As a plastic surgeon at Oregon Cosmetic and Reconstructive Clinic, I meet patients who want to repair years of sun exposure. Over time, UV rays change the skin layer by layer, creating texture changes, pigment shifts, and reduced firmness. When I want to treat deeper signs of sun damage and encourage healthier skin, I often turn to fractionated CO₂ laser resurfacing. I like this approach because it works with your body’s natural ability to renew itself while giving predictable, meaningful improvement.
How the CO₂ Laser Works
The CO₂ laser uses focused light to gently remove damaged skin cells. Because it is fractionated, it treats the skin in tiny microscopic columns, leaving the surrounding skin untouched. This design is important. The untreated skin helps the treated areas heal faster by sending in fresh, healthy cells.
As these new cells grow, the skin becomes smoother, brighter, and more even in tone. This process also encourages your body to build new collagen, which adds strength and support to the deeper layers of the skin.
How the Sun Damages Skin Over Time
When we talk about sun damage, I like to break it down into the different ways UV rays change the skin. These changes add up slowly, and most people notice them more clearly in their 30s, 40s, and beyond. Understanding these patterns helps explain why CO₂ laser resurfacing can be so effective.
Rough or Uneven Skin Texture
Over time, UV rays wear away the smooth outer layer of the skin. This creates dryness, rough patches, and fine bumps, because the skin has a harder time shedding old cells and replacing them with new ones.
Brown Pigmentation (Sunspots)
Years of sun exposure can lead to dark spots and uneven brown patches. These spots form when pigment cells produce extra pigment in response to UV radiation. Even everyday sun exposure—like driving or walking outside—can gradually darken these areas.
Damage to Collagen and Elastin
Sunlight also weakens the deeper support structure of the skin. UV rays break down collagen and elastin fibers, which slowly leads to loose, thin, or crepey skin. Because these fibers provide firmness and bounce, their loss becomes more noticeable with age.
How CO₂ Laser Treatment Helps Improve These Changes
When I evaluate sun-damaged skin, I often see a combination of rough texture, uneven pigmentation, and thinning of the deeper layers. A fractionated CO₂ laser addresses all of these changes because it works on both the surface and the underlying support structure.
By creating microscopic treatment zones—and leaving the surrounding skin intact—the laser encourages healthier cell turnover, smoother texture, more even pigmentation, and renewed collagen growth. This approach supports predictable and safe healing, since only about 20% of the skin surface is treated during each session. The remaining 80% stays intact and helps drive quick, steady recovery.
Because the results build on each other, repeat sessions allow the benefits to “stack,” giving your skin more improvement over time. Each treatment adds another layer of renewal, which helps create smoother texture, clearer pigmentation, and stronger collagen support.
Combination Approaches for Better Healing
Over the years at Oregon Cosmetic and Reconstructive Clinic, I’ve noticed that patients often heal faster and see stronger results when we thoughtfully layer treatments. Because CO₂ laser resurfacing creates a powerful foundation for renewal, adding complementary therapies can support the skin through each step of healing.
Microneedling
Microneedling uses tiny controlled channels to stimulate collagen in a way that reaches different depths than the laser. When combined with CO₂ resurfacing, the two treatments work together to encourage layered collagen formation, resulting in more even improvement in texture and firmness.
Exosomes
Exosomes are small repair signals naturally used by the body to guide healing. When applied after CO₂ resurfacing, exosomes help calm inflammation, boost hydration, and support smoother, more balanced tissue repair.
LED Light Therapy
LED light therapy is gentle, soothing, and effective at reducing redness and encouraging faster healing. When used after laser treatment, LED therapy can shorten downtime and give the skin an early boost toward collagen production.
How These Treatments Work Together
When combined with CO₂ laser resurfacing, microneedling, exosomes, and LED therapy create a layered, supportive environment for the skin to recover. Each step offers something different—one stimulates deeper collagen, another calms the surface, and another speeds healing.
Together, these approaches streamline recovery, reduce downtime, and amplify long-term improvements in texture, pigmentation, and firmness.
What CO₂ Laser Resurfacing Improves
-Rough or uneven skin texture
-Brown pigmentation and sunspots
-Fine lines and deeper wrinkles
-Dullness or uneven tone
-Acne scarring or injury-related scarring
-Early signs of collagen loss
What Recovery Looks Like
After treatment, your skin begins its repair process right away. Your skin may feel a little rough like sandpaper, and you might look like you had a mild sunburn. In 4 days, you will notice flaking of the sandpaper dots as the older skin layers shed and new ones form. Most patients heal steadily over the first week, while deeper collagen rebuilding continues for several months. I guide every patient through a clear recovery plan so they know what to expect and how to care for their skin.
Who Is a Good Candidate?
I recommend CO₂ resurfacing for patients who want more dramatic improvement than lighter treatments—like chemical peels or mild lasers—can offer. If you have significant sun damage, visible texture changes, or deeper lines, this option may fit your goals well.
During your consultation at Oregon Cosmetic and Reconstructive Clinic, I evaluate your skin history, examine your concerns, and create a plan that balances safety and results.
A Friendly Note from Me
I enjoy offering CO₂ laser resurfacing because it works with your body’s natural healing system in a powerful yet controlled way. By treating tiny columns of skin and supporting quick healing, we can refresh your texture, improve your tone, and strengthen your collagen foundation. Many patients appreciate that the improvement feels natural and long-lasting.
To explore more options, visit our skin procedures page.
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