CO2 Laser Treatments in Montreal

It is an ablative resurfacing laser. It vaporizes thousands of microscopic columns of skin in a grid pattern and leaves untouched skin between them to drive healing. Removing tissue is what lets it reach deep scarring and structural sun damage that gentler devices cannot, and it is also why the recovery is significant. We use the Candela CO2RE at our Montreal clinic.

The CO2RE is not a single fixed setting. It runs four fractional modes, and the one we choose changes both what the laser can correct and how long you are out of circulation.

• Luz places shallow columns through the epidermis. It is the refresh setting, used on early texture change and dullness where the skin has not taken much structural damage. Recovery is the shortest of the four, on the order of three to four days before makeup will sit properly.
• Mid drives the same fractional pattern deeper, past the junction between epidermis and dermis. This is the setting for moderate photodamage and for lines around the eyes, mouth and cheeks. Add several days to the Light timeline.
• Profundo pushes narrow columns well into the dermis at high energy. This is the scar setting: deep acne scarring, surgical and traumatic scars, etched lines, stretch marks. Its coverage approaches what older fully-ablative resurfacing achieved, and the redness afterwards lasts proportionally longer.
• Fusion delivers Deep and Light in the same pass, a superficial pattern with a deep spike at the centre of each column. It works the surface and the dermis at once, which is what we want when someone has severe sun damage and deep texture to correct together.

All four are fractional. “Deep” describes how far the columns travel, not the removal of your entire skin surface. Your doctor selects the mode at consultation against what is being treated and what your skin will tolerate, and the trade-off is real: the modes that correct the most also take the most recovery from you. Most of the work described on this page, meaning deep acne scarring, heavy resurfacing and stretch marks, sits in Deep or Fusion.

It depends on the mode, and you should plan around the mode you are actually booked for rather than the best case.

For the Deep and Fusion work most people come to us for, plan on 7 to 10 days of social downtime. Not two, and not “a long weekend.” For roughly a week you will have visible redness, swelling, crusting and peeling, and you will not look presentable for work that puts you in front of people or for any social occasion.

A Light-mode treatment is a shorter proposition, closer to three or four days before makeup will sit properly, and Mid lands between the two. Do not book on the strength of the Light figure and then find yourself scheduled for Deep. Ask which mode you are getting and plan against that number.

Redness outlasts the peeling in every case. A pink or ruddy tone that persists for several weeks to a few months after a deep treatment is normal rather than a complication. Book this against a quiet stretch of your calendar, and take the time off before you book, not after.

Days 1–2: The skin feels like a bad sunburn and looks like one. Swelling peaks in the first 48 hours and is often worst around the eyes on waking, and people are frequently surprised by how puffy the morning after is. The skin weeps a clear or yellowish fluid. This is normal and it is why you sleep elevated and keep ointment on continuously.

Days 3–5: The oozing stops and the surface dries into a fine bronze or brown crust with a sandpaper texture. Swelling starts coming down. This is usually the stage people find hardest to look at.

Days 5–10: The crusting peels off in patches, unevenly, revealing bright pink new skin underneath. It will look blotchy while it is mid-process. Most people are able to cover the remaining pinkness with makeup and return to normal life somewhere in this window.

Weeks 2–12: Pinkness fades gradually. The actual result builds over three to six months as collagen remodels, so what you see at week two is not the outcome.

During the treatment you are numbed with topical anaesthetic for about 45 minutes beforehand, and the device cools as it works. You will still feel heat and a prickling snap, and you will smell something during the pass. It is tolerable but not comfortable.

Afterwards the sensation is intense heat and tightness for the first several hours, worst in the first two or three. Cool compresses and the ointment help. Tell us in advance if you are anxious about pain so we can plan for it rather than improvise on the day.

The aftercare is not optional and it is not light. Three things carry the most weight:

Keep it heavily occluded. The healing skin has no intact barrier and must not be allowed to dry out. That means a thick occlusive ointment, petrolatum-based or whatever we dispense, reapplied throughout the day and night for as long as we tell you, then a heavy bland moisturizer after. Not your usual serum. Nothing with acids, retinoids, vitamin C, fragrance, or exfoliant until we clear you.

Do not pick. At all. Not the crusts, not the flakes, not the piece that is almost off anyway.

Zero sun exposure. Absolute, not approximate.

Beyond those: gentle cleansing with lukewarm water and a mild non-foaming cleanser, sleep with your head elevated for the first few nights, and no exercise, saunas, hot showers, swimming pools, or alcohol while you are healing, because heat and blood flow worsen the swelling. You will get all of this in writing.

You risk a permanent scar, and you risk infection. The crust is the temporary barrier over a wound that has not closed yet. Pulling it off early tears skin that is still knitting together, and the single most common cause of a bad outcome from CO2 laser is a patient who picked. It will itch, sometimes intensely, and it will look like it is ready to come off before it is. Keep it greasy, since ointment reduces the itch, and let every piece fall off on its own. If the itching becomes unbearable, call us instead of touching it.

Absolute. Zero direct sun exposure while you are healing, and rigorous protection for months afterward. New skin after ablative resurfacing has almost no defence against UV, and sun exposure on it causes post-inflammatory hyperpigmentation: brown patches that are harder to fix than whatever you came in to treat, and that can be permanent.

In practice: stay indoors and away from windows in the early days, then broad-spectrum SPF 50 every day once the skin has closed and we have cleared you to apply it, reapplied through the day, with a wide-brimmed hat on top. This holds on cloudy days and in winter. It also means no beach holiday, no ski trip, and no tanning for the period we specify. If you have a sun holiday booked, tell us at the consultation and we will schedule around it.

It depends entirely on what is being treated and how deep we can safely go. Deep acne scarring and stretch marks generally need a series spaced several weeks to a few months apart. Some resurfacing goals are met in a single deeper session. The doctor will give you a realistic number at the consultation, and it will be a range rather than a promise, because the plan is adjusted based on how your skin responds to the first treatment.

Pregnancy and breastfeeding, active infection or a cold sore outbreak in the area, and recent isotretinoin use all rule it out for now. A history of keloid or hypertrophic scarring is a serious concern, because the treatment creates a controlled wound. Deeper skin tones carry a genuine risk of post-inflammatory hyperpigmentation and need either a modified conservative approach with pre-treatment or a different treatment altogether. Conditions and medications that impair wound healing get assessed case by case. The medical director makes this call at the consultation.

No, not while the skin is open, oozing, or crusting. Applying makeup to a healing ablative wound invites infection and interferes with the barrier you are trying to rebuild. Most people can start using a gentle mineral makeup to cover residual pinkness once the peeling has finished and we have cleared you, usually somewhere around day 7 to 10. Wait for us to say so.

Not immediately, and not at the point the redness fades. Once the peeling finishes you will see brighter, smoother skin, but that is early. Collagen remodelling runs for three to six months after treatment, and scar and texture improvement keeps accumulating across that whole period. Judging the outcome at two weeks is the most common mistake people make. We take photographs at each visit so you can see the change against where you started.

Both have defined roles. Our medical director, Dr. Danielle Eiböck, conducts the consultation, assesses your skin and medical history, decides whether you are a candidate, writes the prescription and treatment parameters, and provides medical oversight for your course of treatment. The CO2RE laser sessions themselves are performed by our fully trained, specialized cosmetic nurse, who works to the plan the doctor has set. You will meet the doctor at consultation and see the nurse for your treatments.