What should you know about CO2 laser for atrophic scars?

Atrophic scars are depressions caused by loss or disruption of supportive tissue. They can follow inflammatory conditions such as [Acne](/conditions/acne/) or [Chickenpox](/conditions/chickenpox/). CO2 laser creates controlled injury in selected skin layers, encouraging repair and collagen remodelling that may make uneven texture less noticeable.

Laser cannot recreate every missing layer, and scars differ: rolling scars may be pulled down by fibrous bands, boxcar scars have broader edges, and ice-pick scars are narrow and deep. A clinician may consider [Subcision](/treatments/surgical-dermatology/subcision/), [Microneedling](/treatments/aesthetic-procedures/microneedling/) or [Dermal Fillers](/treatments/injectables/dermal-fillers/) depending on the structure.

Have active acne, eczema or infection assessed before resurfacing. Discuss skin tone, previous darkening after procedures, cold sores, raised-scar history and medicines. Ask whether [Acne Scar Laser Treatment](/treatments/laser-and-energy/acne-scar-laser-treatment/) or a staged combination is appropriate. During recovery, cleanse as instructed, do not pick crusts, protect the skin from sunlight and wait for the barrier to recover before restarting irritating products.

Contact the clinic for worsening pain, spreading redness, pus, fever, new blisters or swelling that continues to increase. Report a persistent or sharply worsening colour change, especially if it follows significant irritation. Emergency care is appropriate for breathing difficulty, facial swelling or a severe allergic reaction.

What scar types do I have, and which one will the laser target? Is any scar tethered or too deep for laser alone? Would subcision, microneedling or filler be more suitable for part of the pattern? What aftercare reduces irritation and pigment change?