Laser resurfacing (CO2, Fraxel, MOXI): what it does, what it costs and what to ask before you book
Laser resurfacing treats what skincare and injectables cannot reach: texture, etched lines, sun damage and scars. Dr Leah’s view is that the right laser is the one whose likely benefit justifies its cost, risk and downtime for that patient, which is rarely the most aggressive option.
In The Ageless Blueprint, Dr Leah rates fractional CO₂, iPixel, Fraxel DUAL and MOXI with BBL out of 10, explains how Dr Leah chooses between them, and works through the three most common disappointments. This page gives the facts you need before a laser consultation.What laser resurfacing is
Laser resurfacing uses light energy to wound the skin in a controlled way so that it heals smoother, with some collagen remodelling. Most modern devices are fractional: they treat many tiny columns of skin and leave untreated skin between them to help healing. Ablative lasers, such as fractional CO₂ and the Er:YAG laser used in Alma’s iPixel at 2940 nm, remove microscopic areas of the surface. Non-ablative lasers, such as the Fraxel DUAL (1550 nm and 1927 nm) and Sciton’s MOXI (1927 nm), heat tissue without deliberately removing the surface.
Neither fractional nor non-ablative means no downtime. Energy, density, number of passes and the area treated all change the recovery. Resurfacing is also different from lifting: it smooths skin and softens scars but cannot replace a facelift or remove a jowl, and deep acne scars may also need subcision or a combined plan.
Generally used for
- Uneven texture, etched or static lines and sun-damaged skin
- Selected acne and surgical scars
- Early photodamage, uneven tone and skin-quality maintenance, often as a course of MOXI with BBL
What the guide covers that this page does not
- Dr Leah’s rating out of 10 for fractional CO₂, iPixel, Fraxel DUAL and MOXI with BBL, and why they differ
- The concern Dr Leah matches to each laser, and the factors that change that starting point
- Which device Dr Leah has found more effective for scars in clinic, and how its settings are varied across one face
- What Dr Leah does when a treatment did very little, or when skin stays red or brown for longer than expected
What to expect
| Results | Smoother texture, softer lines and less visible scars, developing as the skin heals and remodels over weeks to months. Ablative CO₂ offers the largest potential change; iPixel, Fraxel DUAL and MOXI usually work as a course with more gradual results. |
|---|---|
| How long it lasts | Resurfacing changes the skin surface rather than stopping ageing. Static lines around the mouth often need a course of around six iPixel sessions, and a MOXI with BBL course is typically repeated for maintenance. |
| Appointment and downtime | Intensive CO₂: a hot, swollen, red face, then peeling or crusting, with around a week or longer before the skin is socially presentable. iPixel and Fraxel DUAL: redness, swelling and a rough, bronzed or peeling appearance for several days. MOXI with BBL: lighter but still visible recovery, with redness, swelling and a gritty texture for several days. |
| What can go wrong | Infection, cold-sore reactivation, prolonged redness, post-inflammatory pigmentation change and, rarely, scarring or lasting loss of pigment. Risk rises with intensity and with skin prone to pigmentation. Worsening pain, spreading redness, pus, fever, blisters or a new cold sore need prompt assessment. |
| Cost | Fractional CO₂ full face £750 to £1,650 per session. Fraxel full face including the eyes £900 to £1,800 per session. iPixel £600 to £1,500 for a course of three and £1,200 to £3,000 for a course of six. MOXI £400 to £800 per session; BBL with MOXI £800 to £1,500 for the face and £1,200 to £2,000 for face, neck and décolletage. |
Five things to ask before you book
- What change would you expect in my specific concern after one treatment, how many sessions might I need, and what will I look like on days two, five and ten?
- Which wavelength and what intensity are you proposing, and is this a gentle pass or full resurfacing?
- Can I see photographs of patients with my skin type treated with this device and these settings, taken in similar lighting at the same stage of healing?
- I have had cold sores before: will you prescribe antiviral prevention, and what happens if one appears after treatment?
- If my main concern turns out to be sagging or volume loss rather than texture, would you tell me a laser is the wrong starting point?
Dr Leah’s verdict is in the guide
Chapter 17 of The Ageless Blueprint rates fractional CO₂, iPixel, Fraxel DUAL and MOXI with BBL out of 10, weighing results against downtime, cost and risk, and explains why a higher score does not make a device the better choice for a given patient. It sets out how Dr Leah chooses between the four, a table of typical UK and clinic prices, and what Dr Leah does when a laser treatment disappoints. Six pages, with illustrations.
This page gives general information and does not replace a consultation with a qualified practitioner who can assess your face, skin and medical history. Prices are typical UK ranges, accurate as of September 2026, and vary between clinics. For adults aged 18 and over.
Common questions
A fractional laser treats many tiny columns of skin and leaves untreated skin between them, which speeds healing. Ablative lasers such as CO₂ and Er:YAG remove microscopic areas of the surface; non-ablative lasers such as Fraxel DUAL and MOXI heat the tissue without removing it.
Expect a hot, swollen, red face followed by peeling or crusting. A more intensive treatment may need around a week or longer before the skin looks socially presentable, and pinkness can persist beyond that. Recovery varies too much to promise a fixed number of days.
Fractional CO₂ is ablative and can give a more substantial change in selected scars; Fraxel DUAL is non-ablative and its scar improvement can be subtler. Which Dr Leah uses for scars, and why, is in the guide.