Short answer
Laser skin resurfacing uses concentrated light to injure the skin in a controlled way so that it heals with new collagen and a smoother, more even surface. Ablative lasers (such as carbon dioxide and erbium) remove the outer layer and give larger changes with weeks of recovery; non-ablative lasers leave the surface intact, need several sessions and give more gradual, modest results. Which approach, if any, fits depends on the concern, skin colour and how much recovery time and risk are acceptable; resurfacing does not lift sagging skin.
Key points
- Used for fine wrinkles, sun damage, uneven tone and mild to moderate acne scars.
- Ablative treatment: new skin in 7 to 10 days, full recovery at least a month.
- Non-ablative treatment: little downtime, usually 2 to 4 sessions.
- Fractional lasers treat tiny columns of skin, shortening recovery.
- Brown and Black skin carries a higher risk of lasting colour change.
How laser resurfacing works
An ablative laser vaporises the outer layer of skin (the epidermis) and heats the layer beneath (the dermis), which stimulates new collagen as the skin heals. A non-ablative laser heats the dermis to stimulate collagen without removing the surface, so it is gentler.1
Fractional lasers, which can be ablative or non-ablative, treat a grid of microscopic columns and leave the skin between them untouched. The concept was first described in 2004: in the original study, the tiny wounds were covered over by new skin within a day, and a course of four treatments improved wrinkle scores around the eyes by 18% three months later.3 Fractional treatment shortens recovery and reduces side effects, but usually needs 2 to 4 sessions.1
Ablative and non-ablative compared
| Feature | Ablative | Non-ablative |
|---|---|---|
| Examples | Carbon dioxide (CO2), erbium, combination systems | Erbium (non-ablative settings), intense pulsed light |
| Sessions | Usually one (non-fractional) | Typically 2 to 4, over weeks or months |
| Recovery | New skin in 7 to 10 days; full recovery at least a month; redness for months | Swelling or colour change for hours; usual activities straight away |
| Result | Smoother, tighter skin | Gradual; mainly texture and colour |
| Scarring risk | Slightly higher | Lower |
Within ablative treatment, the laser matters too. Carbon dioxide lasers are used for wrinkles and scars and need up to two weeks to heal; erbium lasers treat superficial to moderately deep lines, often need only local anaesthetic and tend to cause fewer side effects.2 Fractional carbon dioxide lasers reach deeper, which brings a greater risk of complicated healing and scarring.2
What it can and cannot do
Laser resurfacing is used for fine wrinkles, age spots, uneven colour or texture, sun damage and mild to moderate acne scars. It cannot fix sagging skin.1 For loose skin and jowls, see whether jowls can be treated without surgery.
Risks, and who may not be suited
Expected effects include swelling, itching, a burning feeling and redness, which after ablative treatment can last for months.1 Redness usually fades over 2 to 3 months but can persist up to a year.2 Recognised complications include acne flares, milia (tiny white bumps), infection (most often a cold sore flare-up), colour changes and scarring.1 Antiviral medicine is often given to prevent cold sores.1
Skin colour is a major factor. Darkening or lightening of the skin is more likely, and longer-lasting, in brown or Black skin.1 Erbium lasers may be a better choice for darker skin tones, and very dark skin can make someone a poor candidate.2
A clinician may advise against resurfacing after isotretinoin (an acne medicine) in the past year, with connective tissue or autoimmune disease or a weakened immune system, a history of keloid scars, previous facial radiotherapy, frequent cold sores, pregnancy or breastfeeding, or a history of the lower eyelid turning outwards (ectropion).1
Common questions
How long until I look normal again?
After non-ablative treatment, usually within hours; after ablative treatment, new skin forms in 7 to 10 days, but full recovery takes at least a month and redness can last longer.1
Is sun protection really necessary?
Yes; avoiding unprotected sun for up to two months beforehand and using SPF 30 or higher daily afterwards is advised, with tinted sunscreens containing iron oxide or titanium dioxide helpful for brown or Black skin.1
Is laser resurfacing better than a chemical peel?
Neither is better in general; both remove or injure skin to a chosen depth, and both share risks such as pigment change and cold sore flares.4 See how chemical peels work.
Should I stop smoking first?
Yes, ideally; at a minimum, avoiding smoking for two weeks before and after treatment is advised.1
Bottom line
Laser resurfacing ranges from gentle non-ablative courses with little downtime to ablative treatments that change the skin more but take weeks to heal. It improves surface texture, tone and some scars rather than sagging, and skin colour strongly shapes which laser, if any, is a sensible option.
Related reading
- Medical aesthetics overview
- How Do Chemical Peels Work, and Which Depth Is Which?
- Which Treatments Can Improve Acne Scars?
- What Is Morpheus8 (Radiofrequency Microneedling)?
- What Are the Treatment Options for Melasma?
Sources
- Mayo Clinic. Laser resurfacing. Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/tests-procedures/laser-resurfacing/about/pac-20385114. Accessed 5 November 2026.
- Cleveland Clinic. Laser Skin Resurfacing: Lasers Types, Skin Conditions, What to Expect. Cleveland Clinic; 2021. https://my.clevelandclinic.org/health/treatments/11015-laser-skin-resurfacing. Accessed 5 November 2026.
- Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers in Surgery and Medicine; 2004;34(5):426–438. https://doi.org/10.1002/lsm.20048
- Mayo Clinic. Chemical peel. Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/tests-procedures/chemical-peel/about/pac-20393473. Accessed 5 November 2026.
Article history
- — First published.