Could a CO2 laser treatment improve my skin in the long term?

Short answer: It can help long-term by tightening texture and softening fine lines via collagen remodeling (peaks ~3–6 months, continues up to ~12), but based on your photos (mild pore prominence, a few small papules, slight cheek redness) fractional CO₂ is likely more aggressive than you need for the gain you’d see.
When CO₂ makes sense
Etched lines, acne scarring, significant sun damage.
Expect ~15–30% texture improvement per fractional session; maintenance every 1–3 years with diligent SPF.
Downsides/risks
5–10 days of downtime, risk of prolonged redness, post-inflammatory hyperpigmentation (higher if you tan easily), rare scarring; antivirals if you get cold sores. Strict sun avoidance needed for 6+ weeks.
Better first-line options for your skin
Daily care (3–6 months):
Broad-spectrum SPF 30–50 every morning.
Retinoid nightly (tretinoin 0.025–0.05% or adapalene) for texture/pores.
Salicylic acid 0.5–2% 2–4×/week (oil/pores).
Azelaic acid 15–20% for redness and small bumps.
Gentle cleanser + non-comedogenic moisturizer.
Office treatments with less downtime:
Fractional non-ablative 1550/1927 nm (e.g., 3–4 sessions) for texture and pores.
Microneedling RF (2–3 sessions) for pores and mild laxity.
Light chemical peels (salicylic or glycolic) or IPL if redness persists.
If you still choose CO₂
Ask for fractional, low-density settings, do a test spot, pre-treat for PIH if prone, and schedule during a low-sun period. Avoid full-field CO₂.
Red flags/avoid for now
Recent isotretinoin use, active infection, keloid tendency, pregnancy, or inability to avoid sun diligently.
Bottom line: You’ll likely get most of the long-term benefit you want from consistent skincare + lower-downtime devices; reserve fractional CO₂ for when you’re chasing deeper lines or scars or if you want a bigger one-and-done reset and accept the downtime/risks.

Hi there!Dr Peterson here - thanks for reaching out. I love discussing lasers as they’re a particular focus of mine.
CO₂ lasers can be very effective for improving skin texture, fine lines, and some types of scarring. Different lasers work in different ways: • Ablative lasers (like CO₂ or Erbium) remove layers of skin to stimulate collagen and new skin growth — great for deeper lines and significant texture issues. • Non-ablative lasers (like Fraxel 1550) heat the deeper skin without removing the surface, improving tone, mild lines, and pigmentation with less downtime.
Good candidates typically have healthy skin, realistic expectations, and are committed to proper healing and sun protection. Lasers are best at improving texture, fine lines, acne or surgical scars, and uneven pigmentation, but they cannot fully stop aging or replace surgical procedures when needed.
Cautions: Ablative lasers have more downtime, risk of redness, scarring, and pigment changes, especially in darker skin types. Proper post-care and experienced administration are essential.
I recommend consulting a board-certified dermatologist to determine the safest and most effective laser for your skin and goals.

Hello! I’m Lauren, the aesthetic provider here at Colorado Plastic Surgery Center. CO2 laser treatment can offer great long-term benefits for your skin. It helps reduce redness, shrink pores, smooth texture, and boost collagen production, leading to clearer, firmer, and more even-toned skin over time.

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon