The basic rule
After fractional CO2 laser, skin behaves like a wound in repair. It heals better when it is clean and moist and left alone. Crusts are part of that process. Pull one off early, and new skin can come away with it. That can leave patchy pigment or a small scar.
This guide is general. Depth and density differ between treatments, so your written instructions always come first. Other lasers, such as pico, have different aftercare.
Post laser scab care in the first 24 hours
The first week
Do not pick, peel, rub or scrub. Let crusts lift by themselves, even in the shower or on your pillow. Keep using ointment until the surface has closed.
Avoid retinoids, exfoliating acids, vitamin C, brightening creams, scrubs, cleansing brushes and face masks until the clinic confirms healing.
Avoid facials, microneedling, other lasers and injectables in the area.
Avoid swimming, saunas, steam and sweaty exercise. Keep hands and phones clean, and change your pillowcase nightly while the surface is open.
Sun protection and make-up
While the surface is open, do not apply sunscreen. Rely on shade and a wide hat, and stay indoors in the middle of the day. Once the surface has closed and peeling has finished, use a broad-spectrum sunscreen each morning, and reapply it outdoors. Keep going for as long as the skin stays pink, because post-inflammatory hyperpigmentation forms during this time. This matters most in Fitzpatrick III to V skin. Make-up also waits until the surface has closed and peeling has finished. Mineral powder is gentler than liquid foundation. Use freshly washed brushes.
What is normal and what is not
| Usually normal | Needs review |
|---|---|
| Redness, swelling, warmth, pinpoint bleeding and oozing in the first two days | Thick yellow or honey-coloured crusts, or oozing that increases |
| Swelling that is worse on the second morning, especially near the eyes | Blisters or small painful clusters of sores |
| Tightness, a sandpaper or bronzed look, and fine peeling | Pain, heat or swelling that rises after the second day |
| Itching, eased with cool compresses and moisturiser | Redness spreading past the treated area, fever or chills |
| Pinkness that stays for a while after peeling | Darkening after peeling, a firm raised area, or one patch that stays red |
Risks and limits of aftercare
Good care lowers risk but cannot remove it. Reported problems after deep fractional CO2 include acne-like eruptions, cold sore outbreaks, and bacterial or yeast infections. In Asian skin, post-inflammatory hyperpigmentation is the main concern. Early scarring is easier to manage than established scarring, so raised areas and lingering redness should be reviewed promptly. Tell the clinic straight away about any warning sign. Outside clinic hours, fever with a spreading, red, hot face needs a doctor the same day. Complication care lists signs that need an emergency department. Your first review looks at healing. Results vary.