Fraxel and fractional CO2 are usually compared for acne scars, and that comparison has its own page, CO2 laser for acne scars. This page answers the other question I am asked about the two lasers. For enlarged pores, fine lines, sun damage and uneven pigmentation, it sets out which laser is chosen, how many sessions are needed, and what the downtime is.
For scars rather than pores, start with which acne scar treatment suits which scar.
Ablative vs non-ablative, the difference that decides everything
Fractional CO2 is ablative. At 10,600 nm it vaporises microscopic columns of skin and heats the tissue around them. Fraxel Dual’s 1,550 nm wavelength is non-ablative. It coagulates columns of dermis and leaves the surface intact. Everything else, namely the downtime, the number of sessions, the pigment risk and the strength of the result per session, follows from that distinction.
Fraxel vs CO2 for enlarged pores
Both tighten pores by remodelling the collagen around them. Fraxel is my usual choice, because pores are a surface problem that does not need ablative depth, and because pore treatment is usually sought by patients who will not accept a week of downtime. Three to five sessions are spaced two to four weeks apart. CO2 at low energy is used where pores sit alongside genuine scarring.
Fraxel vs CO2 for fine lines
Fine lines around the eyes and mouth respond to both lasers. CO2 produces the stronger result per session and is the choice for established lines. Fraxel needs more sessions but suits patients who cannot take downtime or whose skin pigments easily.
Fraxel vs CO2 for sun damage and uneven pigmentation
Fraxel Dual carries a second wavelength, 1,927 nm, aimed at the epidermis, which makes it the laser of the two for sun spots, uneven tone and the fine texture of sun-damaged skin. CO2 is not the first choice for a pigment-only problem. Where pigment is the whole concern, a pico or Q-switch laser is usually the right tool, as set out on the pigmentation treatment page.
Fraxel vs CO2 downtime, sessions and price
| Fraxel 1550 / 1927 | Fractional CO2 | |
|---|---|---|
| Downtime | One to two days of redness and fine flaking | Three to seven days of redness, swelling and flaking |
| Sessions | Three to five, two to four weeks apart | Three to six, four to eight weeks apart |
| Pigment risk in Fitzpatrick III to V | Lower | Higher, needs preparation and lower settings |
| From | $1,000 per session | $390 per session |
Fraxel or CO2 in Asian skin
Post-inflammatory pigmentation after the laser is the risk that decides most of these choices in Singapore. Fraxel’s non-ablative wavelengths have the better record in darker skin. CO2 is used in Fitzpatrick III to V skin at lower energy, with pigment-suppressing preparation and strict sun protection afterwards. A session in the fortnight before a beach holiday is the commonest avoidable cause of a brown patch that outlasts the problem it treated.
Fraxel or CO2, the verdict by concern
Fraxel is chosen for pores and sun damage where no downtime is acceptable. CO2 is chosen for established fine lines when a week of recovery is available. Neither is the first choice for pigment alone, which is covered on the pigmentation page. Acne scars are compared on CO2 vs Fraxel for acne scars. The service pages are Fraxel laser in Singapore and fractional CO2 laser.
Book a consultation with Dr Gerard Ee at The Clifford Clinic
Dr Gerard Ee consults and performs Fraxel and fractional CO2 laser treatment at The Clifford Clinic, 50 Raffles Place, Singapore. Consultations are by appointment. Message the clinic on WhatsApp, or call 6532 2048.
This page is written from published research and from clinical experience in Singapore since 2012. It is for general education, not medical advice. Whether a treatment suits you, what it may achieve and what it may risk can only be established at a consultation. Dr Gerard Ee is the Medical Director of The Clifford Clinic, a private clinic in Singapore, and treatments discussed on this site are provided commercially.
