Fractional CO2 Laser in New Jersey

Fractional CO2 laser resurfacing is one of the most effective in-office treatments available for deeper lines, sun damage, acne scars, and uneven texture. It uses focused carbon dioxide laser energy delivered in microscopic columns, which removes damaged skin and triggers strong collagen production in the layers underneath. The result is firmer, smoother, more even skin from a single treatment for most patients. Dr. Nicole Schrader offers fractional CO2 at Schrader Plastic Surgery in New Jersey. She is double board-certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology. With more than 20 years of experience and 15 years in private practice, she has co-authored more than a dozen papers and presentations in her field. Town Topics Readers’ Choice Awards recognized her as “Best Plastic Surgeon.”

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What Fractional CO2 Laser Treatment Does

Fractional CO2 is an ablative laser, which means it removes thin layers of skin in a precise pattern. The “fractional” part is what makes it different from older full-field CO2 lasers. Instead of treating the entire surface at once, the laser delivers energy in tiny columns, leaving healthy skin between each treated zone.

That untouched skin acts as a healing reservoir, which speeds recovery and lowers the risk of complications while still producing a strong resurfacing effect.

The treatment addresses several concerns in a single session:

Because the laser works at a deeper level than gentler treatments, results tend to be more dramatic and longer lasting. Most patients see continued improvement for several months after a single treatment as collagen and elastin remodel.

How Fractional CO2 Compares to Clear + Brilliant

Clear + Brilliant and fractional CO2 are both fractional lasers, but they sit at different ends of the spectrum. Clear + Brilliant is non-ablative and designed for maintenance and early signs of aging. Fractional CO2 is ablative and designed for patients with more significant concerns who want a single, stronger treatment instead of a series of gentle ones. Patients who have been keeping their skin healthy with lighter treatments sometimes choose fractional CO2 when they are ready for a deeper reset.

Who Is a Good Candidate?

Fractional CO2 is best suited for patients with moderate to significant skin concerns who are willing to commit to a week or so of visible recovery. You may be a good candidate if you:

Have moderate to deep wrinkles, especially around the eyes, mouth, or forehead
Have noticeable sun damage, age spots, or pigmentation
Have acne scars or other textural concerns
Want a single treatment with strong results rather than a series of lighter ones
Are in good general health and not currently pregnant
Do not have an active skin infection in the treatment area

Fractional CO2 has historically been considered most appropriate for lighter skin tones because of the risk of pigment changes in darker skin. Newer settings and protocols have made it safer for a wider range of skin types, but candidacy still depends on careful evaluation. Patients with very advanced facial laxity may benefit more from a facelift or neck rejuvenation, since the laser addresses the surface and collagen layers rather than the underlying structure.

Reset your skin with fractional CO2 laser

Fractional CO2 uses a 10,600-nanometer wavelength of light that is absorbed by water in the skin. The laser vaporizes tissue in the targeted columns and delivers controlled heat to the surrounding skin. The vaporized columns trigger a strong wound-healing response, and the heat in the nearby tissue stimulates collagen and elastin production at a deeper level than non-ablative treatments can reach.

New skin cells begin to fill in the treated columns within the first 24 to 72 hours. Collagen production continues for several months, which is why results keep improving long after the visible recovery is over.

What to Expect During Your Treatment

A fractional CO2 session is performed in the office and typically takes between 30 minutes and an hour depending on the treatment area.

Consultation

Dr. Schrader reviews your skin, your medical history, and your goals. She will discuss the expected depth of treatment, the recovery you should plan for, and whether fractional CO2 is the right choice or whether a different laser or treatment would serve you better.

Preparation

You may be asked to pretreat your skin in the weeks before your appointment, often with a topical product or a short course of antiviral medication if you have a history of cold sores. On the day of treatment, your skin is cleansed and a topical numbing cream is applied. For deeper settings, additional anesthesia options may be offered.

Treatment

Once your skin is numb, the laser handpiece is passed over the treatment area in a controlled pattern. Patients usually describe the sensation as heat with a snapping or prickling feeling. Cooling air is typically used during the session to keep the surface comfortable.

Immediately After

Your skin will look red and feel warm, similar to a strong sunburn. Some patients have mild swelling, especially around the eyes. You will be given detailed aftercare instructions before you leave.

SCHEDULE A FRACTIONAL CO2 LASER CONSULTATION

If you are considering Fractional CO2 Laser treatment, a consultation at Schrader Plastic Surgery is the first step. Dr. Schrader will assess your skin and design a custom treatment plan to deeply resurface texture, diminish imperfections, and dramatically renew your appearance.

Recovery After Fractional CO2 Laser

Recovery length depends on the depth and density of your treatment, with lighter settings healing faster than deeper resurfacing for acne scars or etched lines. The timeline below describes a moderate fractional CO2 treatment.

For the first three to four days, the skin is red, swollen, and may ooze a small amount of fluid as it heals. Frequent application of a healing ointment is important during this time.

By day four or five, the skin typically starts to peel as new skin emerges underneath. By day seven, most patients are comfortable being out in public, though residual pink tone usually lasts another one to two weeks and can be covered with makeup.

A few aftercare basics that make a real difference:

Keep the skin moist with the ointment Dr. Schrader recommends
Avoid direct sun exposure and wear broad-spectrum SPF 30 or higher daily once peeling is complete
Skip retinoids, exfoliants, and active ingredients until cleared
Avoid strenuous exercise, saunas, and hot showers for the first several days
Do not pick at peeling skin

Final results continue to develop for three to six months as collagen remodels.

How Many Treatments Are Needed?

For many patients, a single fractional CO2 treatment produces the change they were looking for. Patients with more significant acne scarring or deep wrinkles sometimes benefit from a second treatment several months later.

The depth and density of the laser settings can also be adjusted to match what your skin can tolerate, so a more conservative setting with a second session is sometimes preferable to one aggressive treatment.

Combining Fractional CO2 With Other Treatments

Fractional CO2 is often part of a larger facial rejuvenation plan rather than a standalone fix.
For patients addressing both volume loss and skin quality, pairing the laser with facial fat grafting can refresh the face on two levels at once. A facelift can also be paired with fractional CO2 to address skin texture the lift itself cannot fix, since a facelift repositions tissue but does not resurface the skin. Lighter ongoing maintenance with Clear + Brilliant or SkinPen microneedling can extend the results of fractional CO2 once the initial recovery is complete.
The approach that best fits your goals will be reviewed during your consultation.

Risks and Side Effects

Fractional CO2 has a strong safety record when performed by an experienced provider, but it is an ablative treatment and the risks are real.

Expected side effects include redness, swelling, peeling, and temporary sensitivity. Less common risks include changes in pigmentation, infection, scarring, and reactivation of cold sores.

Patients with a history of keloid scarring or recent isotretinoin use need extra evaluation before treatment. A careful pre-treatment review with Dr. Schrader is the best way to lower these risks.

Why Choose Dr. Schrader for Fractional CO2

Fractional CO2 produces some of the strongest resurfacing results available without incisions, but it requires the right hands. The depth of the treatment, the settings used, and the way the laser is moved across the skin all change the result. Choosing a provider who understands the face at a deeper level matters.

Training rooted in head and neck surgery

Dr. Schrader earned her medical degree summa cum laude from George-August University in Germany, completed her residency in Otolaryngology-Head and Neck Surgery at Temple University, and finished a fellowship in Facial Plastic and Reconstructive Surgery at Robert Wood Johnson in New Jersey. That training is built on a deep understanding of facial anatomy, which informs every laser setting and treatment plan she chooses.

A practice focused exclusively on the face

She works on faces every day. Patients seeking facelift, eyelid surgery, rhinoplasty, and skin treatments all come to her for the same reason: a provider whose work has been narrowed to one area and refined over decades.

Active in multiple specialty societies

Dr. Schrader is a member of both the American Academy of Facial Plastic and Reconstructive Surgery and the American Academy of Otolaryngology-Head and Neck Surgery, which keeps her connected to advances on both the cosmetic and surgical sides of facial care.

Conservative judgment on a powerful treatment

Fractional CO2 is not the right answer for every patient. Dr. Schrader will tell you when it is and when a different laser or combination of treatments would serve you better.

Frequently Asked Questions

Is fractional CO2 laser painful?

The laser causes a hot, snapping sensation that most patients tolerate well once topical numbing has taken effect. For deeper treatments, additional anesthesia can be offered to keep you comfortable. After the treatment, the skin feels warm and tight rather than sharply painful, similar to a sunburn. Any discomfort is usually managed with over-the-counter pain relievers and the cooling care plan Dr. Schrader provides.

How much downtime should I plan for?

Downtime depends on the depth of your treatment. Lighter fractional settings can mean three to five days of social downtime, while a moderate treatment runs about a week, and deeper resurfacing for acne scars or etched lines can need seven to ten days before makeup looks seamless. Residual pink tone may linger for one to two more weeks and can be covered with makeup. Final results continue to develop over the next three to six months.

Can fractional CO2 treat acne scars?

Yes. Fractional CO2 is one of the most effective non-surgical treatments for atrophic acne scars, particularly rolling and boxcar types. The laser resurfaces the uneven skin and stimulates new collagen in the deeper layers, which softens the edges of scars over time. Multiple treatments are sometimes needed for deeper scarring, and Dr. Schrader will evaluate the type and depth of your scars before recommending a plan.

How long do the results last?

The collagen and elastin produced after fractional CO2 last for years. Pigment and texture improvements can also be very long lasting, though continued sun exposure, aging, and skin care habits all play a role. Lighter touch-up treatments can extend the results over time.

Is fractional CO2 safe for darker skin tones?

Fractional CO2 has historically been used most often on lighter skin tones because of the risk of pigmentation changes in darker skin. Newer settings and pretreatment protocols have widened the range of patients who can be treated safely. Dr. Schrader evaluates skin tone and history of pigmentation carefully before recommending the laser, and in some cases may suggest a different treatment that carries less pigment risk.

Can I combine fractional CO2 with a facelift?

Yes. Fractional CO2 is often combined with a facelift because the two treatments address different problems. A facelift repositions tissue and corrects laxity, while fractional CO2 resurfaces the skin and reduces lines, sun damage, and texture. The two can be performed at the same time or staged a few months apart, and Dr. Schrader will recommend the timing that best fits your plan.

This article was written by Dr. Nicole Schrader.

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