Is "CO2 fully ablative laser" the gold standard much more effective than CO2 fractional laser?

Fractional lasers have less down-time, but may not give you the results you want. Typically I do a combination of lasers like clear and brilliant, fraxel, viva 4-6 weeks after co2 with microneedling/prp to get the best outcomes with texture and tone.  Please see an expert. Best, Dr. Emer.

In my practice, I offer both treatments. Patient response is found to be similar between the two treatments, however, the downtime for CO2 is generally around 3-4 weeks vs the fractional laser which is just a few days. The CO2 laser is usually a one time deal and while less invasive, the fractional treatments may require up to three treatments.

Give it more time for the collagen replenishment to take place. Those dots are actual new collagen and will blend in over the next 2-4 months. Standard CO2 is very helpful and has about 10 days of recovery.

Fully ablative CO2 laser is more effective than fractionated ablative laser but at a price.  The healing time is much longer and the possibility of side effects greater with the fully ablative treatment.  The fractionated ablative lasers are safer and faster healing but the downside is that you might need to do 2 or 3 treatments to get a similar response.  You can even have lower risk and faster healing by choosing treatment with a fractionated non-ablative laser. Then you might need 3 or 4 treatments to get a similar response.  Ultimately, you have to weigh all these factors and then decide which treatment is right for you.  Fortunately, you have options which didn't exist 10 years ago.  I hope this helps.  All the best.