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Fractional CO2 Laser vs LED Light Therapy

Fractional CO2 Laser: An ablative laser that vaporizes thousands of microscopic columns of skin, leaving untouched skin between them to heal from. It is the most effective in-office treatment for indented acne scars, and the one with the most downtime and the highest pigment risk.

LED Light Therapy: Panels, masks, and handhelds that shine red, near-infrared, or blue light on the skin. No ultraviolet and no downtime. The science is real, the marketing runs far ahead of it, and most of the studies are small and funded by device makers.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist
Last updated: 10/22/2026
Editorial illustration for Fractional CO2 Laser, based on the entry’s treatment or equipment reference.Editorial illustration for LED Light Therapy, based on the entry’s treatment or equipment reference.
Choose ifKey differencesWhat is it?What it treatsTreatment areasSkin tonesHow it worksBefore your treatmentDay of treatmentAfter your treatmentRisksCostQuestionsRelated

Choose Fractional CO2 Laser if…

Choose for the biggest single improvement in indented acne scars or deep sun damage, accepting the most downtime and pigment risk.

  • Boxcar or rolling acne scars
  • Deep sun damage or wrinkles
  • You can take a week or more off

Choose LED Light Therapy if…

Choose as a gentle, painless add-on for mild acne or fine lines — the marketing runs well ahead of the evidence.

  • Mild acne alongside skincare
  • You want no downtime or pain
  • You'll use it several times a week
Often combined

Can you have both?

Red LED is often used after CO2 laser to calm the skin during healing.

Key differences

● Fractional CO2 Laser
● LED Light Therapy
DowntimeNone → 2+ weeks
1–2 weeks
None
PainMinimal → Needs anesthesia or sedation
Needs anesthesia or sedation
Minimal
Results showImmediately → 3+ months
1–3 months
1–3 months
How long it lastsWeeks → Years or permanent
Years or permanent
Weeks
Visits neededOne → Every few months
A short series (2–3)
Every few months
Cost per visit$ → $$$$$
$$$$
$
ReversibleYes, can be undone → No, permanent
No, permanent
No, wears off

What is it?

Fractional CO2 Laser

LED Light Therapy

What is it?

It is an ablative laser.

It creates microscopic columns of injury in the skin.

Untreated skin speeds healing.

Skin between the columns supports recovery.

It is intensive.

It is stronger than a facial but less than fully ablative resurfacing.

History matters.

Pigment, keloid, herpes and isotretinoin history need assessment.

It uses light-emitting diodes.

LEDs expose skin to visible or near-infrared light.

Effects depend on the setup.

Wavelength, device and indication all matter.

It is not phototherapy.

It differs from UV treatment and photodynamic therapy.

Clearance is not proof.

A home-device clearance does not prove every claim.

What it treats

Evidence level
Fractional CO2 Laser
LED Light Therapy
Strong evidenceMost established uses
Acne scarring on light skin. Small sharply cut pits and broad shallow dips across a cheek, several sitting inside faint flat pink marks, with no active spots.

Acne Scarring

Major improvement in many scar types.

Educational illustration of healed broad indented scars with defined edges on the left cheek, with the face turned to the person’s right on light skin.

Boxcar Scars

Smooths wide scars.

A relaxed forehead with faint shallow horizontal fine lines.

Wrinkles and Fine Lines

Tightens and smooths.

—
Moderate evidenceSome supportive research
AI-generated educational illustration of Sun Spots: 1. Sun Spots Header — Light Skin; Lighter skin. Not a clinical photograph.

Sun Spots

Clears sun damage.

—
Limited evidenceEarly or small studies
—
Inflamed acne on light skin. The spots sit in a patch of pink, and the ring of redness around each one is easy to see. A few have a yellow-white head, and the skin between them is dry and flaking.

Acne

Blue light modestly reduces spots.

A relaxed forehead with faint shallow horizontal fine lines.

Wrinkles and Fine Lines

Red light may slightly smooth.

Not effective
—
Acne scarring on light skin. Small sharply cut pits and broad shallow dips across a cheek, several sitting inside faint flat pink marks, with no active spots.

Acne Scarring

Doesn't change scars.

Can make it worse
Flat tan patches with soft irregular edges across the forehead and upper cheek of an adult with light skin, the surface completely smooth.

Melasma

High risk of darkening.

Redness and fine superficial vessels across a light-skinned cheek and nose.

Rosacea

Can worsen redness.

Flat tan patches with soft irregular edges across the forehead and upper cheek of an adult with light skin, the surface completely smooth.

Melasma

Light can darken patches.

Treatment areas

Treatment areas

Face; the selected area depends on the concern and treatment plan.

Face; the selected area depends on the concern and treatment plan.

Skin tones

Skin tone
● Fractional CO2 Laser
● LED Light Therapy
Lighter skin
Some risk
Prolonged redness possible.
Low risk
No ultraviolet.
Medium skin
Higher risk
Dark marks are common; pre-treatment helps.
Low risk
No ultraviolet.
Deeper skin
Higher risk
Highest pigment risk of these treatments; low-density settings and an experienced provider are essential.
Some risk
Visible light can darken melasma-prone skin.

How it works

Fractional CO2 Laser

LED Light Therapy

How it works
Fractional CO₂ Laser mechanism diagram. Creates tiny treatment channels: Laser energy absorbed by water removes narrow columns of tissue. Untreated skin supports healing: Skin between the channels helps the surface repair. Collagen remodels over time: Repair can improve selected scars, lines, and texture.
LED Light Therapy mechanism diagram. LEDs deliver selected wavelengths: The device exposes skin to a planned light regimen. Light is absorbed by its targets: Effects depend on wavelength, device, and treatment goal. Response builds over a course: Some regimens may help selected skin concerns; results vary.
Diagram explanation

Creates tiny treatment channels: Laser energy absorbed by water removes narrow columns of tissue. Untreated skin supports healing: Skin between the channels helps the surface repair. Collagen remodels over time: Repair can improve selected scars, lines, and texture.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

LEDs deliver selected wavelengths: The device exposes skin to a planned light regimen. Light is absorbed by its targets: Effects depend on wavelength, device, and treatment goal. Response builds over a course: Some regimens may help selected skin concerns; results vary.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

Before your treatment

Fractional CO2 Laser
LED Light Therapy
2–4 weeks before

Sun and pigment cream: No sun, and do not arrive tanned.

Sun and pigment cream: On deeper skin tones a pigment-blocking cream usually starts two to four weeks ahead.

Plan ahead: Time off and supplies: Book the time off, arrange a driver if sedation is planned, buy plain petrolatum and a gentle cleanser, and plan a week at home.

Not specified
The week before

Actives and smoking: Stop retinoids, benzoyl peroxide and acids.

1 to 2 days before: Antiviral tablets: Antiviral tablets start a day or two before and continue for several days after, since an outbreak in healing skin can scar.

Ask your provider: Conditions and medicines: Ask first about lupus, porphyria, another light-sensitive condition, a retinal condition, past eye surgery or seizures.

Day of treatment

Fractional CO2 Laser
LED Light Therapy
Before you arrive
Not specified

Before each session: Clean skin: Sunscreen, makeup and thick moisturizer block visible light, mineral sunscreens especially, so a session over sunscreen does little.

Before session one: Baseline photo: Photograph your face in daylight, same spot, no makeup.

Shields and dose: Have the eye shields to hand before you start.

Arrival & prep

Skin is examined and photographed.

In a clinic, skin is cleansed.

Treatment

The handpiece is passed or stamped over each zone.

Expect rapid clicking, a burning smell, and a smoke evacuator running. Heat builds fast and feels hot rather than sharp. A full face takes 30 to 60 minutes, genuinely painful without proper anesthesia. The burning carries on for an hour or two.

The panel or mask sits close to the skin and runs for 10 to 20 minutes.

Red light is a strong glow even through closed eyes; near-infrared is invisible but feels warm. Shields stay on the whole session. It does not hurt. Expect mild warmth, and sometimes a headache after, usually from light without shields.

Before you leave

Skin is deep red, hot, swollen and weeping clear fluid, with a fine grid pattern visible.

Skin looks unchanged, maybe flushed for a few minutes.

After your treatment

Fractional CO2 Laser
LED Light Therapy
First 24 hours

Days 1 to 3: Swelling peaks on the first or second morning and can partly close the eyes.

Days 1 to 2: Dryness or a headache are uncommon and mild.

Days 2–7

Days 3 to 14: The skin turns bronze or grid-patterned brown, then flakes and sheets off, showing bright pink skin.

Not specified
Weeks 2–4

Week 3 to Month 12: Redness fades slowly, a month on light settings and three months or longer on aggressive ones.

Weeks 1 to 4: Little visible change.

Beyond 1 month
Not specified

Weeks 8 to 12: If a photograph in the same light shows nothing by now, more weeks will not change the answer.

Time to results

1–3 months, improving to 6

8–12 weeks of regular use

How long results last

Years

Only while used

Risks

Risks
  • Dark patches
  • Redness that will not settle
  • Pale or white patches
  • An acne or milia flare
  • Itching that is severe
  • Darkening or worsening melasma
  • Headaches or eye discomfort after sessions
  • A rash or unusual redness after sessions
  • Burns from a device
  • Skin cancer

Cost

Per session

A full-face session in the US usually runs $1,000 to $3,000, varying by city, device, depth, and whether sedation or an operating room is involved.

Home devices are the main market, from roughly $50 for a handheld wand to several hundred dollars for a full-face mask, and higher.

Insurance

Insurance does not cover resurfacing for acne scars, which is classed as cosmetic.

Insurance does not cover it.

Questions

Fractional CO2 Laser

LED Light Therapy

Individual Questions
How much downtime does fractional CO2 really need?

Five to ten days at home. Swelling and oozing days one to three, bronzing and sloughing days three to seven, and by day seven to ten the surface has closed and mineral makeup is usually allowed. Redness then fades over weeks to a few months.

Will it get rid of my acne scars?

It improves them substantially, more than any other single treatment, but it does not remove them. Rolling and boxcar scars respond best, icepick scars least, and mixed scarring usually needs subcision or TCA CROSS too.

Is it safe on deeper skin tones?

Experienced providers do it using lower density, longer intervals, and pigment creams before and after. Dark marks are common and fade over months. The rare risk of permanent pigment loss is why many people with deeper skin tones choose microneedling instead.

How many sessions will I need?

One to three, 6 to 12 weeks apart, judged six months after the last one.

Does it hurt?

Yes, without proper anesthesia. Numbing cream alone is not enough for a full face, so nerve blocks, injected anesthetic or oral sedation are standard, and burning continues for an hour or two afterward.

Can I have it before a wedding or a big event?

Only with months of margin. Skin looks worse before it looks better, and redness can last one to three months. Six months ahead is a reasonable minimum.

Does LED light therapy actually work?

Partly, and modestly. The best-supported uses are blue light for mild inflammatory acne and red or near-infrared light for wound healing. For fine lines and redness there are small positive trials, usually 8 to 12 weeks long. The literature is limited by small numbers, short follow-up, devices that differ from each other, few comparisons against proven treatments, and a lot of manufacturer involvement.

Are home masks as good as the panels in a clinic?

They generally put out less light per minute, which is why home instructions ask for several sessions a week. Over three months a consistently used home device may deliver more total exposure than occasional clinic add-ons. What is not true is that a trial of a clinic panel tells you what a particular mask will do.

Does FDA clearance mean it is proven?

No — most are cleared as substantially equivalent to a device already on the market. That is a judgment about similarity and basic safety, not evidence of a useful result.

Do I need eye protection?

Yes, and it is the one safety point worth being strict about. These devices are bright, they sit close to the face, and blue wavelengths carry a recognized photochemical hazard to the retina with prolonged exposure. Keep the shields on for the whole session, and ask your doctor first if you have a retinal condition or have had eye surgery.

How long before I know if it is doing anything?

Give it 8 to 12 weeks of consistent use, then compare a photograph taken on day one in the same light and without makeup. Judging by memory in the mirror is how people persuade themselves either way.

Can it replace a retinoid, or sunscreen, or treatment for my acne?

No — it sits on top of those, and the gain from adding it to a good routine is small. Using it instead of treatment for a condition that scars is the one way a low-risk device causes harm.

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