Discover comprehensive answers to your questions and gain insights into our specialised approach to scar management.

What is CO2 (Carbon Dioxide) Laser, Ablative Fractional CO2 laser?

CO2 laser is a cutting-edge technology in the field of medicine, revolutionising medical and surgical skin treatments.

CO2 laser is used to treat the following: 

  • Scar improvement.
  • Skin pigmentation issues. 
  • Pre-cancerous skin lesions. 
  • Skin resurfacing (to remove fine lines and wrinkles).
  • As a precise surgical cutting instrument.  
  • The CO2 laser works by emitting a concentrated beam of light at a specific wavelength that is selectively absorbed by water molecules within the skin. 
  • When the laser energy interacts with these water molecules, it generates heat, vaporising targeted tissue with remarkable precision. 
  • This controlled damage to the skin prompts it to rejuvenate and heal, stimulating collagen remodelling. 
  • This results in the gradual improvement of scars over time, making them feel and look better. 
  • Ablative laser treatments remove the skin’s outermost layers, while non-ablative lasers work by heating underlying tissues without causing visible damage to the surface. 
  • Ablative lasers are used for more severe skin conditions and produce more significant effects on the skin than non-ablative lasers. 
  • The CO2 laser used at The Scar Clinic is an ablative laser. 
  • Fractionation is a way of delivering the laser energy to the skin.
  • Instead of leaving a larger raw surface when removing the outer skin layers, the fractionated laser heats tiny columns of skin (called microthermal zones or MTZs), whilst leaving undamaged columns of skin next to the treated area.  
  • This means the skin heals very quickly from the laser – in a few days – reducing the risks of prolonged healing, pigmentation change, infection and scarring.  
  • This had been a total game-changer for the treatment of scars and has been used in our service for over a decade now. 
  • CO2 ablative laser is the most powerful laser to treat skin conditions, and as such must have a licensed health practitioner to safely deliver the treatment. 
  • It is much more powerful than non-ablative lasers and Intense Pulsed Light (IPL) treatment, which is often what is offered in salons and non-medical cosmetic services. 
  • The improvement in scars seen with CO2 ablative laser is much greater and much quicker than other less powerful lasers.
  • The use of fractionated laser delivery (in small treatment zones with undamaged columns of skin alongside) means that the risk of pigmentation change is very low now – previously with other types of laser delivery this risk was much higher. 
  • As there is still a small risk of pigmentation change, which is higher in darker-skinned individuals, your scar surgeon may suggest a test patch of the laser first.


  • Most people start to see results after a couple of weeks post-treatment, but this can differ between individuals. Some patients can feel improvement earlier, whilst some patients take longer.  
  • Many patients require more than one laser treatment to achieve desired improvement – this usually ranges between 3 and 6 treatments. 
  • Every patient and every scar is different, therefore it is only possible to decide what treatments are best for your scar by a consultation with The Scar Clinic Perth surgeons.
  • The consultation takes around 20-30 minutes and involves a full discussion about your scar, your medical and surgical history and a full examination and may include clinical photography to monitor your treatment and to determine which treatments are most appropriate for you. 
  • A consultation costs approximately $250 against which you will be able to claim a Medicare rebate of $80.85 with a GP/Medical referral. 
  • The cost of the laser will depend on the size of the scar treated and whether you require local anaesthetic cream or a general anaesthetic. 
  • The cost of scar surgery will depend on the size of the scar and the techniques used to improve it (scar rearrangement, spray-on-skin, graft etc.) as well as whether a general or local anaesthetic will be used. 
  • Most scar procedures are partially subsidised by Medicare and private health funds, however there is often an out of pocket gap to be paid and checking with your insurance provider is recommended.  
  • All costs for any treatment or surgery will be clearly explained after the consultation and prior to commencement of treatment.  


  • Ablative fractionated CO2 lasers are the most powerful medical lasers to treat the skin and are not available in beauty salons.  
  • They require a licensed health care professional to use them, often a doctor with many years of experience. 
  • At the Scar Clinic Dr. Rea, Dr. Douglas and Dr. Goodwin-Walters have a combined experience with lasers spanning 25 years and only use medical grade lasers and products. 


  • CO2 laser treatment has been shown to be effective in the treatment of early and well-established scarring.
  • There are local, national and international research papers published to support its effectiveness in improving the appearance, symptoms and pliability of scars – references below: 


  • Douglas et al. 2019.Carbon dioxide laser treatment in burn-related scarring: A prospective randomised controlled trial. JPRAS. 72(6) pp. 863-70. 
  • Miletta et al. 2021. Fractional ablative laser therapy is an effective treatment for hypertrophic burn scars: A prospective study of objective and subjective measures. Ann Surg. 275(6) pp. e574-80. 
  • Lewis et al. 2023. Carbon-dioxide laser treatment of burn-related scarring: The results of the ELIPSE (Early Laser Intervention Promotes Scar Evolution) prospective randomised controlled trial. JPRAS. 84. Pp. 368-76. 
  • Issler-Fisher et al. 2017. Ablative Fractional CO2 laser for burn scar reconstruction: an extensive subjective and objective short-term outcome analysis of a prospective treatment cohort. Burns. 43.pp. 573-82. 


All laser treatments comes with some risks. There will certainly be some swelling and redness in the treated scar area – this will settle over days and weeks but the redness can persist for many weeks. There are also risks of pigmentation changes – the treated area being lighter or darker than the surrounding skin. These are usually temporary and amenable to treatment but can rarely be permanent. Skin sensitivity changes are also a risk – usually these are positive changes, but there are risks of scars becoming more sensitive and again this is usually temporary but can rarely be permanent.

Infection is also a small risk (which is why we ask you not to swim for 2 weeks post-laser or sweat excessively in the first few days) and this may need treatment with antibiotics or antivirals.

Worsening of scarring is very rare but is a risk that is there, however small, and needs to be mentioned.