What it is
CO₂ skin resurfacing uses a fractional 10,600 nanometer carbon dioxide laser to remove microscopic columns of skin tissue, leaving the surrounding skin intact. The treated columns heal over the following days, and the dermis underneath responds by producing new collagen and reorganizing its structure over the following months.
The result: sun damage and pigment irregularity reduce, fine lines and texture smooth, atrophic scars fill in, and skin quality changes at a structural level — not just on the surface.
It is the most effective single treatment in cosmetic dermatology for true photodamage. It is also the treatment with the most downtime. Both of those facts matter.
How Dr. Brown approaches it
CO₂ resurfacing at Esvie is performed by Dr. Brown personally — not delegated. Settings (density, energy, depth) are selected by your skin type, the indication, and how aggressive a single course you can absorb in the calendar window you have available.
For broad photodamage, treatment covers the full face. For acne scarring, settings may be deeper at the scar bed and lighter on intervening skin. For perioral or periorbital fine lines, only those areas are treated and downtime is more contained.
Most patients are well-served by one carefully-planned aggressive course rather than a series of light passes. The depth of the laser pulse, not the number of sessions, drives the result.
What to expect
Day of treatment: Topical anesthesia is applied for approximately one hour before. Treatment itself takes thirty to sixty minutes depending on area. A sensation of heat and tightness follows; oozing and crusting begin within hours.
Days 1–5: The skin oozes, crusts, and weeps as the treated columns heal. Frequent gentle cleansing and occlusive ointment (typically Aquaphor or Vaseline) per the post-care plan. No makeup. No sun. No scrubbing.
Days 5–10: Crusts release. Skin underneath is bright pink and very sensitive. Mineral makeup may be tolerated. Most patients return to social activity by day 7–10, depending on aggressiveness of treatment.
Weeks 2–8: Pinkness gradually fades. Skin texture continues to refine. Sun protection is critical — UV exposure during this window is the single largest cause of post-treatment pigment change.
Months 3–6: Final result. Collagen remodeling matures. Most photodamage indications continue to improve through month six.
Candidacy
Good candidates have meaningful photodamage, fine lines, or atrophic scarring; have skin types I–III; are willing to commit to 5–10 days of social downtime; are diligent about sun protection; and do not have active skin infection or recent isotretinoin use.
Not a candidate if you have active acne, herpes simplex outbreak, or any infection at the planned site. Not a candidate within six to twelve months of isotretinoin therapy. Not a candidate if you are pregnant or nursing. Not a candidate with a history of keloid or hypertrophic scarring.
Skin types IV–VI carry higher risk of post-inflammatory hyperpigmentation. Treatment is possible with conservative settings and aggressive pre-treatment, but the conversation is different and Dr. Brown will say so honestly.
If CO₂ is too aggressive a tool for your situation, the better answer is often microneedling RF, IPL, or a non-ablative resurfacing protocol — all of which are also performed by Dr. Brown.