What's the Difference Between CO2 and Fractional Laser Resurfacing?

Not exactly, and the names cause real confusion. "CO2" describes the type of laser, one that produces light at a wavelength of 10,600 nanometers, which water in the skin absorbs readily. "Fractional" describes how a laser delivers its energy, in a pattern of tiny columns with healthy skin left untouched between them. The two terms overlap, because a CO2 laser can be fractional.

The more useful distinction for patients is ablative versus non-ablative.

• Ablative lasers remove the outer layer of damaged skin. CO2 lasers are the best-known example.
• Non-ablative lasers pass through the surface and heat the tissue underneath, leaving the top layer intact.

Dr. Kiripolsky offers both, with fractional CO2 resurfacing alongside non-ablative laser resurfacing with the ResurFX laser. Comparing the two shows how much depth shapes the experience.

CO2 lasers emit concentrated light energy that turns into heat when it meets the skin. The controlled micro-injuries this creates trigger a strong healing response, and the body produces new collagen and elastin. As old, damaged skin is removed and new skin forms, the skin looks smoother, tighter, and fresher.

Some CO2 lasers are fully ablative and treat both the epidermis and the dermis, which causes more damage to the skin and a longer recovery. Fractional CO2 lasers split the energy into a pixelated pattern. Because untreated skin surrounds each treated column, the skin repairs itself faster, and patients get much of the collagen-building benefit of a fully ablative laser with fewer side effects.

CO2 resurfacing is often described as a gold standard for skin rejuvenation. It can reduce fine wrinkles, sun damage, age spots, stretch marks, mild skin laxity, uneven texture, and scars. Because it reaches deeper, it can address problems that have been present for years, such as acne scars and post-surgical scars.

ResurFX uses a wavelength of 1565 nanometers and delivers it in a fractional pattern. Instead of removing the surface, it heats the tissue underneath and triggers new collagen production within the dermis. The device offers over 600 combinations of size, shape, and density, and Dr. Kiripolsky can use low, medium, or high energy settings to reach different depths.

Treatment is gentler and faster. Depending on the area, a session takes about 15 to 30 minutes. A topical anesthetic cream numbs the skin, and a built-in cooling feature adds comfort. ResurFX improves sun spots, liver spots, melasma, fine lines and wrinkles, stretch marks, and mild acne scars, and it can even out skin tone and texture.

This is the question most patients care about, and the answer follows the depth.

After fractional CO2. Expect tenderness for about an hour after the session, followed by skin that looks red and scabbed over. Peeling is a normal sign that you are healing. Research on fractionated CO2 reports roughly 8 to 12 days of social downtime. You will need to wear sunscreen and limit sun exposure for months to prevent pigment changes.

After ResurFX. Redness lasts a few days, and a cold compress helps with any discomfort. Mild scabbing and dryness may follow, and you should avoid picking. Because side effects are mild and short, patients can often return to daily life quickly.

Neither is risk-free, and both require sun protection, but the recovery gap is large. If you cannot take more than a few days away from public life, that alone may decide the question.

Both routes deliver results. In one study, wrinkle and pigment scores improved with every resurfacing technique tested.

CO2 and ResurFX also differ in how many visits you will need.

• CO2. Many patients seeking anti-aging results are satisfied after a single session. Some choose 2 to 4 sessions in total, depending on their needs, with a few months between sessions so the skin heals fully and reveals each treatment's results. Improvements often appear within about 2 weeks of healing, and collagen keeps building over the following 6 months.
• ResurFX. Most patients achieve optimal results with a series of three to five treatments spaced several weeks apart. You will usually see significant improvement after the first session, and collagen continues to regenerate over the following months.

In other words, CO2 packs more of the work into fewer, bigger treatments, while ResurFX spreads it across smaller ones.

Choose by concern, because the tools are not interchangeable.

• Deeper wrinkles, significant sun damage, and more severe scarring generally point toward CO2.
• Pigment problems such as sun spots and melasma, fine lines, mild acne scars, and early texture changes often suit ResurFX.
• Redness from broken capillaries, spider veins, or rosacea responds to neither. CO2 lasers are not effective for vascular lesions, and light-based therapy such as intense pulsed light is usually the better option.

Yes. ResurFX is considered safe for all skin types on the Fitzpatrick scale, which categorizes skin by color and its ability to tan. Fractional CO2 is gentle enough for all skin types for benign conditions, but patients with darker skin tones may be more prone to keloids and pigment changes afterward. If you have a history of keloids or pigment problems, tell your dermatologist so that she can customize your preparation and the laser settings.

The practice also offers CoolPeel, a gentler CO2 laser that uses lower heat levels, for patients who want CO2 benefits with a lower risk of side effects.

Preparation reduces side effects. Protect your skin from UV rays by using a broad-spectrum sunscreen with an SPF of 30 or higher and avoiding sun exposure, because UV rays raise the risk of discoloration after treatment. If you have a history of hyperpigmentation, Dr. Kiripolsky may prescribe hydroquinone, and she also prescribes an antiviral medication ahead of CO2 treatment to help prevent a viral infection. Skip exfoliating products and photosensitizing medications in the days before your session.

Weigh how deep your concern runs, how much downtime you can accept, how many visits fit your schedule, and your skin tone. A consultation lets Dr. Kiripolsky look at your skin, review your history, and recommend one laser, the other, or a combination. Laser skin resurfacing in Beverly Hills comes in many forms, and the right match is individual.

Because lasers are powerful tools, the provider matters as much as the device. A guide to choosing the best dermatologist in Beverly Hills explains how to check credentials and training. For acne scarring, Dr. Kiripolsky's acne scarring treatment approach combines lasers with other methods, and microneedling is a gentler option for mild texture concerns. ResurFX can also improve pigment concerns such as melasma. Lasers do not relax expression lines, so some patients pair resurfacing with neuromodulators such as Botox. You can see real outcomes in the practice's ResurFX before-and-after gallery, and you can learn more about Dr. Kiripolsky on her about page.

Dr. Kiripolsky sees patients in Beverly Hills and Newport Beach, and you can book a consultation to find out which laser suits your skin.