Fractional laser treatment is a skin resurfacing technique that uses a laser to treat only a fraction of the skin’s surface at a time, leaving tiny columns of untouched skin between each treated spot. This design speeds healing dramatically compared to older lasers that treated the entire surface at once. It’s used to improve fine wrinkles, acne scars, sun damage, uneven skin tone, and rough texture, with sessions typically costing between $400 and $2,500 in the United States.
How Fractional Lasers Work
Traditional laser resurfacing removes or heats the entire surface of the treated area. Fractional lasers take a different approach: they deliver thousands of tiny, evenly spaced beams that each create a microscopic column of treated tissue. These columns, called microthermal zones, are surrounded on all sides by normal, healthy skin. Each zone contains a narrow channel where the laser has done its work, ringed by a thin border of heat-affected tissue.
The untouched skin between these columns is what makes the treatment effective and relatively safe. That intact tissue acts as a reservoir of stem cells, growth factors, and immune cells that migrate into the treated zones and kickstart repair. Your body essentially treats each microscopic column as a tiny wound, replacing old or damaged tissue with fresh collagen and new skin cells. Because the “wounds” are so small and so much healthy skin remains, healing happens far faster than it would if the entire surface were treated at once.
Ablative vs. Non-Ablative Types
Fractional lasers come in two broad categories, and the distinction matters because it affects your results, downtime, and risk level.
Ablative fractional lasers physically remove the top layer of skin (the epidermis) within each microscopic column. They use CO2 or erbium wavelengths and penetrate deeper into the skin. This makes them more powerful for treating pronounced acne scars, deeper wrinkles, and significant sun damage, but it also means a longer recovery.
Non-ablative fractional lasers heat the deeper layers of skin without breaking through the surface. The epidermis stays intact, which means less downtime and a lower risk of complications. These are better suited for mild texture issues, early signs of aging, and subtle discoloration. The tradeoff is that results are more gradual, and you’ll likely need more sessions to reach the same level of improvement an ablative laser could achieve in fewer treatments.
What It Treats
Fractional lasers are most commonly used for fine wrinkles, age spots, uneven skin color or texture, sun-damaged skin, and mild to moderate acne scars. The ablative versions tend to be the go-to for deeper acne scarring and more advanced photoaging, while non-ablative options work well for people with milder concerns who want minimal disruption to their routine.
Beyond cosmetic concerns, fractional CO2 lasers are sometimes used in clinical settings for surgical scars and certain skin conditions where controlled tissue remodeling is beneficial.
What the Procedure Feels Like
A numbing cream is applied to the treatment area 30 to 60 minutes before the procedure begins. This significantly reduces discomfort but doesn’t eliminate it entirely. The session itself takes roughly 60 minutes for a full face. During treatment, you’ll hear crackling and popping sounds from the laser and feel a sensation often compared to being snapped with a rubber band, along with warmth spreading across the skin.
The intensity varies depending on whether you’re getting an ablative or non-ablative treatment and how aggressively the settings are dialed. Some providers offer additional pain management for deeper ablative sessions.
How Many Sessions You’ll Need
The typical recommendation is three to five sessions spaced four to six weeks apart. Each session builds on the last, with cumulative improvements in firmness, smoothness, and skin tone developing over the course of treatment. That said, the actual number depends on what you’re treating, how your skin responds, and which type of laser is being used. Someone treating mild sun spots with a non-ablative laser may need five or more sessions, while a single aggressive ablative treatment can produce noticeable results on its own.
Recovery and Healing Timeline
For ablative fractional treatments, expect about one to two weeks for the initial healing phase. In the first two to three days, the treated area will be red, swollen, and uncomfortable. Applying an ice pack wrapped in a soft cloth for 15 to 20 minutes several times a day helps manage swelling during this stage.
Over the following days, the skin may turn a red or dark brownish color, and a crust will form over the treated zones. This crust falls off on its own within one to two weeks. Picking at it risks scarring and infection. During this period, you should avoid swimming pools, saunas, hot tubs, and shaving over the treated area.
Full results take longer to appear. It often takes many weeks to notice visible improvement as new collagen continues forming beneath the surface. Redness can persist for several weeks to a few months, gradually fading as the skin remodels itself. Non-ablative treatments have a much shorter recovery, often just a day or two of mild redness and swelling.
Aftercare Basics
Sun protection is critical after any fractional laser treatment. Your newly resurfaced skin is far more vulnerable to UV damage and pigmentation changes. Consistent use of broad-spectrum sunscreen and avoiding direct sun exposure in the weeks following treatment is essential to protecting your results and preventing dark spots from forming.
Keep the treated area clean and moisturized. Avoid active skincare ingredients like retinoids, exfoliating acids, and vitamin C until your provider clears you, as these can irritate healing skin. Let any crusting resolve naturally. The goal during recovery is to support your skin’s own repair process without introducing anything that could disrupt it.
Side Effects and Risks
The most common side effects are redness, swelling, and temporary darkening or crusting of the treated skin. These are expected parts of the healing process, not complications. More significant risks include infection, prolonged redness, and scarring, though fractional technology has substantially reduced these compared to traditional full-surface laser resurfacing.
Post-inflammatory hyperpigmentation, where the treated skin develops dark patches during healing, is a particular concern for people with darker skin tones. Research shows that people with Fitzpatrick skin types III through VI (medium to deep complexions) face a meaningfully higher risk of this side effect. In one study of laser-treated patients, about 17% developed hyperpigmentation. Active acne and prior chemical peels were also identified as risk factors. If you have a deeper skin tone, it’s worth discussing this risk specifically with your provider, as treatment settings and pre-treatment protocols can be adjusted to reduce it.
Who Should Avoid It
Certain conditions rule out fractional laser treatment entirely. If you’ve taken isotretinoin (a powerful acne medication) within the past 6 to 12 months, you need to wait. Isotretinoin impairs skin regeneration and significantly increases the risk of abnormal scarring after laser procedures. Active skin infections, including herpes simplex outbreaks in the treatment area, are also absolute contraindications. The same applies to severe immune suppression and active autoimmune diseases, both of which can compromise wound healing.
A longer list of relative contraindications requires careful consideration rather than an automatic no. These include pregnancy or breastfeeding, a history of keloid or hypertrophic scarring, use of blood thinners, active inflammatory acne or dermatitis, vitiligo, psoriasis, and recent or planned sun exposure. People with any of these factors aren’t necessarily excluded but need a thorough evaluation before proceeding.
Cost Expectations
In the United States, the national average ranges from $400 to $2,500 per session. Where you fall in that range depends on the type of laser used (ablative costs more), the size of the treatment area, your geographic location, and the provider’s experience level. Since most people need three to five sessions, total treatment costs can add up quickly. Fractional laser resurfacing is considered cosmetic, so insurance typically does not cover it.