Fractional CO₂ vs Fully Ablative CO₂

Understanding the difference — and which option suits your skin

If you are researching CO₂ laser resurfacing, you have likely come across two terms: fully ablative CO₂ and fractional CO₂. Although they sound similar, they behave very differently in the skin. Therefore, choosing the right approach matters, especially if you want visible improvement without unnecessary risk.

At our London clinic, we prioritise skin safety, longevity and realistic outcomes. Because of this, we work exclusively with fractional CO₂ technology, not fully ablative CO₂. Below, you will find a clear, clinical comparison to help you understand why.

What Is Fully Ablative CO₂ Laser?

Fully ablative CO₂ removes the entire surface layer of skin in a single treatment. Because it vaporises large areas of tissue at once, it creates an intense wound response.

As a result, recovery is long and demanding.

Key points to understand

• Downtime often lasts several weeks, with redness persisting for months
• Risk of post-inflammatory hyperpigmentation, scarring and infection is high
• Treatment is not suitable for darker skin tones (Fitzpatrick IV–VI)
• Results do not replace surgery, despite what social media may suggest

Therefore, although fully ablative CO₂ can improve severe skin damage, it carries significant risk. For this reason, it is rarely appropriate in modern aesthetic practice, particularly in diverse skin populations.

What Is Fractional CO₂ Laser?

Fractional CO₂ works differently. Instead of removing the entire surface, it treats the skin in controlled micro-columns, leaving surrounding tissue intact. Because healthy skin remains between treated areas, healing is faster and safer.

At our clinic, we use eCO₂ by Lutronic, a South Korean system designed with inclusive skin safety in mind.

Why fractional CO₂ behaves better

• Energy is delivered in fractions, not as a full sheet
• Skin repairs itself more efficiently between treated zones
• Results build gradually over sessions, not aggressively in one sitting
• Risk of pigmentation and scarring is significantly reduced

As a result, fractional CO₂ allows us to improve skin quality while respecting the skin’s biology.

Safety Across Skin Tones

Skin tone matters when choosing laser treatments. Because melanin reacts to heat, aggressive lasers increase pigmentation risk in deeper skin tones.

Fractional CO₂, when used correctly, offers a safer option.

• Suitable for lighter to darker skin tones, including Fitzpatrick IV–VI
• Pigment-regulating support is recommended for deeper tones
• Treatment plans are adjusted carefully as your skin responds

Therefore, this approach aligns with long-term skin health rather than short-term intensity.

What Fractional CO₂ Can Treat

Fractional CO₂ is an all-rounder because it improves both surface quality and deeper structure.

It can help improve:

• Fine lines and deeper wrinkles
• Skin laxity, including around the eyes
• Hyperpigmentation, including periorbital darkness
• Acne scarring and textural irregularities
• Stretch marks on face and body

Because it stimulates collagen while resurfacing the skin, results appear natural and progressive.

Downtime and Recovery: What to Expect

Recovery with fractional CO₂ remains manageable.

• Social downtime is typically 3–5 days
• Redness settles gradually over 4–5 weeks
• Mild erythema is expected and supported in-clinic

To optimise healing, we often pair treatment with exosomes or LED healing therapy. As a result, inflammation settles faster and complication risk reduces further.

Which Option Is Right for You?

In most cases, fractional CO₂ offers the better risk-to-reward balance. It respects your skin’s healing capacity, adapts over time, and supports long-term improvement without extreme downtime.

Fully ablative CO₂ may still exist, however modern fractional systems achieve comparable results without the same level of trauma.

The Next Step

If you are considering CO₂ laser resurfacing, professional assessment matters. During consultation, we evaluate your skin tone, concerns and recovery tolerance before recommending a plan.

At our London clinic, we focus on outcomes that improve your skin safely, not trends that promise too much.

Book a consultation to explore whether fractional CO₂ laser treatment fits your skin goals and how we support healing every step of the way.