Energy & Resurfacing

The most powerful resurfacing tool we have, and the one most often used on the wrong patient. Here is what the treatment does to skin, who it suits, and an honest day-by-day account of the recovery nobody describes in advance.

Last reviewed 15 September 2026

Consumer devices are sold on the mechanism of the clinic machine they resemble, at a fraction of the power. That gap is the whole story, and it decides which of these are worth owning and which are furniture.

Last reviewed 16 September 2026

Either the energy is too low to do what is claimed, or it is high enough to be a burn risk without imaging.

Last reviewed 15 September 2026

Depth is everything. Superficial peels do a little; medium-depth peels do a lot and carry matching downtime.

Last reviewed 15 September 2026

The most reliably effective resurfacing tool available, with a recovery that matches the size of the effect.

Last reviewed 15 September 2026

Genuinely good at pigment and vessels. Close to useless for texture or lines, which is half of what it is sold for.

Last reviewed 15 September 2026

A measurable millimeter-scale lift of the brow in the right candidate, and very little in the wrong one.

Last reviewed 15 September 2026

Consistent, modest improvement in texture and acne scarring across several sessions.

Last reviewed 15 September 2026

Real deep-dermal remodeling in mild to moderate laxity, and consistently oversold as a facelift alternative.

Last reviewed 15 September 2026

Dermatologic Surgery examined whether patients using a retinoid around the time of ablative laser resurfacing developed less post-inflammatory hyperpigmentation, in the skin types where that risk is highest. Pigment left behind after resurfacing is the complication that decides candidacy in darker skin, and it is why a treatment that suits one patient is a poor idea for another with the same finding. Anything that shifts that risk changes the conversation about who is a candidate, not the settings on the machine.

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], “Post-inflammatory Hyperpigmentation After Ablative Laser Resurfacing in Darker Skin: Are Concurrent Retinoids Protective?” — read the original

Read the full guide: Fractional CO2 Recovery, Day by Day: What the Two Weeks Actually Look Like →

Lasers in Surgery and Medicine reports a sixty-two-year-old woman who suffered an embolic stroke after full-field ablative Erbium:YAG resurfacing. The proposed mechanism is specific and worth understanding: significant pain during the procedure prompted a Valsalva maneuver, and a previously unknown patent foramen ovale allowed a clot to cross from the venous side to the arterial one. This is a single case report of a first-described event, so it says nothing about the general risk of resurfacing. What it does argue for is adequate anesthesia during ablative treatment, because pain that makes someone bear down is a mechanism and not just discomfort.

Lasers in surgery and medicine, “Stroke Following Facial Laser Resurfacing Procedure-A Case Report.” — read the original

Read the full guide: Fractional CO2 Recovery, Day by Day: What the Two Weeks Actually Look Like →