Comprehensive Guide to CO2 Fractional Laser Aftercare

CO2 Laser Preparation and Post-Care

Regardless of the CO2 indication, whether for acne scars, wrinkles, or skin resurfacing, patients must follow the same foundational skincare protocol to support safe and effective healing.

Seven Days Before Treatment – Skin Preparation

Before your CO2 Fractional Laser treatment, it is crucial to prepare your skin to ensure the best results and minimize potential risks. Here are the steps to follow:

• Bleaching Lotion: Start using the prescribed bleaching cream, containing 5% transaminase acid, niacinamide, and kojic acid, at least 2 weeks before the treatment. Apply it once daily in the evening and leave it overnight. This lotion, provided after your consultation, costs $70. Discontinue use 3 days before the treatment to reduce the risk of skin irritation.
• Sun Protection: Apply a broad-spectrum sunscreen with SPF 30 or higher daily and avoid excessive sun exposure. This protects your skin from damage and ensures it is in the best condition for the treatment.
• Avoid Certain Products: Avoid using products containing retinoids, glycolic acids, or salicylic acids for at least one week before the treatment. These ingredients can increase skin sensitivity and the risk of irritation.

Day Before Treatment – Final Preparations

• Cleanse your face in the evening using a mild, non-exfoliating cleanser (e.g., CeraVe Hydrating Cleanser or Vivier HEXAM).
• Do not apply any skincare products, including moisturizers or makeup, after cleansing.
• Avoid alcohol and caffeine. Get 7–8 hours of sleep to reduce inflammation and support healing.
• Continue drinking water to maintain skin hydration.

Treatment Day

• Arrive with clean, makeup-free skin. Do not apply any product prior to the appointment.
• A topical numbing cream will be applied for 30–60 minutes before the procedure. Oral analgesics may be used if previously arranged.
• Expect a sensation of heat and mild discomfort during the procedure.
• After treatment, the skin will be red, swollen, and hot. Cooling devices may be used.
• A protective ointment such as Aquaphor or Vivier V-STAT will be applied to form a healing barrier.
• Avoid touching your face, heat exposure, sweating, and direct sunlight.

Immediately after treatment

• At the clinic, a cold compress or cooling device will be applied to reduce heat and inflammation.
• A thick layer of a healing ointment such as Aquaphor or Vivier V-STAT will be applied to protect the skin and retain moisture.
• Written post-care instructions will be provided, and prescriptions (e.g., antivirals or pain relievers) may be given if needed.
• At home, patients should avoid touching, rubbing, or picking at the treated area.
• Reapply the healing ointment every 2–3 hours to keep the skin continuously moist and support optimal healing.
• Avoid all other skincare products, including cleansers, serums, makeup, and sunscreen, unless recommended by the provider.
• Cold compresses may be used to reduce discomfort as needed.
• Sleep with your head elevated (using two pillows) to minimize facial swelling.
• Stay away from heat sources such as hot showers, steam rooms, and saunas for at least 24 hours.
• Avoid sun exposure completely and stay indoors as much as possible for the first 24 hours.

First 24 hours after CO2 laser

• Do not wash your face for the first 24 hours unless specifically instructed by your provider.
• Keep the treated area continuously covered with a healing ointment such as Aquaphor or Vivier V-STAT to prevent dryness and promote healing.
• Avoid all skincare products including cleansers, toners, serums, moisturizers, and sunscreens.
• Do not apply makeup or any cosmetics to the treated area.
• Use cold compresses intermittently to reduce discomfort, redness, and swelling—do not apply ice directly to the skin.
• Refrain from touching, scratching, or picking at the skin under any circumstances.
• Stay indoors and avoid all direct sunlight; do not expose the skin to heat or UV rays.
• Do not engage in any strenuous activity, exercise, or anything that induces sweating.
• Sleep with your head elevated to minimize swelling—use two pillows or a wedge pillow.
• Stay hydrated by drinking water regularly, but avoid hot beverages and alcohol.

Post-Treatment Care: Days 1 to 3 After CO2 Laser

• Cleanse your face gently 2–3 times daily using sterile saline solution or a gentle cleanser such as Vivier HEXAM, as advised by your provider.
• Pat your skin dry with a clean, soft towel—do not rub or wipe.
• Apply a thick layer of Aquaphor or Vivier V-STAT after each cleansing to keep the skin moist and protected at all times.
• Continue to avoid all makeup, sunscreen, and active skincare products.
• Use cold compresses intermittently to manage swelling, redness, and discomfort—never apply ice directly to the skin.
• Avoid any physical activity that causes sweating, including exercise, saunas, and hot showers.
• Sleep on your back with your head elevated to help reduce swelling and fluid retention.
• Do not attempt to exfoliate, peel, or remove any flaking or scabbing skin—allow it to shed naturally.
• Stay indoors and avoid any exposure to direct or indirect sunlight.
• Continue staying hydrated and avoid alcohol, spicy foods, or anything that could increase facial flushing.

Post-Treatment Care: Days 3 to 7 After CO2 Laser

• Continue cleansing your face twice daily with a gentle, non-foaming cleanser such as Vivier HEXAM or CeraVe Hydrating Cleanser.
• Moisturize regularly using a non-comedogenic, fragrance-free cream like Vivier LEXXEL or CeraVe Moisturizing Cream to support skin barrier repair.
• Discontinue the use of Aquaphor or occlusive ointments unless instructed otherwise by your provider.
• Expect mild peeling and flaking—do not pick, rub, or peel the skin manually.
• Do not resume makeup, sunscreen, or active skincare products (retinol, acids, vitamin C) unless cleared by your provider.
• Limit sun exposure; if you must go outdoors, wear a wide-brimmed hat and avoid peak sunlight hours.
• Avoid sweating, hot environments, and high-impact activities until peeling has fully resolved.
• If itching or dryness occurs, apply a light, gentle moisturizer and avoid scratching the skin.
• Monitor your skin for any signs of infection such as excessive redness, pus, or unusual pain, and contact your provider if they occur.
• Continue sleeping with your head elevated if swelling persists and maintain proper hydration.

Post-Treatment Care: Days 7 to 14 After CO2 Laser

• You may gradually return to your regular skincare routine if your provider approves, starting with gentle cleansers and moisturizers.
• Introduce sunscreen daily—use a broad-spectrum SPF 50 or higher that is non-irritating, such as EltaMD UV Clear or Vivier Sheer SPF 45.
• Makeup can typically be resumed around day 10, provided the skin is no longer peeling or irritated.
• Reintroduce active ingredients like retinol, alpha hydroxy acids, or vitamin C only with your provider’s guidance.
• Continue moisturizing 2–3 times daily with a barrier-repair cream to maintain hydration and support healing.
• Avoid aggressive treatments (exfoliation, scrubs, waxing, or harsh facials) for at least two more weeks.
• Protect your skin meticulously from sun exposure with SPF, hats, and shade when outdoors.
• If you experience lingering redness, consider calming products with niacinamide or peptides as recommended.
• Skin texture and tone will continue to improve gradually over the coming weeks—be patient and consistent with care.
• Attend any scheduled follow-up appointments to monitor progress and discuss future treatments if necessary.

Long-Term Post-Treatment Care: 3 Weeks and Beyond

• Apply a broad-spectrum sunscreen with SPF 50+ every morning, even on cloudy days, to protect your new skin and prevent pigmentation or sun damage.
• Maintain a consistent skincare routine focused on hydration, barrier repair, and sun protection. Use a gentle cleanser, a hydrating moisturizer, and SPF daily.
• Introduce or resume active ingredients such as retinol, vitamin C, and glycolic acid slowly and only as tolerated. Start with 2–3 times per week and build up gradually.
• Use medical-grade products with peptides, hyaluronic acid, or growth factors to support collagen regeneration and prolong the treatment results.
• Avoid direct sun exposure, tanning beds, and harsh environmental conditions as much as possible. Wear hats and seek shade when outdoors.
• Continue avoiding invasive facial treatments (e.g., microneedling, peels, laser) until your provider confirms the skin is fully healed—typically 6–8 weeks post-treatment.
• Stay well-hydrated and maintain a healthy lifestyle, including a balanced diet rich in antioxidants, to support skin health from within.
• Schedule follow-up appointments as recommended to assess long-term outcomes and discuss potential maintenance treatments if needed.
• Be patient—collagen remodeling continues for 3 to 6 months, and your skin will keep improving during this time with proper care and protection.