessions depends on both the severity of the skin concern and how your skin reacts to each laser procedure. Patients with extensive sun damage, deep-set wrinkles, or long-standing scars often require many treatments to achieve dramatic improvement.

Additionally, your skin’s healing ability, treatment area, and carbon dioxide laser intensity all affect the total number of sessions. 

Those aiming for subtle refinement may benefit from lighter, fractional CO2 laser treatment, while individuals seeking dramatic rejuvenation might opt for fewer but more intensive ablative laser resurfacing sessions.

It’s also worth noting that laser skin rejuvenation is cumulative, collagen continues to regenerate for months following treatment, so results from earlier sessions continue improving even as you progress through your treatment plan. A study of fractional CO2 for facial acne scars, 3–4 sessions spaced six weeks apart showed meaningful clinical improvement.

How Treatment Intensity Affects Session Count

The intensity of your CO2 laser skin treatment directly influences both recovery time and how many sessions are necessary. Deeper, high-energy treatments reach further into the layers of skin, often requiring fewer total sessions but longer healing periods. For example:

• Ablative CO2 laser resurfacing: Involves removing the full outer layer of skin, offering dramatic improvements in one or two sessions but with downtime lasting up to two weeks.
• Fractional CO2 laser: Treats a portion of the skin using microscopic laser beams, allowing quicker recovery with more treatments spaced 4–6 weeks apart.
• Non-ablative laser resurfacing: Provides mild rejuvenation without damaging surface layers; often requires five or more sessions for subtle, gradual enhancement.

Balancing treatment intensity with your recovery capacity ensures a customised plan that suits your skin’s resilience and tolerance.

Your practitioner will assess your skin type, desired results, and lifestyle to recommend whether you should undergo 2 to 4 deeper treatments or a longer series of gentler sessions.

In sequential multimodal laser therapy (CO2 fractional + non-ablative wavelengths), patients received three sessions at two-month intervals with favourable outcomes and good tolerability, illustrating how combining technologies may reduce or optimise the number of CO2 passes needed.

Factors That Affect the Number of CO2 Laser Sessions

Every CO2 laser skin resurfacing plan is tailored based on several critical factors that influence treatment response, healing, and long-term results. Understanding these helps you and your practitioner design a regimen that meets both your cosmetic and clinical goals.

Skin Type, Condition, and Treatment Goals

Your skin type, tone, and specific condition play a major role in determining how many CO2 laser treatments are needed.

• Darker skin tones: Safe use of CO2 laser on darker skin involves careful energy adjustment and fractional methods that preserve portions of untreated skin, promoting faster recovery and lowering the risk of hyperpigmentation.
• Lighter skin types: Can often tolerate higher-intensity resurfacing treatments with reduced risk of pigment change. 
• Treatment goals: Patients targeting mild texture or fine lines may need fewer sessions than those treating deep acne scars or extensive sun damage. 

Your practitioner will evaluate whether your goal is mild smoothing, overall brightening, or advanced correction to determine the series of treatments required.

Energy Settings, Laser Type, and Depth of Treatment

The type of laser used significantly affects session count.

• Higher energy settings: Deliver deeper penetration, treating thicker layers of skin and yielding more visible improvement in fewer sessions. 
• Shallower resurfacing: Requires a higher total number of sessions, but with less downtime and reduced risk. 
• Advanced laser systems: Like the fractional CO2 laser skin or carbon dioxide laser, allow practitioners to precisely control treatment depth for optimal outcomes. 

An experienced professional will customise these parameters based on the treatment area and desired level of correction, ensuring balance between efficacy and comfort.

Practitioner Expertise and Equipment Quality

The skill and experience of your practitioner are as important as the laser itself. A qualified, well-trained specialist understands how to tailor each laser skin resurfacing session to your specific needs, adjusting parameters for skin color, texture, and tolerance.

High-quality, medical-grade lasers also influence how many CO2 laser treatments you’ll need. Advanced systems deliver consistent energy distribution, protecting the surrounding skin and enabling faster healing skin recovery. 

This precision not only enhances safety but can also reduce the number of sessions required to achieve your ideal outcome.

How Often Should You Get CO2 Laser Treatments?

The success of your CO2 laser skin resurfacing depends not only on how many treatments you receive but also on how often they are performed. 

The skin requires sufficient time to heal, regenerate new skin, and rebuild collagen between sessions. Proper timing ensures your healing skin remains healthy, maximises collagen production, and prevents overstimulation that could lead to irritation or pigmentation issues, especially for those with darker skin tones.

Understanding the ideal frequency for CO2 laser treatments helps you achieve consistent, long-term improvement while maintaining your skin’s integrity and resilience.

Recommended Time Between Sessions

Most specialists recommend spacing CO2 laser treatments approximately four to six weeks apart. This time frame allows your skin tissue to fully recover and encourages optimal collagen and elastin formation before the next procedure.

During this period, your skin will be red initially and then begin to regenerate as the outer layer of skin sheds and new skin forms underneath. The carbon dioxide laser stimulates deep repair within the dermis, which continues for several weeks after your appointment. 

Performing another resurfacing treatment too soon can interfere with this process and increase the risk of inflammation or sensitivity.

For deeper ablative laser procedures, practitioners may recommend a longer gap of 8 to 12 weeks, while fractional CO2 laser sessions, being less invasive, can safely be done at 4- to 6-week intervals. 

Here are the general guidelines for spacing sessions:

• Fractional CO2 Laser: Offers mild to moderate intensity and is typically repeated every 4–6 weeks. It’s safe for most skin types and provides noticeable improvement with a quicker recovery.
• Fully Ablative CO2 Laser: Delivers a deep and intensive treatment, recommended at intervals of every 8–12 weeks. It involves longer downtime but achieves dramatic results in fewer sessions.
• Non-Ablative Laser: A gentle, surface-level treatment that can be performed every 3–4 weeks. It requires more sessions to achieve visible improvements but has minimal recovery time.

Signs Your Skin Is Ready for Another Treatment

Listening to your skin is essential before scheduling your next CO2 laser session. The following are key indicators that your healing skin is ready for further rejuvenation:

• The treated area appears calm with minimal redness or swelling. 
• New skin has fully replaced the exfoliated or peeled layers. 
• The surface feels smoother, and skin texture has improved noticeably. 
• There are no signs of irritation, infection, or excessive dryness. 

Your practitioner may also evaluate the layer of your skin treated previously and determine whether additional microscopic laser beams should target deeper or shallower levels in the next session.

Scheduling your next treatment too early may stress the surrounding skin, whereas waiting too long could slow your progress. Maintaining consistency with the recommended intervals ensures steady, cumulative improvement in laser skin rejuvenation results.

What to Expect After Each CO2 Laser Session

Following each CO2 fractional laser session, your skin will undergo a predictable healing cycle. 

Immediately after treatment, it’s normal to experience redness, warmth, and mild swelling, signs that your body is beginning to regenerate new collagen and repair skin tissue. Typical recovery milestones:

• Days 1–3: The skin will be red and sensitive. Mild crusting or peeling may begin as the outer layer of skin renews itself. 
• Days 4–7: New skin starts to emerge, and redness gradually subsides. The skin feels tighter and smoother. 
• Days 7–14: Texture improves as healing skin settles. Makeup may be applied if approved by your practitioner. 
• Weeks 3–4: Collagen synthesis increases, improving firmness, tone, and brightness. 

The depth of your laser treatment determines the exact healing time. Fractional CO2 laser resurfacing usually heals within one to two weeks, whereas ablative laser procedures can require three to four weeks for full recovery.

Healing Time and Skin Regeneration Cycle

The healing skin process is complex but follows a natural rhythm. After the CO2 laser treatment, the heat from the laser triggers the skin’s repair mechanism by removing damaged cells and stimulating fresh growth.

• Shallow resurfacing treatments target the outer layer of skin, resulting in quicker recovery and minimal downtime.  
• Deeper resurfacing treatments penetrate further into the dermis, requiring longer recovery but producing more significant long-term improvement. 

The skin typically regenerates within 7–10 days after a fractional CO2 laser skin resurfacing session. However, collagen remodelling continues for months following treatment, leading to gradual tightening and refinement of facial skin texture.

Understanding this cycle helps patients set realistic expectations, visible improvement unfolds slowly but steadily, reflecting the skin’s natural regeneration timeline.

Visible Improvements After Each Appointment

You may notice subtle but encouraging changes even a few days after your laser treatment, as the new skin begins to emerge. Improvements in tone, clarity, and texture become more visible over two to three weeks.

By the second or third session, fine lines, acne scars, and sun damage begin to fade noticeably. The laser skin gradually appears brighter, smoother, and more youthful. 

Because CO2 laser skin resurfacing rebuilds collagen deep within the dermis, each session amplifies the effects of the previous one. Many patients observe:

• Diminished wrinkles and fine lines 
• Reduced pigmentation and age spots 
• Enhanced firmness and elasticity 
• A refined, radiant glow 

Each session contributes to ongoing laser skin rejuvenation, with results continuing to improve long after the final treatment.

How Results Evolve Across Multiple Sessions

The benefits of CO2 laser treatments are cumulative, the results from one session enhance the next. Collagen production and tissue remodelling increase progressively with each procedure.

• After one treatment: Noticeable brightness and smoothness, though deeper issues may remain. 
• After two to three sessions: Marked improvement in skin tone, texture, and reduced scarring. 
• After four to five sessions: Optimal facial rejuvenation, visible lifting, and long-term firmness. 

Because CO2 laser treatments are needed to build upon one another, patience is key. As the healing skin strengthens and collagen matures, your complexion becomes more refined, resilient, and radiant.

A retrospective study of 121 patients receiving fractional CO2 laser therapy (206 sessions) reported that after the first session, the rate of “moderate to excellent” improvement was 50.4 %.

By following the recommended series of treatments and spacing them properly, you’ll achieve lasting results that continue to evolve over months following treatment, revealing smoother, youthful, and healthier skin that looks naturally renewed.

Long-Term Maintenance After Completing CO2 Laser Sessions

Completing a CO2 laser skin resurfacing series is only part of the journey. The next, and equally important, step is maintaining your results over the long term. Knowing the Duration of CO2 Laser Results helps you set realistic expectations and plan an effective maintenance strategy. 

Proper post-treatment care, a structured skincare routine, and consistent follow-up ensure that the new skin revealed during your laser rejuvenation continues to look healthy, firm, and radiant.

How to Maintain Results with Proper Skincare

A tailored, science-backed skincare routine is fundamental to sustaining the rejuvenation achieved from CO2 fractional laser treatments. 

Your healing skin remains sensitive for several weeks following your final session, so it’s important to prioritise hydration, protection, and gentle renewal. Key components of effective post-CO2 skincare include:

• Broad-spectrum SPF 30+ protection: Daily sunscreen use is non-negotiable. The heat from the laser makes your skin more sensitive to UV rays, so consistent protection prevents pigmentation recurrence and premature aging. 
• Hydrating serums and moisturisers: Look for formulas containing hyaluronic acid, ceramides, and peptides to maintain elasticity and hydration in healing skin. These ingredients help strengthen the outer layer of skin and support long-term collagen stability. 
• Avoiding harsh exfoliants: Skip retinoids, acids, or scrubs for at least three to four weeks after your last resurfacing treatment. These can irritate or thin new skin that’s still regenerating. 
• Supporting skin barrier health: Use gentle cleansers and repair creams rich in antioxidants to protect against free radicals and maintain smooth skin texture. 

Over time, maintaining consistent hydration and UV protection enhances the lasting results of your carbon dioxide laser sessions, keeping your complexion youthful and resilient.

Complementary Treatments to Extend Results

To prolong the effects of CO2 laser skin treatments, many practitioners recommend integrating complementary procedures that continue stimulating collagen and refining the skin’s surface. 

These maintenance therapies are less invasive and can be alternated between or combined strategically throughout the year. Common complementary options include:

• Microneedling: Helps boost collagen renewal and enhance skin firmness when performed three to six months after CO2 laser resurfacing. It targets the deeper layers of skin, improving scars and texture without disrupting the surface. 
• Chemical Peels: Gentle peels help maintain brightness and remove dull surface buildup, promoting smooth skin with minimal downtime. They can be performed every 3–4 months to refresh tone and clarity.
• LED Light Therapy: Speeds up post-laser healing and strengthens the skin barrier. Red and near-infrared wavelengths improve circulation and stimulate fibroblast activity, reinforcing skin rejuvenation. 
• Hydrafacial or Oxygen Therapy: Keeps new skin hydrated and radiant, improving elasticity and luminosity. 

These complementary treatments work synergistically with fractional CO2 laser outcomes, ensuring that collagen remodelling continues long after your initial sessions are complete.

When to Schedule Follow-Up Assessments

Routine follow-up appointments are essential to monitor progress and adjust your maintenance plan as your skin tissue evolves. 

A typical follow-up schedule involves visiting your practitioner every three to six months. During these sessions, your specialist may:

• Evaluate the skin’s healing rate and texture improvement. 
• Recommend targeted fractional laser touch-ups for persistent wrinkles or pigment irregularities. 
• Adjust skincare prescriptions to suit seasonal or hormonal changes. 
• Identify whether non-ablative laser or peel treatments could enhance long-term tone and firmness. 

Regular assessments not only ensure the lasting results of your CO2 laser resurfacing but also help catch early signs of photoaging or environmental stress. In a long-term follow-up of patients undergoing full facial CO2 laser resurfacing, the mean improvement in rhytid (wrinkle) score was about 45%, consistent across facial subsites.

• Daily Skincare Routine: Should be maintained every day to support hydration, UV protection, and skin barrier health.
• Complementary Treatments: Recommended every 3–6 months to enhance collagen production and refine skin texture.
• Follow-Up Assessments: Ideally conducted every 3–6 months to monitor overall skin health and make preventive adjustments as needed.

CO2 Laser vs Other Treatments: How Session Frequency Differs

Different types of laser resurfacing vary in their required frequency and intensity. The carbon dioxide (CO2) laser is often more powerful than other laser skin treatments, penetrating deeper layers for dramatic results, but it also requires longer healing times and wider spacing between sessions.

In contrast, Erbium lasers and Pico lasers target more superficial or specific pigmentation issues, often allowing shorter recovery periods and fewer sessions.

Comparing to Erbium, Pico, and Fractional Lasers

Here’s how CO2 laser skin resurfacing compares with other popular modalities:

• CO2 Laser (Ablative/Fractional): Penetrates deep into the dermal layers, typically requiring 3–5 sessions with a 1–3 week recovery period. It’s best suited for deep wrinkles, acne scars, and significant texture or tone irregularities.
• Erbium Laser: Targets medium to shallow skin layers, needing around 2–3 sessions and 3–7 days of recovery. Ideal for superficial pigmentation issues and mild wrinkles.
• Pico Laser: Works at the epidermal level with 3–6 sessions and minimal downtime. It effectively treats pigmentation, tattoo removal, and overall skin brightness.
• Fractional Laser (Non-Ablative): Offers controlled depth penetration, generally requiring 4–6 sessions with 2–5 days of recovery. It’s best for subtle rejuvenation and ongoing skin maintenance.

While Erbium laser resurfacing provides more subtle correction with reduced heat exposure (beneficial for darker skin tones), CO2 laser resurfacing uses deeper thermal energy to restructure collagen, making it superior for those seeking more transformative, long-term rejuvenation.

Combining CO2 Laser with Microneedling or Peels

For patients seeking a hybrid approach, combining CO2 laser with microneedling or chemical peels can amplify results. These synergistic procedures address both surface texture and deeper collagen remodeling simultaneously.

• CO2 + Microneedling: This combination boosts collagen at multiple skin depths, improving acne scars, loose skin, and fine lines. The fractional CO2 laser handpiece first stimulates dermal restructuring, while microneedling reinforces collagen formation weeks later. 
• CO2 + Peels: A mild peel post-laser (after healing) can refine the outer layer of skin, remove remaining pigmentation, and enhance luminosity. 

Together, these treatments optimise facial rejuvenation, delivering smoother, firmer, and more even-toned skin with minimal downtime between procedures.

How CO2 Laser Complements Non-Laser Maintenance Treatments

Not all maintenance has to involve lasers. Integrating non-laser treatments ensures the new skin remains strong, hydrated, and resistant to future aging. Recommended non-laser maintenance practices include:

• Professional facials and enzyme therapy: To remove dead cells and enhance oxygenation. 
• Topical retinoids or growth factor serums: Introduced gradually after full recovery to support ongoing cell turnover. 
• Nutrient-rich diet and hydration: Skin regeneration relies on vitamins A, C, E, and amino acids that promote collagen integrity. 
• Regular sleep and stress management: Essential for maintaining balanced skin regeneration and barrier function. 

By combining these ongoing care strategies with the results of CO2 laser skin resurfacing, you maintain a healthy glow and protect the investment made in your rejuvenation treatments.

How Treatment Goals Influence Session Planning

Your treatment goals play a crucial role in determining the number of CO2 laser sessions required for optimal results. Specific objectives, such as reducing the appearance of deeper wrinkles or treating extensive scarring, often necessitate a comprehensive assessment and tailored session planning. 

An experienced practitioner will evaluate your skin condition and collaboratively develop an individualised treatment plan tailored to your unique aspirations.

Understanding your treatment goals allows the practitioner to devise a strategy that maximises the efficacy of each session. For instance, if addressing pigmentation issues or improving overall skin texture is your aim, fewer sessions may suffice. 

Conversely, if you seek considerable improvements in thick scar tissue or pronounced lines, you may encounter the need for more frequent sessions.

Overall, the emphasis on individualised treatment ensures that each aspect of your skin's requirements is accounted for. 

By aligning session frequency with your specific objectives, you enhance your chances of achieving a satisfying outcome from the CO2 laser treatment process.

Can Multiple CO2 Laser Sessions Be Done Safely?

Yes, multiple CO2 laser sessions can be completed safely, provided they are spaced adequately, typically four to six weeks apart. This interval allows your skin to heal properly between treatments, reducing the risk of side effects, including scarring or pigmentation alterations. Proper timing is crucial for optimal results.

Prior to commencing your treatment course, a qualified practitioner should conduct a comprehensive evaluation of your medical history and skin type. 

This assessment ensures that all risk or safety considerations are addressed, leading to a tailored approach that meets your aesthetic goals. Engaging with an experienced professional gives you peace of mind as you embark on your journey with CO2 laser therapy.

Regular check-ins with your practitioner throughout your treatment can help monitor your progress and respond to any concerns that may arise. Taking these precautions ensures that your experience with multiple sessions remains as safe and effective as possible.

Before You Go...

Achieving lasting results from your skin treatment goes far beyond the session itself, it’s about how you care for your skin in the weeks and months that follow. Choosing a skilled practitioner, following tailored aftercare, and maintaining a healthy lifestyle all play a crucial role in how effectively your skin rejuvenates and how long your results endure.

About the Institute of Medical Physics

The Institute of Medical Physics, founded by Dr. Emanuel Paleco, is a leading centre for Medical and Aesthetic Laser Science. With its flagship clinic in King’s Cross and additional locations across North London and Essex, the Institute continues to pioneer innovative treatments in medical laser technology and advanced aesthetic care.

Experience the difference of science-led skin rejuvenation. Book a consultation with Dr. Emanuel Paleco and his expert team at the Institute of Medical Physics to begin your personalised treatment plan.