SKINNON-SURGICAL
CO2 Laser Resurfacing in Delafield
Smoother texture and more even tone through controlled resurfacing
CO2 laser resurfacing is a treatment for people who want to address wrinkles, sun damage and brown spots, acne or surgical scars, enlarged pores, uneven texture, or mild skin laxity. A carbon dioxide laser emits infrared light at 10,600 nm, removing damaged surface skin and heating the tissue beneath it so new collagen forms during healing. Modern fractional systems divide the beam into microbeams that treat narrow columns of skin and leave the surrounding tissue intact, shortening recovery compared with fully ablative resurfacing. Treatment can range from a light superficial pass to deep resurfacing. At Consona in Delafield, Wisconsin, the treatment plan is set by Dr. Lucas Boehm, a board-certified plastic surgeon.
At a Glance
- A CO2 laser emits at a wavelength of 10,600 nm, which is preferentially absorbed by the water inside skin cells[1]
- Fractional treatment splits the beam into many microbeams, creating columns of treated skin surrounded by normal, undamaged tissue[1]
- After fractional CO2 resurfacing the skin surface typically regrows within 6 to 7 days, while redness, peeling, and skin fragility can persist for up to three months[1]
- In one study of fractional CO2 resurfacing, 80% of participants reported a satisfactory reduction in visible wrinkles[3]
- Fractional CO2 systems are significantly safer than the non-fractional lasers they replaced, with fewer reports of scarring and pigment change[3]
Overview
A CO2 laser resurfaces skin by vaporizing it to a controlled depth. Its 10,600 nm wavelength is absorbed by the water inside skin cells, so each pulse removes a precise surface layer and leaves a narrow zone of heated tissue beneath it. This heat contracts existing collagen and prompts the dermis to produce new collagen over the following months.
Fractional delivery changed who can have resurfacing and how long recovery takes. Instead of removing the entire surface, the laser divides its beam into thousands of microbeams. Each one creates a small treated column surrounded by untouched tissue. Cells from the untreated skin repopulate those columns, reducing the healing period from the two to three weeks associated with fully ablative resurfacing to about one week. Fractional treatment also carries a lower risk of pigment change and scarring.
Depth and density determine the character of the treatment. A superficial, low-density pass addresses texture and tone with a few days of redness and peeling. Deeper, denser treatment reaches established wrinkles, acne scars, and laxity, with a longer recovery. The setting is chosen according to the concern, skin type, and amount of workable downtime.
The change continues after the surface has healed. Redness fades over the following weeks, and collagen formation keeps improving texture and firmness for three to six months. Sun protection is part of this period because newly resurfaced skin pigments easily.
What to expect
- A consultation assesses the concern, skin type, history of cold sores or scarring, recent medications, and how much downtime is workable, and sets the treatment depth
- Antiviral prophylaxis is started beforehand when there is any history of cold sores, and active skincare is paused for about a week
- The treatment area is cleansed and photographed, and protective eyewear is fitted
- Topical anesthetic is applied and left in place for about 30 to 60 minutes; deeper treatments may add local anesthetic blocks or oral sedation
- The anesthetic is removed and the skin is cleansed again
- The handpiece is passed over the treatment area in a systematic pattern, delivering the fractional grid at the planned depth and density
- Additional passes are made over deeper scars or wrinkles where the plan calls for them
- A smoke evacuator clears the laser plume during treatment
- Cooling and a healing ointment are applied to the treated skin
- Written aftercare is reviewed with you, covering ointment, gentle cleansing, and sun avoidance
How a CO2 laser resurfacing works
- Water strongly absorbs the CO2 laser's 10,600 nm wavelength. When a pulse reaches the skin, water in the outermost cells boils away immediately. This vaporizes a thin layer of tissue and leaves a band of heated, coagulated collagen underneath.
- Vaporization removes damaged surface skin. The remaining heat contracts existing collagen fibers and signals the dermis to produce more collagen.
- In fractional mode, a scanner divides the beam into microbeams and places them in a grid. Every treated column sits beside untreated skin. Keratinocytes and follicular cells from those intact areas migrate into the columns, closing the surface within days rather than weeks.
- The controlled injury begins with inflammation. Fibroblasts then lay down new type III collagen, which is gradually replaced by stronger type I collagen. Over three to six months, skin thickness increases, newly formed collagen becomes more organized, and the band of sun-damaged, disorganized dermis becomes thinner.
- Superficial, low-density settings address texture and pigment with minimal downtime. Deeper, denser settings reach dermal scarring and laxity that a surface pass cannot, with longer redness and more aftercare.
When it's recommended
- Fine lines and wrinkles, including around the eyes and mouth
- Sun damage (photoaging), uneven tone, and brown spots
- Acne scars, particularly atrophic (indented) scars
- Surgical and traumatic scars
- Enlarged pores and rough or uneven skin texture
- Mild to moderate skin laxity
- Overall skin quality on the face, with settings ranging from a light superficial pass to deep resurfacing
Is a CO2 laser resurfacing right for you?
Reach out to learn more from Dr. Lucas Boehm.
Concerns it addresses
Recovery & aftercare
- The skin weeps and forms fine crusts for the first two to three days; ointment keeps it moist while it heals
- The surface regrows within about 6 to 7 days after fractional treatment, and most patients return to daily activities within a week
- Pinkness or redness fades over two to six weeks after a moderate treatment and can last longer after a deep one
- Makeup can usually be worn once the surface has closed
- Broad-spectrum sunscreen and shade are essential for several weeks, because newly resurfaced skin pigments easily
- Retinoids, exfoliating acids, and other active products are held for 7 to 10 days
- Collagen remodeling continues for three to six months, and texture and firmness keep improving through that period
Alternatives
- Erbium:YAG fractional laser resurfacing (shallower thermal effect and shorter recovery)
- Non-ablative fractional laser treatment (minimal downtime, more sessions, milder change)
- Chemical peels for superficial pigment and texture concerns
- Microneedling, with or without radiofrequency, for texture and mild scarring
- Surgical lifting for skin laxity beyond what resurfacing can address
- Injectable fillers or biostimulators for volume loss rather than surface change
Frequently Asked Questions
- CO2 laser resurfacing uses a carbon dioxide laser to remove skin to a controlled depth and heat the tissue underneath. The skin then rebuilds with new collagen as it heals. Modern fractional systems treat a grid of small columns rather than the entire surface at once, which shortens recovery. The treatment is used for wrinkles, sun damage, scars, enlarged pores, uneven texture, and mild laxity.
- Topical numbing cream is applied before treatment. Deeper resurfacing may also involve local anesthetic blocks or oral sedation. During the laser passes, people typically feel heat with a prickling or snapping sensation, which most tolerate well. The area feels similar to a sunburn for a few days afterward.
- Fractional CO2 resurfacing is generally considered safe when the depth and density are adjusted for the person's skin type and concern. Leaving untreated skin between the treated columns speeds healing and lowers the risk of pigment change and scarring. Scarring is rare and is usually associated with overly aggressive settings, infection, or poor aftercare.
- The number depends on the treatment depth. One deeper session can address established wrinkles or scars. Two to three lighter sessions spaced about 4 to 8 weeks apart suit people who prefer less downtime with each visit. The plan is based on the concern and the amount of recovery time that works for the patient.
- The skin weeps and forms fine crusts for the first two to three days. After fractional treatment, the surface regrows within about one week. Pinkness fades over the following weeks and lasts longer after deep resurfacing. Ointment and sun avoidance are central to aftercare, and improvement continues for three to six months as new collagen forms.
- CO2 resurfacing is avoided during pregnancy or breastfeeding; after oral isotretinoin within the previous 6 to 12 months; and when the treatment area has an active infection, open wound, or active acne. It is also avoided with a history of keloid or hypertrophic scarring, prior radiation or burns to the area, damaged skin structures from autoimmune disease, or conditions such as vitiligo or psoriasis that can spread into injured skin. A recent suntan or planned sun exposure during healing also rules out treatment at that time. Darker skin types can be treated with conservative settings, with skin type accounted for in the treatment plan.
- The laser is used for fine lines and wrinkles, sun damage and brown spots, acne and surgical scars, enlarged pores, rough texture, and mild laxity. Settings range from a light superficial pass with a few days of redness to deep resurfacing for established wrinkles and scars. The depth is selected for the concern rather than applying one setting to everyone.
- Surgery and resurfacing address different layers. A facelift or eyelid surgery repositions descended tissue and removes excess skin, but it does not change the quality of the skin itself. CO2 resurfacing addresses sun damage, texture, and fine lines etched into the skin at rest. Which layer a given face needs, or whether it needs both, is part of the plan Dr. Boehm sets at consultation.
- Yes, when the scar's main problem is surface texture or discoloration. Fractional resurfacing softens indented acne scars and blends the surface of a healed surgical scar. A scar that is too wide or runs in an unfavorable direction is a surgical question, and scar revision may be the better approach. The scar is sorted into one group or the other during consultation before treatment is chosen.
- A light superficial pass leaves the skin pink and lightly peeling for a few days, and most people return to their routine within that time. A deep treatment weeps and crusts for two to three days, regrows its surface within about one week, and remains pink for several weeks. Sun avoidance is part of recovery at every depth because newly resurfaced skin pigments easily.
CO2 Laser Resurfacing risks & candidacy
Who should avoid this
- Oral isotretinoin within the previous 6 to 12 months, because of delayed healing and the risk of scarring
- Active skin infection, open wounds, or active acne in the treatment area
- History of keloid or hypertrophic scarring
- Prior radiation therapy, burns, or autoimmune disease that has damaged the skin's adnexal structures, which are needed to re-epithelialize
- Skin conditions that koebnerize (spread into injured skin), such as vitiligo or psoriasis
- Pregnancy or breastfeeding
- A recent suntan or planned sun exposure during healing
Who needs extra care
- Darker skin types (Fitzpatrick IV to VI) carry a higher risk of post-inflammatory pigment change and are treated with conservative settings, pre-treatment pigment control, and strict sun avoidance
- A history of cold sores calls for antiviral prophylaxis around the treatment, because resurfacing can reactivate herpes simplex
- Retinoids, exfoliating acids, and other active skincare are paused for about a week before and after treatment
- Treatment on the neck, chest, and hands uses lower settings than the face, because those areas have fewer follicles to heal from
Possible risks
- Redness, swelling, and a sunburn-like heat in the treated area for several days to weeks
- Oozing, crusting, and peeling during the first week
- Post-inflammatory hyperpigmentation, more likely in darker skin types and after sun exposure
- Delayed hypopigmentation (lighter patches), less common and more likely after deep treatment
- Reactivation of herpes simplex (cold sores) without antiviral prophylaxis
- Bacterial or fungal infection if aftercare is not followed
- Acneiform breakouts or milia (small white bumps) as the skin heals
- Prolonged redness lasting several months after deeper treatment
- Scarring, rare and usually associated with overly aggressive settings, infection, or poor aftercare
Your surgeon
Care that respects what makes you, you.
Dr. Lucas Boehm is a Wisconsin native, board-certified, fellowship-trained plastic surgeon and the founder of Consona Plastic Surgery and Aesthetics. His practice is dedicated exclusively to aesthetic surgery of the face, nose, breast, and body, with particular expertise in deep plane facelifts, rhinoplasty, and aesthetic breast surgery. He completed his undergraduate education at the University of Wisconsin–Madison, earned his medical degree from the Medical College of Wisconsin, and completed his plastic surgery residency there as well. He then pursued an Aesthetic Society-endorsed fellowship in aesthetic surgery under the mentorship of Dr. Bradley Calobrace in Louisville, Kentucky. Known for meticulous attention to detail, he approaches each case with precision and intention. His philosophy emphasizes harmony and balance – enhancing what is already beautiful while ensuring every change feels natural, thoughtful, and uniquely you.
- Board-certified
- Am. Board of Plastic Surgery
- Fellowship-trained
- Aesthetic surgery
- 12+ years
- In practice
Sources & references
This article draws on 6 sources, including peer-reviewed research.
Government & research
Medically reviewed by Dr. Lucas Boehm, MD · Last reviewed: 2026-09-17