CO2RE® (Candela — fractional CO2 laser resurfacing)

In a sentence: CO2RE is a fractional carbon‑dioxide laser that removes tiny columns of old skin and sparks new collagen—smoothing lines, tightening fine crepe, and fading sun damage—with more impact (and more healing) than “light” lasers.1

Who it’s best for

  • 40s–50s: etched lines around the mouth/cheeks, sun damage, acne‑mark texture on face/neck/chest.2
  • 60s: deeper wrinkles and crepey skin when you want bigger change than non‑ablative lasers can deliver.3
  • Skin tones: safest in lighter tones (Fitzpatrick I–III). Darker complexions (IV–VI) carry a higher risk of temporary darkening (PIH); if treated, parameters must be conservative and operator very experienced.3

What it can do

  • Soften deep and etched lines (perioral, cheek) more than “light” fractional lasers.2
  • Smooth texture and scars and brighten blotchy sun damage.3
  • Treat face, neck, chest; settings can be tailored from light to aggressive depending on goals.1

What it can’t do

It won’t replace a surgical lift for heavy jowls, and it isn’t ideal for melasma‑prone skin. Expect real change in lines/texture, but plan for meaningful healing time compared with MOXI/LaseMD/Fraxel‑1927.

Treatment & sessions

  • During: after numbing, the laser creates microscopic channels that remove old skin and heat the dermis to build collagen. A full face usually takes 20–45 minutes (longer if combined areas).4
  • How many: many people do 1 session for a step‑change, or 2 lighter sessions 3–6 months apart.3
  • When you see it: after crusting/peel (first two weeks), pinkness settles over weeks; smoothing continues for 3–6 months as collagen rebuilds.5

Healing time & aftercare

  • Downtime: plan for ~7–14 days of visible healing (redness, oozing/crusting, then flaking). Pinkness can last weeks before it fully blends.3 6
  • Comfort: sunburn‑like heat and swelling are common the first 24–72 h.6
  • Aftercare basics: frequent cleansing and ointment, vinegar soaks as advised, antiviral prophylaxis if you get cold sores, and strict SPF/hat. Don’t pick crusts; avoid heat/gyms until re‑epithelialised.7 5

Safety & skin of colour

Because CO2 removes skin and heats the dermis, PIH (temporary darkening) is more likely in deeper complexions. Many clinics either avoid ablative CO2 for Fitzpatrick IV–VI or use very cautious, test‑spotted protocols. Pretreatment lightening (e.g., hydroquinone) and strict sun avoidance lower PIH risk.3 8

Possible side effects & complications

  • Common: redness, swelling, crusting, “sunburn” sensation; milia or acne flares as you heal.3
  • Less common: post‑inflammatory hyperpigmentation, prolonged redness, cold‑sore reactivation (antivirals help).3
  • Rare: infection, scarring, hypopigmentation, eye‑area risks (e.g., ectropion with deep peri‑ocular passes)—why eye protection and expert operators matter.3

Who should avoid or delay (contra‑/precautions)

  • Active infection or open wounds; active cold sore without antivirals.
  • Recent isotretinoin use (typically defer ~6 months; your clinician will individualise).3
  • Strong keloid/hypertrophic scar history, prior radiation to the area, or connective‑tissue disorders—needs careful assessment.3
  • Pregnancy/breast‑feeding are commonly deferred.

Regulatory & platform notes (U.S.)

  • CO2RE (Syneron‑Candela) is an FDA‑cleared Class II laser system for dermatologic procedures requiring ablation, coagulation and resurfacing; see 510(k) K181523 (product code GEX).1
  • Manufacturer materials describe multiple modes (from light “polish” to deep fractional and surgical) and interchangeable handpieces; clinics tailor depth/coverage to your goals.9

How CO2RE compares

  • Versus 1927 nm “light” lasers (MOXI/LaseMD Ultra): those give glow with 2–5 days’ flaking; CO2RE delivers stronger smoothing and line reduction but needs a true recovery window.
  • Versus Er:YAG (ProFractional/Contour TRL): Er:YAG can have faster re‑epithelialisation and less heat; CO2 often gives a bit more tightening at comparable depths.3
  • Versus other CO2 platforms (UltraPulse, Tetra/CoolPeel): all are capable; results depend more on settings and operator than brand. Discuss which handpiece/mode they’ll use and why.

At‑a‑glance

  • Best for: etched lines, crepey texture, acne‑mark smoothing, field sun damage.
  • Sessions: often 1 (or 2 lighter) sessions; results build 3–6 months.
  • Downtime: plan 7–14 days visible healing; pinkness fades over weeks.
  • Operator matters: choose a clinic experienced with your skin type and with peri‑oral/peri‑ocular resurfacing.

References (open in new tab)

  1. FDA 510(k) K181523 — Syneron‑Candela CO2RE (indications/classification)
  2. JAAD — Fractional CO2 resurfacing outcomes for wrinkles
  3. DermNet — CO2 laser: candidates, risks, recovery
  4. American Board of Cosmetic Surgery — CO2 basics & recovery
  5. ASPS — Laser resurfacing recovery & risks
  6. Clinic post‑care — CO2RE recovery timeline & do’s/don’ts
  7. Clinic post‑care — vinegar soaks/ointment guidance
  8. Drugs in Context (2025) — Strategy to reduce PIH after fractional CO2
  9. CO2RE brochure — modes & handpieces (manufacturer)

Region notes: CO2RE is widely available in US/Canada/UK/EU/Australia. Specific claims and settings vary by country—confirm locally.

  • Hits: 384066