Laser skin resurfacing uses concentrated light energy to remove damaged outer skin and trigger your body’s natural collagen production, resulting in smoother, tighter, more evenly toned skin. It treats a range of concerns, from fine lines and acne scars to sun damage and uneven pigmentation, with results that can last several years depending on the type of laser used and how you care for your skin afterward.
How It Works at the Skin Level
The basic principle is controlled damage followed by healing. An intense beam of light energy targets the skin, and the heat from that beam stimulates the deeper layer (the dermis) to ramp up collagen production. Collagen is the protein responsible for skin firmness and elasticity, and as new collagen forms over the weeks and months after treatment, the skin becomes visibly smoother and tighter.
There are two broad categories of laser, and the difference between them matters for both results and recovery. Ablative lasers vaporize the outer layer of skin entirely, which produces the most dramatic improvement but requires real downtime. Nonablative lasers leave the skin surface intact, heating the tissue underneath to stimulate collagen without an open wound. The tradeoff is more moderate results with far less recovery time.
Both types can be delivered in a “fractional” pattern, where the laser creates thousands of microscopic columns of treated tissue separated by untouched skin. This speeds healing because the intact skin between columns helps the treated areas recover faster.
What It Treats
Laser resurfacing is most commonly used for:
- Acne scars. Fractional ablative lasers can improve the depth and appearance of atrophic (indented) acne scars by as much as 50% after a series of four to five monthly treatments. Both scar smoothness and volume show measurable improvement that continues to develop for six months or longer after the final session.
- Fine lines and wrinkles. For deeper facial wrinkles and significant sun damage, ablative lasers remain the treatment of choice. Nonablative lasers work better for finer lines and more subtle textural issues.
- Uneven pigmentation and sun damage. Brown spots, age spots, and general discoloration from UV exposure respond well. Melasma, a stubborn form of facial pigmentation, also responds to certain laser types, though results vary by how deep the pigment sits in the skin.
- Skin laxity. The heat from ablative lasers causes immediate collagen contraction, producing a tightening effect. One study found CO2 laser treatment produced roughly 34% tissue tightening that persisted at six months, a result described as long-lasting if not permanent.
Ablative Laser Types
The two main ablative lasers are CO2 (carbon dioxide) and Er:YAG (erbium). They work differently and suit different situations.
CO2 lasers deliver more heat to surrounding tissue, which causes immediate collagen contraction and tightening during the procedure itself. That heat-induced tightening is distinct from wound healing and tends to be more predictable. In clinical comparisons, CO2 lasers produced about 43% intraoperative tightening that settled to 34% at six months, with no scarring observed in study patients.
Erbium lasers are more precise and deposit less heat. The tightening they produce comes primarily from wound contraction rather than thermal collagen shrinkage, which means it develops gradually over the first month rather than appearing immediately. By six months, erbium-treated skin showed 36% tightening, nearly matching CO2 results in the vertical plane. However, the wound-contraction mechanism carries a slightly higher risk of scarring in some patients. Erbium lasers are often preferred for lighter resurfacing or when less downtime is desired.
Recovery After Treatment
Recovery depends heavily on whether you have ablative or nonablative treatment. Nonablative procedures require little to no downtime. You might have some redness for a day or two, but most people return to normal activities immediately.
Ablative treatment, particularly full-face CO2 resurfacing, is a different experience. In the first few days, expect redness, pinpoint oozing, and a “bronzed” appearance as the treated layer dries and begins to shed. Most people feel comfortable resuming video calls around day five and can return to in-person work, using makeup to cover residual pinkness, by the end of the first week. That pinkness can linger for several weeks to a few months, gradually fading as the new skin matures.
Sun protection during recovery is not optional. The fresh skin is highly vulnerable to UV damage, and sun exposure during healing is one of the most common triggers for post-inflammatory hyperpigmentation, where the treated area develops new dark patches instead of the even tone you were hoping for.
Risks for Darker Skin Tones
Laser resurfacing carries specific risks for people with darker skin. The higher the melanin content in your skin, the greater the chance that the laser’s energy will trigger post-inflammatory hyperpigmentation. In studies of various laser types used for melasma, roughly 18% of patients in some groups developed new hyperpigmentation after treatment, even when the original pigmentation improved.
This does not mean darker skin tones cannot benefit from laser resurfacing. It does mean that device selection, energy settings, and pre-treatment preparation all require more expertise. Practitioners experienced with higher Fitzpatrick skin types (the clinical scale for skin pigmentation) typically use lower energy settings, fractional delivery patterns, and sometimes pre-treatment with skin-lightening agents to reduce the risk. If you have medium to dark skin, choosing a provider with specific experience treating your skin type is one of the most important decisions you can make.
How Long Results Last
You can expect to see an immediate difference in skin texture and tone after ablative treatment, but the full result takes time to develop. Collagen remodeling continues for up to a year after the procedure, meaning your skin keeps improving months after you’ve healed. The improvement from a single ablative treatment can last several years.
Results are not permanent in the sense that your skin stops aging. Normal biological aging and ongoing sun exposure will eventually create new wrinkles and discoloration. How long your results hold depends on your age, genetics, sun habits, and skincare routine. Consistent sunscreen use is the single biggest factor in preserving what the laser achieved. Many people return for additional treatments years later as new signs of aging appear.
Nonablative treatments typically produce subtler improvements that may require multiple sessions to reach your goal. Because each session is gentler, the cumulative result builds over time rather than appearing all at once.
Cost and Number of Sessions
The national average cost for laser skin resurfacing is $1,829 per session, according to the American Society of Plastic Surgeons. That figure varies widely depending on the type of laser, the size of the treatment area, and your geographic location. A single ablative session treating the full face will cost more than a nonablative treatment targeting a small area of scarring.
Ablative resurfacing often achieves significant results in one to two sessions. Nonablative treatments and fractional approaches typically require three to six sessions spaced weeks apart. For acne scars specifically, the clinical literature points to four to five monthly sessions as the range where 50% improvement becomes achievable. Insurance rarely covers laser resurfacing when it is performed for cosmetic reasons, though some plans may cover treatment for scars resulting from injury or surgery.