C02 Laser or Another Laser?

for acne scars, hyperpigmentation, and bulbous of nose. i believe c02 laser would be the best option. however, i also heard that co2 tends to tighten skin and that is something i do not want since, i am a guy and it would seems weird, so are there any other laser out there that will be as effective as the c02 laser and not cause this? thanks

Doctor Answers 11

Acne Scars and Thicker Male Skin

It is hard to suggest the best laser therapy without assessing your unique skin anatomy in person.  Both C02 and erbium can play a role in resurfacing.  I tend to favor fractionated C02 for acne scar procedures with a series of treatments.

Chicago Facial Plastic Surgeon
4.8 out of 5 stars 163 reviews


I would be careful with CO2, it is probably the least predictable in terms of pigmentation outcome. If you want to deal with acne scars you will need a lot of energy and you may end up with pigment changes you dont like. I suggest using a radiofrequency device platform

Ryan Neinstein, MD, FRCSC
New York Plastic Surgeon
4.9 out of 5 stars 72 reviews

C02 Laser or Another Laser?

Thank you for your question. The tightening will be at a level that will not be too obvious.  Usually, even with the tightening experienced, patients still want more, so do not be too afraid of the tightening.  It will be subtle. I hope this helps.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Co2 for acne scars, hyperpigmentation and bulbous nose

Your skin will tighten but it won't really make you look wierd. For Acne Scars I would use a multilayered approach.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 84 reviews

CO2 laser and skin tightening

CO2 laser is the best laser and in fact the best treatment for acne scars in general. It also treats hyperpigmentation well. It can no decrease the bulbous tip of the nose unless this is a condition called rhinophyma which is much less frequent thqan the usual large cartilages causing a bulbous tip. CO2 lasers do tighten the skin but not a lot and certainly not like a facelift. The laser can be used at different settings that will influence how much tightening there is. You would be best served to see a plastic surgeon who is able to determine the best methods of treatment not only for the skin problems but also for the tip of the nose.

William LoVerme, MD
Boston Plastic Surgeon
4.4 out of 5 stars 32 reviews

Fractional co2 treatment for the face and acne scars

The fractional co2 laser works well to resurface and retexture the skin in cases of scarring.  I would advise this laser for most acne scar treatments as it is highly safe and effective. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Sculpting the skin with lasers.

A little tightening of the acne scarred area is a benefit, and wouldn't give you a pulled look.  Acne scarring tends to also cause some premature loss of elasticity, so it is more than just a topography problem.  In the days before lasers, patients with severe acne scarring would get dermabrasion and a secondary facelift due to this increased laxity.  You could test that by pulling gently on the area that still looks irregular after smoothing.  If it suddenly smoothed out, then tightening was the treatment of choice, not more resurfacing.  Fraxel/profractional would also help if a little tightening is needed at this point.  For your bulbous tip, the first question that needs to be answered is whether that is due to thick skin, such as rhinophyma from rosacea, or excessive cartilage inside the tip.  If thinning is required, CO2 allows more thinning usually than erbium.  Thinning the skin with a laser won't help excess cartilage while a rhinoplasty will.

Myles Goldflies, MD
Seattle Plastic Surgeon
4.3 out of 5 stars 11 reviews

Fractional CO2 great for Acne Scars

Fractional CO2 has become our best weapon in the treatment of acne scars, as it is safe and effective.  Tightening of the skin does occur, but this is mild and does not result in an abnormal look.  Improvement of pigmentation may also occur, but it would depend upon your particular pigment issues which would be best assessed in consultation.  Topical agents, chemical peels or other lasers may be right for your pigment concerns.

For the bulbous nose, a combination of ablative laser (CO2, Fractionated CO2, Erbium), electrocautery and/or surgical debulking may be necessary-- again, depending upon the actualy anatomy of your concern.

Be sure to consult with a  Board Certified physician such as Dermatologist who is expert in laser therapy to get your best treatment plan and results.

Jeffrey C. Poole, MD
Metairie Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

Fractional CO2 laser

In general favor using fractional CO2 laser.  Gives best combination of improvement and easier recovery.  Should improve your appearance.  May need supplementation with an Erbium laser to maximize the results. Be sure to see an experienced laser surgeon who performs the procedure and does not delegate it to a staff member.  Unlikely to have any excessive skin tightening that you are concerned about.  Have your physician determine whether you are a good candidate for the procedure and discuss possible outcomes. 

Bulbous nasal tip can have more than one cause

Requires examination to determine whether this procedure should be used to treat your nasal tip.  Depending on the cause of the bulbous tip a rhinoplasty may be a better procedure.

Paul Carniol, MD
Summit Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Fractional CO2 laser is best for acne scars

Though there may be some tightening with use of the Fractional CO2 laser ( Fraxel Re:Pair for example) don't look at this as a negative. It will not be excessive and is one of the mechanisms of improvement.A bulbous nose may require more aggressive treatment . I usually use a combination of pulsed CO2,pulsed erbium and fractional CO2. The Fractional Erbium (Sciton for example ) can also be used to treat acne scars and if you really are opposed to tightening, this laser gives less tightening. You really need a consultation with a Dermatologist who is expert with lasers.

Richard Fitzpatrick, MD (in memoriam)
San Diego Dermatologic Surgeon
4.3 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.