CO2 Laser Treatment for Acne Scars
Fractional CO2 laser resurfacing for acne scars using the Alma Hybrid platform. Effective for ice pick, boxcar and rolling scars through controlled ablation and deep collagen remodelling.
At Berkshire Aesthetics, CO2 laser treatment for acne scarring is carried out under the clinical supervision of Dr Selena Langdon. Each treatment plan is developed following a thorough assessment of your scar type, skin tone and treatment goals. See our acne scar treatment overview for all available scar treatment options, or visit our acne & scarring hub for a full guide to the conditions we treat.
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Who is CO2 laser for acne scars suitable for?
CO2 laser treatment for acne scars is appropriate for patients who have completed their active acne management and are left with textural scarring that has not responded adequately to less intensive treatments. If you are still experiencing active breakouts, we recommend addressing those first — visit our acne treatment page for more information.
The Alma Hybrid CO2 laser is particularly suited to patients with moderate to severe atrophic scarring — especially ice pick and boxcar scars — where the depth and nature of the scarring warrants a more intensive resurfacing approach. Patients should be in good general health and willing to commit to 7–10 days of social downtime per session.
How CO2 laser treats acne scars
The Alma Hybrid CO2 laser uses fractional resurfacing technology to deliver controlled microcolumns of laser energy into the scarred skin. Each microcolumn vaporises a narrow channel of damaged tissue, leaving surrounding skin intact. This fractional approach triggers the body’s wound-healing cascade while preserving enough healthy tissue to support rapid re-epithelialisation.
The thermal effect of the CO2 wavelength (10,600nm) causes immediate tissue contraction around each microcolumn. Over the following weeks and months, fibroblasts are activated to produce new collagen and elastin fibres, progressively filling and remodelling the depressed scar tissue from within. This collagen remodelling process continues for 3–6 months after each session.
The Alma Hybrid platform combines ablative CO2 with a non-ablative 1570nm wavelength, allowing your doctor to customise the balance between surface ablation and deeper thermal stimulation. This dual-wavelength approach achieves effective scar improvement with a more manageable recovery compared to traditional fully ablative CO2 lasers.
For full details on the Alma Hybrid platform, visit our Alma Hybrid CO2 Laser treatment page.
Scar types and CO2 laser effectiveness
Different types of acne scars respond differently to CO2 laser resurfacing. Your doctor will assess your specific scar pattern during consultation to determine whether CO2 laser is the most effective approach for your scarring.
Ice pick scars
Good responseIce pick scars are narrow, deep, V-shaped indentations. CO2 laser ablates the walls of the scar channel and stimulates collagen production to fill the depression from beneath. Multiple sessions are typically needed due to the depth of these scars. Fractional resurfacing progressively reduces scar depth with each treatment.
Boxcar scars
Excellent responseBoxcar scars have well-defined vertical edges and a flat base. CO2 laser is highly effective for boxcar scars because the fractional ablation smooths the sharp edges and stimulates collagen remodelling across the flat base, raising the depressed tissue. Both shallow and deeper boxcar scars typically show significant improvement.
Rolling scars
Moderate responseRolling scars create a wave-like, undulating surface caused by fibrous bands tethering the skin to deeper tissue. CO2 laser alone provides moderate improvement for rolling scars. For optimal results, your doctor may recommend combining CO2 laser with Morpheus8 RF microneedling, which delivers radiofrequency energy to deeper tissue layers to release tethered bands and remodel subdermal collagen.
Hypertrophic scars
Different approach neededHypertrophic and keloid scars involve excessive collagen deposition rather than tissue loss. These raised, firm scars require a fundamentally different treatment approach and CO2 laser is not typically the first-line option. Your doctor will assess whether alternative treatments such as corticosteroid injection, silicone therapy or carefully calibrated laser settings may be more appropriate.
Treatment protocol
CO2 laser treatment for acne scars follows a structured clinical protocol to ensure safety and optimise results. Your treatment plan will be tailored to your specific scar pattern, skin type and goals.
Assessment and consultation
A thorough assessment of your scar type, depth, distribution, skin tone (Fitzpatrick type) and medical history. Your doctor will explain which scars are most likely to respond to CO2 laser and set realistic expectations for improvement. A personalised treatment plan is developed, which may include combination approaches.
Test patch consideration
For patients with darker skin tones or those who have not previously undergone laser treatment, a test patch may be recommended. This involves treating a small, discreet area to assess how your skin responds to the laser energy and healing process before proceeding with a full treatment session.
Treatment sessions
Most patients require 2–3 treatment sessions, though this varies depending on scar severity. Each session takes approximately 30–60 minutes depending on the area treated. Topical anaesthetic is applied beforehand to manage discomfort. Your doctor adjusts laser parameters for each session based on your healing response.
Session spacing
Sessions are spaced 6–8 weeks apart to allow complete healing and the early stages of collagen remodelling between treatments. This interval ensures the skin has fully recovered before the next session and allows your doctor to assess progress and adjust the treatment plan if needed.
For detailed information about what to expect during recovery, visit our CO2 laser recovery and downtime guide.
Combining CO2 with other scar treatments
For many patients, combining CO2 laser with complementary treatments produces superior outcomes compared to laser alone. Your doctor will design a combination protocol if appropriate for your scar pattern.
Morpheus8 RF Microneedling
Morpheus8 combines microneedling with radiofrequency energy to remodel collagen at depths of up to 4mm. It is particularly effective when combined with CO2 laser for rolling scars, where the RF energy can release tethered fibrous bands and stimulate deep collagen renewal that complements the surface resurfacing achieved by the laser.
Learn more about Morpheus8SkinPen Microneedling
SkinPen microneedling can be used between CO2 laser sessions to maintain collagen stimulation with less downtime, or as a standalone treatment for milder scarring areas that do not require full laser resurfacing. It is safe for all skin tones and offers a shorter recovery period of 2–3 days.
Learn more about SkinPenPolynucleotides
Polynucleotides are injectable biostimulators derived from purified DNA fragments that promote tissue regeneration at a cellular level. When used alongside CO2 laser treatment, they enhance fibroblast activity and cell turnover, supporting the healing process and improving overall skin quality in scarred areas.
Learn more about polynucleotidesResults timeline for scarring
CO2 laser scar treatment requires patience. The collagen remodelling process that drives scar improvement continues for months after each session, meaning your results will improve progressively over time.
Initial visible improvement in scar depth and skin texture as the first phase of collagen remodelling takes effect. Post-treatment redness will have largely resolved and new skin will appear smoother.
Progressive improvement as deeper collagen remodelling continues. Most patients see significant change by this stage, with measurable reduction in scar depth and improved surface texture across treated areas.
Continued refinement as collagen maturation completes. Final results become apparent, particularly for deeper scars. This is typically when your doctor will assess whether additional sessions would provide further benefit.
Complete removal of acne scars is rarely achievable, but significant improvement in depth, texture and overall appearance is realistic. Most patients achieve 40–70% improvement in scar depth over a full course of treatment. Your doctor will set clear, honest expectations during your consultation.
Treatment pathways
Your treatment pathway will depend on your scar type, severity and skin characteristics. Below are the key modalities we use for acne scar treatment, often in combination with CO2 laser.
Related topics
Explore related pages within our CO2 Laser Resurfacing service:
Why we start with a consultation
Every treatment begins with a medical assessment. We need to understand your medical history, current health, skin condition and concerns before prescribing any procedure. This protects your safety and ensures the treatment is clinically appropriate for you.
During your consultation, Dr Langdon will explain what the treatment can realistically achieve, any risks specific to you, and whether an alternative might be more appropriate.
All bookings are subject to our Booking Conditions.
Frequently Asked Questions: CO2 Laser for Acne Scars
This content is for informational purposes only and does not constitute medical advice. Individual suitability for any treatment is assessed during a consultation. Always seek the guidance of a qualified medical professional with any questions regarding a medical condition or treatment.
- CQC registered clinic — regulated and inspected
- Doctor-led clinical oversight by Dr Selena Langdon (GMC 6159259)
- Complaints process and patient rights
Page last reviewed: February 2026
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