Fractional CO₂
Resurfacing.
For acne scars, deep texture, and sun damage that topical treatments cannot reach. A controlled, fractional laser injury that triggers your skin to rebuild itself — over months, not minutes.
Book this treatmentWhat it is
Fractional CO₂ resurfacing uses a carbon dioxide laser to create thousands of microscopic treatment columns in the skin — leaving untreated skin between each one. This "fractional" approach means faster healing than old-fashioned full-surface resurfacing, while still reaching deep enough to remodel scars and pigmentation.
The laser works by vaporizing microscopic columns of tissue, which triggers the body's wound-healing response. New collagen forms over the following three to six months, gradually filling in scars and refining texture. It is one of the few treatments that can meaningfully improve deep acne scarring.
It is not a lunch-break procedure. It is a medical treatment with real downtime and real risk if done poorly. We perform it conservatively, with settings chosen for your skin type — particularly important for Filipino skin, which has a higher risk of post-inflammatory pigmentation.
Who it's for
CO₂ resurfacing is appropriate for patients with:
- Atrophic acne scars — the rolling, boxcar, and ice-pick types
- Deep texture concerns that haven't responded to microneedling or peels
- Sun damage and actinic keratoses
- Deep-set pigmentation that topical treatments can't reach
- Visible pores caused by loss of dermal support
It is not appropriate for active acne, open infections, darker skin types with melasma (we'd approach that differently), patients on isotretinoin within the last six months, or anyone who cannot commit to the aftercare and downtime.
The process
A typical session runs about 90 minutes from arrival to discharge:
- 15 min — Skin prep, photographs, and final settings review with Dr. Marasigan
- 30 min — Topical numbing cream applied and allowed to take effect
- 20–30 min — The laser pass itself, performed by Dr. Marasigan
- 15 min — Post-treatment cooling, dressing, and aftercare briefing
We will not perform the laser on the same day as your first consultation. We need to see your skin, understand your history, and ensure you're prepared for the aftercare. Most patients book the laser 1–2 weeks after their initial skin reading.
Aftercare
Expect 5–7 days of visible downtime. The treated skin will be red, then bronzed, then peel in sheets. This is normal and expected. You will be given a detailed aftercare kit and we will see you for a check-up at day 3 and day 7.
- Days 1–2: Redness, swelling, mild discomfort. Soak and moisturize as directed.
- Days 3–5: Bronzing and peeling begin. Do not pick. Do not exfoliate.
- Days 5–7: Peeling completes. Skin still pink but presentable.
- Weeks 2–4: Pinkness fades. Strict sun protection mandatory.
- Months 1–6: Collagen continues to remodel. Final results visible at 4–6 months.
Sun protection is non-negotiable. Filipino skin is particularly prone to post-inflammatory hyperpigmentation after laser, and one bad sun exposure in the first month can undo months of progress. We will provide mineral sunscreen and a hat — please use both.
Pricing
Pricing depends on the area treated and the depth of the pass:
- Full face, single session — ₱18,000
- Full face, package of 3 — ₱48,000 (saving ₱6,000)
- Localized area (e.g., cheeks only) — ₱9,000
- Neck or décolletage add-on — ₱8,000
Prices include the numbing, the laser session, the aftercare kit, and the day-3 and day-7 check-ups. There are no hidden costs. If a touch-up is needed at 6 months, it is discounted 30% for existing patients.
Common questions
Most patients describe it as a hot, prickling sensation — manageable with the topical numbing. We can also offer oral pain relief or mild sedation for anxious patients. The first 12 hours after the numbing wears off are the most uncomfortable; we'll provide protocols to keep you comfortable.
For mild scarring, one session is often enough. For moderate to deep scarring, we usually recommend three sessions spaced 8–12 weeks apart. We will not push you toward a package — we'd rather do one excellent session and reassess.
Yes, with caveats. Filipino skin (Fitzpatrick types III–V) carries a higher risk of post-inflammatory hyperpigmentation. We mitigate this by using conservative settings, pre-treating with tyrosinase inhibitors for 4–6 weeks, and insisting on strict sun protection after. Dr. Marasigan has performed this procedure on Filipino skin for over a decade.
Often yes, but not in the same session. We commonly combine CO₂ resurfacing with subcision for deep rolling scars (done 4–6 weeks before), or with PRP microneedling between sessions. We will not combine it with botulinum, fillers, or chemical peels in the same week.
Book a consultation
Start with a skin reading.
We won't perform CO₂ resurfacing on day one. We'll read your skin, discuss alternatives, and only proceed if it's the right call. ₱2,000, deductible from treatment.