CO2 Laser for Scars Treatment: All You Need to Know

By PMUHub Editorial Team| Last updated on May 12, 2023

Lasers are used for treating a wide variety of skin imperfections including different types of scars. CO2 lasers are especially common because they’re versatile. Here’s all you need to know about the use of CO2 lasers in different kinds of scar treatments.

co2 laser for scars

Image source: Instagram @cosmedixclinics

CO2 laser scar treatment can be considered a subset of laser skin resurfacing. It’s a type of skincare that uses lasers to improve the skin’s texture, elasticity, and overall youthfulness.

In this case, the treatment specifically targets scar tissue. It’s usually done on the face, but body scars can also be treated. In either case you first need to consult with your doctor and your dermatologist, and then with a cosmetic or plastic surgeon.

Here’s everything you need to know about scar treatments with CO2 lasers.

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Briefly About CO2 Lasers

CO2 lasers include any laser tool that uses carbon dioxide gas as a medium for the light energy that the laser emits.

There are a few different types of lasers that use carbon dioxide, so there are two major types of CO2 laser treatments: ablative and fractional.

Ablative CO2 Lasers

Ablative treatments are the earliest method of laser skincare. They target the epidermis and vaporize the cells in that layer of skin using concentrated heat. This means inflicting a micro-injury on the patient’s skin in order to stimulate the body’s natural healing mechanisms.

The skin in the targeted area boosts the production of new collagen and elastin to replace the vaporized cells. As a result, the new skin is smoother, healthier, tighter, and more flexible.

Fractional CO2 Lasers

Fractional treatments are named for the way that the laser energy is distributed onto the skin.

Instead of one strong laser beam, it’s split into hundreds or even thousands separate smaller beams with a little bit of space between each.

This way, the treatment leaves small spots of untouched skin between the areas targeted by the laser. It’s less dramatic and the micro-injuries are less intense. This way of distributing the laser energy reduces the downtime required after the treatment, as well as the total recovery time that the patient will need.

You can read more about ablative and fractional CO2 lasers in our comprehensive Guide to CO2 Laser Resurfacing.

Using CO2 Laser for Scars

In terms of removing scars or at least reducing the severity of their appearance, CO2 lasers are fairly versatile.

However, keep in mind that their effects heavily depend on your skin’s natural capacity for collagen production. If that capacity is reduced in any way, the effects of the laser treatment may not be as extensive as you’d hoped, or it might take a longer time and a few sessions to achieve them.

That’s why you should always consult with both an expert dermatologist and a laser tech or surgeon. They can perform a well-rounded assessment of your skin’s condition and give you a realistic idea of what you can expect.


Always look for a certified and licensed surgeon who is experienced in laser skincare, and if possible try to find someone who specializes in using CO2 laser for scars.

Even if you can’t locate a specialist, your chosen surgeon needs to have a wealth of experience with scars, because scar tissue is different from regular skin imperfections, such as wrinkles.

CO2 Laser for Hypertrophic Scars

Hypertrophic scars are caused by your body producing an excess of connective tissue while it’s healing a wound. This results in a raised scar, which is nonetheless not as severe as a keloid scar.

Carbon dioxide laser treatment is a highly effective method for improving the appearance of such hypertrophic scars. The most successful approach involves combining fractional CO2 laser treatment with other laser skin resurfacing techniques.

On top of aesthetic impact, it can also improve the medical aspect of hypertrophic scarring. Specifically, it’s very good for reducing larger scars that impede normal movement.

CO2 Laser for Acne Scars

CO2 laser is very effective in removing or reducing acne scars, either ablatively or fractionally. In either case, high-energy lasers produce better outcomes than those on low-energy settings.

Older acne scars are more challenging to remove and carry a greater risk of side effects, such as pigmentation, skin sensitivity, persistent erythema (redness), and acneiform eruption.1

As to specific acne scar types, boxcar and rolling scars are more responsive to treatment, while icepick scars are the most difficult to remove.

Fractional CO2 Laser for Acne Scars

The fractional method of applying carbon dioxide laser is highly effective for resurfacing acne scars, though the degree of success greatly varies depending on the type of scar.

As with ablative CO2, fractional treatment is more effective for rolling and boxcar acne scars than icepick scars, and the more recent the scar is the better the chance of success.

How Much Does CO2 Laser for Acne Scars Cost?

We can’t give you a precise answer. The price can be anywhere between several hundred and upwards of $1000.

Pricing varies between clinics, surgeons, and geographical areas. The price of acne scar removal with a carbon dioxide laser depends on a few factors, including:

  • The type of scars (rolling, boxcar, icepick)
  • The severity of the scarring
  • The size of the affected area
  • How old the scars are
  • The type of treatment (ablative or fractional)
  • How many sessions you need in total
  • The surgeon’s expertise and experience
  • The location and reputation of the clinic
  • Whether you will need anesthetic, etc.

Generally speaking, ablative CO2 laser skincare is more expensive than fractional options.

You should also factor in potential extra costs, such as additional sessions, aftercare products your surgeon or dermatologist might recommend, or antiviral medication if you have the herpes virus.

Keep in mind that laser skin resurfacing, including acne scar removal, usually isn’t covered by insurance. That’s because these procedures are categorized as cosmetic.

The only possible exception is if your insurance provider determines that the acne scars are a genuine medical problem, but the chances of that are low. Instead, ask your chosen clinic about payment plans and financing options.

CO2 Laser for Surgical Scars

Ablative laser therapy is an effective treatment for surgical and traumatic scars. The best outcomes are achieved with prompt laser resurfacing, though, so you would need to bring this up to your doctor and insurance as soon as possible after the event.

In the case of surgical scars, CO2 laser treatment should ideally be administered immediately after surgery and primary recovery. In general, CO2 laser resurfacing of scar tissue is recommended to be performed within 6-10 weeks following the surgery or trauma.

Fractional CO2 Laser for Surgical Scars

Fractional CO2 laser is likewise a highly effective treatment for surgical scars. As we already mentioned, fractional lasers target evenly spaced micro areas of the skin. This means the procedure is minimally invasive and with very little downtime.

The number of sessions required depends on the severity of the scars, but typically, you might expect to see significant improvement after just one treatment.

The same restrictions apply as for ablative CO2 – try to have the treatment as soon as possible after the surgery and primary recovery to achieve the best results.

How Much Does CO2 Laser for Surgical Scars Cost?

Just like it’s the case for acne scar treatment, the price of treating surgical scars with a CO2 laser depends on many factors, including the type of laser used, your location, as well as the complexity of the case and the number of sessions you need.

So it can go from a couple of hundred up to a few thousand dollars.

Book consults at a clinic, let them assess the situation, and they’ll give you a price.

When Is CO2 Laser Scar Removal a Bad Idea?

As with any other surgical procedure, sometimes laser treatments aren’t the best way to go. It might be a bad idea for you to undergo a CO2 laser treatment for your scars if any of the following applies to you:

  • You have underlying health issues
  • Your immune system is weak or compromised in any way
  • You have notably dark (pigmented) skin
  • There’s excess or sagging skin in the treatment area
  • There are very deep wrinkles in the area
  • You have an active herpes flareup or a history of cold sores
  • There’s active acne in the treatment area
  • You have a history of laser treatments (facials or other)

None of these things are absolutely forbidding factors, but they do put you at greater risk of unwanted side effects. Potential side effects of CO2 laser treatments include hyperpigmentation, hypopigmentation, and keloid scarring.

Alternative to CO2 Scar Treatment: Microneedling

If you can’t have a laser treatment for any reason, but you still want to do something about your scars, you might consider alternative forms of restorative skincare. One such option is microneedling.

Microneedling is a type of collagen induction treatment. At the most basic level, it works very similarly to laser resurfacing: micro-injuries are inflicted onto the skin in the area that needs to be treated, which boosts collagen and elastin production, resulting in smoother skin.

The difference is that microneedling uses tiny needles rather than any kind of energy beam. It’s a completely mechanical treatment. It’s quite non-invasive and not aggressive at all, and you don’t need a surgeon to perform it.

Just find a licensed, experienced beautician or esthetician and ask about microneedling options for your skin type and specific condition. There are a few variations available, including microneedling with a derma pen, derma rolling, derma stamping, and nanoneedling.

You can learn about all that and much more in our in-depth Guide to Microneedling.

Image source: Instagram @lidijatesic_skincare

CO2 Laser for Scars Treatment – Main Takeaways

CO2 lasers are fairly versatile in terms of removing scars or at least reducing the severity of their appearance. They can be applied ablative or fractionally, and can target different types of scar tissue. This includes hypertrophic, surgical, traumatic, and acne scars.

The degree of success you can expect depends on the type and severity of the scar itself, as well as how old it is, and your general skin condition.

Before you decide to undergo a CO2 laser skin treatment, consult with your doctor and dermatologist for the best approach. Then take your time and find a licensed, board-certified, experienced surgeon to do the procedure.



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