Fractionated CO2 laser for acne scarring

North Bristol NHS Trust is responsible for delivering the Bristol Laser Centre service. Fractional laser treatment has become the most popular treatment for acne scarring. The aim is to improve the skin texture and reduce the appearance of acne scarring.

How does fractionated CO2 laser work?

The laser beam from a CO2 laser is divided up (fractionated) into thousands of very narrow shafts of light which make tiny holes through the surface of the skin. As the skin heals this leads to the formation of new healthy collagen to tighten the skin and smooth out the acne scars.

How much improvement can I expect?

Studies have shown 30-50% improvement in acne scarring from a single treatment, but results vary between individuals. This treatment is not suitable for thick keloid scars and may not make much difference to deep ice-pick scars.

How many treatments will I need?

One to three treatment sessions may be required at about six month intervals. A small area will be treated on the first occasion to ensure that the treatment is safe and effective for you.

What does the procedure involve?

  • You will be asked to attend an hour before your treatment.
  • The laser nurse will put a numbing cream on which will take about an hour to work.
  • The laser feels uncomfortable and some people describe it as painful.
  • A stream of cold air may be blown across the skin during the procedure and this, together with the numbing cream, will help to reduce the discomfort.
  • You may find it helpful to take paracetamol or ibuprofen before you leave home.
  • The procedure itself will take about half an hour.
  • You will be provided with laser proof goggles or patches to protect your eyes.

What happens after treatment?

  • Your skin will look and feel like moderate sunburn.
  • It may be swollen and slightly oozy for 24 hours, after which the skin surface will peel for three to seven days.
  • Once the skin has healed, in about seven days, it may look pink for another three to six weeks. You can use make-up to cover it as soon as the skin has healed.
  • You should be prepared to take a week off work, contact sports and swimming.
  • You will be given a detailed leaflet about how to look after your skin after the laser treatment.

When will I see improvement?

Improvement in scars can be seen from a week after treatment, but the skin texture can continue to improve for three to six months.

What are the possible side-effects?

  • Lightening or darkening of the skin pigmentation can occur after fractionated CO2 laser treatment. This is usually temporary but can be permanent. Darkening of the skin is more common in darker skin types and can sometimes be treated with topical bleaching creams.
  • Scarring can occur after CO2 laser treatment but this is uncommon.
  • A flare-up of acne spots or white bumps (milia) can occur on the skin surface.
  • Infection after CO2 laser treatment is possible but uncommon. If you have a history of cold sores you may be prescribed anti-viral medication to take before your treatment to prevent a flare-up of the cold sore virus.

You may not be suitable for this treatment if:

  • You are on Warfarin.
  • You are on Roaccutane or have taken Roaccutane within the previous 12 months.
  • You are on oral steroids.
  • You have an active facial infection or skin infection, including cold sores.
  • You are pregnant or breastfeeding.
  • You are sun-tanned or have a fake tan.
  • You have very dark skin.
  • You have active acne spots.

How do I book in?

If you would like to arrange a consultation please contact the Laser Centre on 0117 414 1212.

You can also email us with any queries.


If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.