Laser skin resurfacing (Laser resurfacing (ablative and non-ablative))
A treatment that uses laser light to remove or heat layers of skin, aiming to improve texture, fine lines, scars and sun damage.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Laser resurfacing improves skin texture, fine lines, sun damage and some scars; it does not lift loose skin or replace lost volume.
- Ablative lasers (such as CO2) do more but have more downtime and risk; non-ablative lasers are gentler and usually need a course.
- Skin tone matters: darker skin has a higher risk of pigment changes, and CO2 laser in particular may not be suitable.
- The device, settings and operator's training strongly affect both results and safety, so choosing a suitably qualified clinician is essential.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Can improve skin texture and fine lines
People with active skin infection, cold sores, eczema flare or broken skin in the area.
Skin feels hot and looks red; ablative laser causes swelling and oozing. Follow wound-care advice, keep the skin moist as directed, and use sun protection.
Clear written wound-care and aftercare with sun-protection and no-picking advice.
Skin feels hot and looks red; ablative laser causes swelling and oozing. Follow wound-care advice, keep the skin...
Non-ablative redness settles. Ablative skin crusts and peels, revealing pink new skin. Do not pick the skin, which...
Ablative skin usually heals enough to cover with make-up if advised. Non-ablative results build gradually over a...
Pinkness fades and collagen change continues, so results keep improving for some months. Pigment can keep changing...
What is laser skin resurfacing?
Laser skin resurfacing uses beams of laser light to improve the skin's surface and stimulate new collagen. It is used for fine lines, uneven texture, sun damage, some pigmentation and certain scars.
There are two broad approaches. Ablative lasers (such as CO2 or erbium/Er:YAG) remove the outer layers of skin for a stronger effect but with more downtime and risk. Non-ablative lasers heat the skin beneath the surface without removing it, giving a milder effect with less downtime, usually over a course of treatments. Many modern devices are 'fractional', treating tiny columns of skin and leaving areas in between untouched, which speeds healing.
What resurfacing can achieve depends on the laser type and strength, your skin type and the practitioner's skill. Stronger ablative treatment does more in one go but carries more risk; lighter and non-ablative treatments are gentler but need repeating. It improves the skin surface and firmness a little; it does not lift sagging skin or replace lost volume.
Laser type and skin tone matter for safety. CO2 lasers in particular can cause lasting pigment changes and are less suitable for darker skin; the wrong device or settings can cause burns and scarring.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Ablative laser (CO2)
Removes outer skin layers and tightens more strongly. Gives marked results but the most downtime and the highest risk of pigment change and scarring; less suitable for darker...
Ablative laser (erbium / Er:YAG)
Removes skin more gently than CO2, with faster healing and a lower risk of pigment change. Often preferred for finer work or slightly darker skin.
Non-ablative laser
Heats the deeper skin without removing the surface. Milder effect, less downtime, usually given as a course. Lower risk of pigment problems, so more suitable for darker skin.
Fractional laser
Either ablative or non-ablative, but treats only tiny columns of skin at a time, leaving untreated skin in between. This shortens healing and lowers risk compared with...
Preparing for your procedure
- Have a consultation with a suitably qualified clinician who assesses your skin type and recommends the right laser and strength.
- Tell them about cold sores, a tendency to scar or keloid, recent sun exposure or tanning, pregnancy, and all medicines and skincare.
- Mention if you take or have recently taken isotretinoin (Roaccutane), as resurfacing is usually delayed for several months afterwards.
- Follow any skin-preparation routine you are given and avoid sun and sunbeds beforehand.
- Use strict daily sun protection before and after, as tanned or sun-exposed skin raises the risk of pigment problems.
- Arrange downtime suited to the treatment strength, particularly for ablative laser.
- Discuss antiviral tablets beforehand if you are prone to cold sores.
What happens
Your eyes are protected and the skin is cleaned. Numbing cream is usually applied; stronger ablative treatments may also use local anaesthetic or sedation. The clinician moves the laser over the treatment area, and you may feel heat, prickling or a snapping sensation, with cooling used to keep you comfortable.
Light and non-ablative treatments take less time and you can often return to normal activities with some redness. Ablative treatments take longer and leave the skin red, swollen and raw, needing careful wound care while it heals.
Afterwards your skin may feel hot, look red or pink, and (after ablative laser) ooze, crust and peel over the following days to weeks as new skin forms.
Is this procedure right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- People with active skin infection, cold sores, eczema flare or broken skin in the area.
- People who have recently taken isotretinoin (Roaccutane), where resurfacing is usually delayed for months.
- People with darker skin tones considering CO2 laser, where pigment risk is high; another device may be safer.
- People with a strong tendency to keloid or abnormal scarring, especially for ablative laser.
- People expecting laser to lift loose skin or remove deep folds.
Delay or rearrange if…
- You have an active cold sore, skin infection or inflamed skin in the area.
- You are tanned or have had recent sun exposure or sunburn.
- You are pregnant or breastfeeding and treatment is not advised.
- You have recently used isotretinoin or strong resurfacing treatments.
- You cannot avoid sun exposure during healing.
Alternatives to discuss
- Good skincare and daily sun protection alone.
- Chemical peels for texture, tone and surface lines.
- Microneedling or other texture treatments.
- Prescription creams for pigmentation, via a dermatologist.
- Doing nothing if concerns are mild.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Comfort, sedation or contrast choices
If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.
Benefits
- Can improve skin texture and fine lines
- Can reduce sun damage and some pigmentation
- Can soften certain scars, including acne scars
- Can give a modest tightening and fresher appearance
- Fractional and non-ablative options offer improvement with less downtime
Risks & complications
- Redness, swelling and a hot or stinging feeling after treatment
- Peeling, flaking or crusting as the skin heals (more with ablative laser)
- Temporary darkening or sensitivity of the treated skin
- Needing several non-ablative sessions before seeing much change
- Longer-lasting redness, especially after ablative laser
- Patches of darker pigment (post-inflammatory hyperpigmentation), more likely in darker skin
- Cold sore (herpes) flare-up if you are prone to them
- Infection of the treated skin
- An uneven or disappointing result
- Permanent lightening of the skin (hypopigmentation), more likely after CO2 laser
- Burns and scarring, including raised or keloid scars
- A visible line between treated and untreated skin
- Eye injury if eye protection is not used correctly
The main risks are pigment changes and, less often, burns or scarring. People with darker skin tones are more prone to pigment problems, and CO2 laser in particular may not be suitable; an experienced clinician will choose the device, settings and approach to match your skin. Tanned or sun-exposed skin raises the risk, so strict sun protection before and after is important. Eye protection must always be used.
Published figures to discuss
The chance and type of complication depend strongly on the laser type and settings, skin type and aftercare, so a single complication rate is not meaningful across all treatments. Fractional and non-ablative lasers generally carry lower risk than full-surface ablative laser. Darker skin has a higher risk of pigment change, and CO2 laser carries a higher risk of lasting lightening than erbium. Tanned skin and picking during healing increase the risks.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Redness, swelling, peeling and sensitivity | Expected after ablative laser; common but milder after many fractional/non-ablative treatments | Pinkness after stronger ablative resurfacing can last weeks to months. | Guide sourcesClinical context |
| Post-inflammatory hyperpigmentation | Reported from low single figures up to about 30%+ in some resurfacing series | Risk is higher with darker skin types, tanning/recent sun exposure, aggressive settings and poor sun protection. | Fractional CO2 laser resurfacing complications — review (PMC)pmc.ncbi.nlm.nih.govPublished figure |
| Herpes/cold-sore reactivation or skin infection | Uncommon but important | Antiviral prophylaxis is often used for ablative facial resurfacing, especially if you have a cold-sore history. | Fractional CO2 laser resurfacing complications — review (PMC)pmc.ncbi.nlm.nih.govSource-linked context |
| Scarring, burns or permanent pigment loss | Rare with appropriate settings and aftercare, but potentially difficult to correct | Operator training, device choice, skin type and early recognition of infection or burns are central to safety. | Fractional CO2 laser resurfacing complications — review (PMC)pmc.ncbi.nlm.nih.govSource-linked context |
| Under-treatment or need for a course | Common with non-ablative and lower-downtime lasers | Lower-risk treatments often need several sessions and give subtler results than ablative resurfacing. | Fractional CO2 laser resurfacing complications — review (PMC)pmc.ncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Recovery depends on the laser and its strength. Light and non-ablative treatments may cause only a day or two of redness, while strong ablative laser leaves the skin raw, red and swollen and can take one to two weeks before it looks presentable, with pinkness for longer.
- Redness and a hot or tight feeling soon after treatment
- Peeling, flaking or crusting as the skin heals
- Temporary darkening or extra sensitivity of the skin
- Longer-lasting pinkness after ablative laser
- Gradual improvement over a course with non-ablative treatment
Aftercare
- Follow wound-care instructions and keep the skin moist with the products recommended.
- Apply high-factor sun protection daily and avoid sun exposure while healing.
- Do not pick, scratch or peel the crusting skin, as this can cause scarring or pigment changes.
- Avoid make-up, exfoliating products and active skincare until your clinician says it is safe.
- Avoid saunas, heavy exercise and very hot environments while the skin settles.
- Take any prescribed antiviral or other medicines as directed.
- Attend follow-up so healing can be checked, especially after ablative laser.
- High-factor sunscreen ready
- Recommended healing ointment or moisturiser and gentle cleanser
- Antiviral tablets if prescribed for cold sores
- Time off appropriate to the treatment strength booked
- Written wound-care and aftercare instructions
- A contact route for problems or signs of infection
Scars and how they heal
Light and non-ablative laser does not normally cause scars. Stronger ablative laser carries a real, if uncommon, risk of burns and scarring, including raised or keloid scars, particularly if the skin is picked while healing or if you are prone to scarring. Pigment changes (darker or lighter patches) are more common than true scars and are more likely in darker skin. Correct device choice, settings, sun protection and not picking the skin reduce these risks.
⚠ Get urgent help if…
- Spreading redness, heat, swelling, pus or fever (signs of infection)
- Painful blisters, raw areas or skin breakdown beyond what you were told to expect
- A cold sore outbreak spreading across the treated area
- Skin that is unusually dark, white or scarred as it heals
- Severe or worsening pain rather than settling discomfort
- Any eye pain or vision change after treatment near the eyes
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good result is smoother, fresher skin with improvement in fine lines, sun damage or scars, and sometimes a little tightening. Stronger ablative laser does more in one session but with more risk and downtime; non-ablative laser builds change over a course. Because collagen continues to remodel, results keep improving for some months, and are best judged once the skin has fully healed.
Resurfacing improves the skin surface and firmness modestly. It does not lift sagging skin, remove deep folds or replace lost volume, and results vary with skin type and sun habits.
Results are not permanent. Skin keeps ageing and is affected by sun exposure, so improvements fade over time. A strong ablative treatment can last for years, while non-ablative results are gentler and often maintained with repeat sessions. Daily sun protection and good skincare help results last. How long any treatment lasts varies between people.
Related tests, treatments or support
Laser resurfacing is sometimes combined or alternated with other skin treatments, or used with injectables that treat different problems (anti-wrinkle injections for movement lines, fillers for volume). Stacking treatments, or treating too aggressively, can increase the risk of pigment problems, burns and scarring, so spacing and planning matter. A careful clinician tailors this to your skin rather than combining everything at once.
Follow-up & long-term care
Non-ablative treatments usually need review to plan the next session in a course. Ablative laser needs follow-up to check wound healing, manage redness or pigment changes, and guide when you can resume normal skincare and sun exposure.
- Daily high-factor sun protection to protect results and reduce pigment problems.
- A gentle, suitable skincare routine as advised.
- Repeat non-ablative sessions periodically if recommended, rather than over-treating.
- Review with your clinician if texture or pigmentation concerns return.
Repeat, follow-on and what comes next
- Non-ablative laser is usually repeated as a course rather than 'revised'.
- Pigment changes may need creams, time, sun avoidance or further treatment to settle.
- Burns or scarring after ablative laser can be hard to correct and may need specialist input.
- An under-treated result may be improved with further sessions, but over-treatment cannot simply be reversed.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear written wound-care and aftercare with sun-protection and no-picking advice.
- A plan for what to do if pigment changes, infection, burn or scarring occur.
- Antiviral cover arranged if you are prone to cold sores.
- Follow-up appropriate to the treatment, with close review after ablative laser.
- Honest advice on realistic results and spacing of repeat treatments.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The laser type and strength, and the area treated
- Who performs it and their training (ablative laser needs an experienced clinician)
- Number of sessions in a course (non-ablative usually needs several)
- Whether local anaesthetic or sedation is needed (ablative laser)
- Skin-preparation products, wound care and aftercare included
- Clinic location and setting
- The clinician's fee and their qualifications and experience with the device
- The laser type and number of sessions
- Whether skin-preparation products, wound care and aftercare are included
- Whether anaesthetic or sedation is included for ablative treatment
- What is covered if there is a pigment problem, infection, burn or scarring
- Cancellation policy and total cost of a course
On the NHS? Cosmetic laser resurfacing is private only, though laser treatment for some scars or skin conditions may be provided by an NHS dermatology or plastic surgery service when clinically indicated.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- No discussion of how skin type affects pigment, burn and scarring risk.
- Using a 'one device fits all' approach without matching it to your skin.
- No mention of isotretinoin history, cold sores or recent sun exposure.
- No wound-care or sun-protection plan after ablative treatment.
- No check of the operator's training on that specific device.
Marketing red flags
- Laser promoted as a quick fix with no mention of pigment, burn or scarring risk.
- Strong ablative laser offered in non-medical settings by untrained operators.
- Claims laser will lift sagging skin or remove deep wrinkles.
- No assessment of skin type or device suitability.
- Heavily discounted courses that encourage over-treatment.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Which type of laser are you recommending for me, and why?
- Is this device and setting suitable for my skin type, and what is my risk of pigment changes or scarring?
- How much downtime should I expect, and how should I care for my skin afterwards?
- How many sessions will I need, and what realistic result can I expect?
- What will you do if I get a pigment problem, infection, burn or scarring?
- What are your qualifications and experience with this laser and my skin type?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my procedure, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this procedure not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is it available on the NHS?
Does it hurt?
How much downtime is there?
Is laser resurfacing safe for darker skin?
How many sessions will I need?
Will it tighten loose skin?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Advice about cosmetic procedures British Association of Dermatologists — Patient information leaflets GMC — Guidance for doctors offering cosmetic interventions Ablative laser resurfacing — StatPearls (NCBI) Nonablative, fractional and ablative laser resurfacing — review Fractional CO2 laser resurfacing complications — review (PMC) Laser complications — StatPearls (NCBI Bookshelf)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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