CoolPeel vs Full CO2 Resurfacing Which Is Right for You?
Both run on the same laser at our doctor-led clinic in Newstead, Brisbane. One stays at the surface and heals in a few days. The other goes deeper and takes a fortnight. Here is how to tell which one your skin actually needs.
- Choose CoolPeel if the problem is the surface of your skin: rough texture, dullness, pores, fine lines. A few days of recovery, repeated as a short course.
- Choose full fractional CO2 if the problem sits deeper: set-in wrinkles, or acne scarring with real depth. One treatment, about two weeks of recovery.
- Deeper is not better. It is just deeper, and it costs you more healing time.
- Your skin type and the Brisbane sun can change the answer. Individual results vary.
The only difference that matters
Both treatments use the same CO2 laser, in the same room, at our Newstead clinic in Brisbane. The one thing that changes is how long each pulse lasts.
A very short pulse lifts a thin layer of surface skin before heat has time to spread sideways. That setting is CoolPeel. A longer pulse reaches deeper and leaves warmth around each treated point. That is full fractional CO2.3
Short pulse, shallow, quick recovery. Longer pulse, deeper, longer recovery. Everything else follows from that one choice.
What sits in each layer
Broadly, CoolPeel works at the shallow end and full fractional CO2 reaches further into the dermis. Neither is fixed to a layer, though. Depth shifts with the energy, the pulse length and the number of passes, and it is chosen for your skin on the day.
Depth is also only half of it. A short pulse leaves almost no heat behind. A longer pulse leaves a rim of heated tissue around each treated point. Laboratory work on skin samples shows that varying the energy delivered changes the size of both the ablated core and that heated rim, and that the repair response it sets off is still active three months later.2
How far each one reaches
CoolPeel is probably right for you if
- Your skin looks rough, dull or tired rather than lined
- Pores look larger than they used to
- You have fine surface lines, not set-in wrinkles
- You have light acne marks or early textural scarring
- You cannot take a fortnight away from work or from people
CoolPeel is planned as a short course: usually three or four sessions about four weeks apart, then maintenance once or twice a year. The improvement builds up rather than arriving all at once.
Full fractional CO2 is probably right for you if
- Wrinkles are set in, particularly around the mouth and eyes
- Acne scarring has real depth to it
- There is heavy sun damage across the face, neck or décolletage
- Skin has thinned and feels crepey, with mild laxity
- You can plan around two weeks of visible healing and months of careful sun protection
Full fractional CO2 is done as a whole-face treatment. Resurfaced skin changes in tone and texture, so treating one patch leaves a visible line where it meets untreated skin. Skin biopsies taken after this kind of treatment show remodelling still under way at three months.2 Because it is a bigger commitment, we plan it around your calendar and around the Brisbane sun.
The risks are larger too: patchy darkening of the skin afterwards, infection, redness that lingers, and, less commonly, scarring or pale patches that do not recover (hypopigmentation).56 These are discussed in full before anything is booked, and our Risks & Complications page sets them out.
Side by side
| CoolPeel | Full fractional CO2 | |
|---|---|---|
| How deep | Mostly the surface layer | Into the dermis, depending on settings |
| Heat left behind | Very little | A controlled amount, by design |
| Time off | About 3–5 days: redness, then light flaking | 7–14 days, then weeks of pinkness |
| How many | 3–4 sessions, 4 weeks apart | 1 treatment, occasionally 2 |
| Area treated | Face, or one defined area | Whole face, to avoid a visible line |
| Best for | Texture, dullness, pores, fine lines | Set-in wrinkles, deeper scarring, sun damage |
| Risk | Lower | Higher, and needs careful selection |
Depth, recovery and results vary with the settings used, your skin type and your assessment at our Newstead clinic. Individual results vary.
What the week actually looks like
After CoolPeel
- Days 0–1: warm and red, like mild sunburn.
- Days 2–4: a fine sandpaper texture forms, then flakes away.
- Days 3–5: most people are comfortable in makeup and back to normal.
Most patients travelling in from around Brisbane book a CoolPeel on a Thursday or Friday and are presentable by Monday. These timings come from manufacturer material and our own experience in Newstead rather than from independent trials.
After full fractional CO2
- Days 0–3: swollen, weeping and hot. Careful aftercare is essential.
- Days 3–7: crusting and dark micro-dots as the treated points lift.
- Days 7–14: new skin appears, bright pink and fragile.
- Weeks 3–12: redness fades. Makeup is usually fine from about week two.
- Month 3 onwards: remodelling continues under the surface and the result settles.
These timings reflect what is reported in published series of deep fractional CO2 treatment and our own practice. Recovery differs from person to person and with the settings used.6
Three things that change the answer
1. Your skin type. Deeper resurfacing causes inflammation, and in naturally darker skin that can trigger patchy darkening in the weeks afterwards (post-inflammatory hyperpigmentation).57 Brisbane is a diverse city and this matters here. For some patients the better answer is a gentler device such as Laser Genesis or Clear + Brilliant.
2. The Brisbane sun. Ultraviolet levels stay high across most of the Brisbane year, and freshly resurfaced skin has no barrier left to protect it. Many patients choose the cooler months for the deeper treatment. Daily sun protection is part of the treatment either way.
3. What you actually want changed. Neither treatment lifts sagging skin, replaces lost volume, or fixes melasma, where heat can make things worse. If that is your main concern, resurfacing is the wrong tool and we will tell you so.
What the evidence really shows
The technique is well supported. Treating skin in narrow columns was first described in 2004,1 and laboratory work then showed the pattern of injury this produces and how long the repair response lasts.2 In a small pilot study of sun-damaged faces, a blinded doctor scored the overall result about 60 per cent improved three months after one treatment, though wrinkles alone scored closer to 50 per cent.4 That is one study of a few dozen people, not a settled figure.
Brand names are a different matter. CoolPeel is a trade name for one short-pulse setting, not a separate technology, and the published evidence for that setting specifically is thin. A 2024 split-face study of twelve women, co-written by employees of the platform's manufacturer, was retracted by the journal in January 2026. The journal gave two reasons: the peer review it received did not meet the journal's own standards, and the research had not been put to an ethics committee before it began.8
None of that means the setting does not work. It means the evidence for fractional CO2 as a technique is strong, and the evidence for this particular branded setting is not yet there.
How we decide with you
It comes down to three things: how deep your concern sits, how much recovery you can realistically take, and how your skin behaves when it is inflamed. At our Newstead clinic in Brisbane we work that out with a full skin history and VISIA imaging, which shows texture, pigment and the sun damage that is not yet visible in a mirror.
Often the real question is sequence. A course of CoolPeel first, with full fractional CO2 planned later once your skin is prepared and the timing suits you. Our Newstead rooms sit just north of the Brisbane CBD and are easy to reach from across Brisbane's inner north.
References & Important Information
- Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers in Surgery and Medicine. 2004;34(5):426–438. PMID 15216537
- Hantash BM, Bedi VP, Kapadia B, et al. In vivo histological evaluation of a novel ablative fractional resurfacing device. Lasers in Surgery and Medicine. 2007;39(2):96–107. PMID 17311274
- Alexiades-Armenakas MR, Dover JS, Arndt KA. The spectrum of laser skin resurfacing: nonablative, fractional, and ablative laser resurfacing. Journal of the American Academy of Dermatology. 2008;58(5):719–737. PMID 18423256
- Tierney EP, Hanke CW, Petersen J, et al. Clinical and echographic analysis of ablative fractionated carbon dioxide laser in the treatment of photodamaged facial skin. Pilot study; blinded assessment at three months. Dermatologic Surgery. 2010;36(12):2009–2021. PMID 21040129
- Metelitsa AI, Alster TS. Fractionated laser skin resurfacing treatment complications: a review. Dermatologic Surgery. 2010;36(3):299–306. PMID 20100273
- Shamsaldeen O, Peterson JD, Goldman MP. The adverse events of deep fractional CO2: a retrospective study of 490 treatments in 374 patients. Lasers in Surgery and Medicine. 2011;43(6):453–456.
- Manuskiatti W, Triwongwaranat D, Varothai S, Eimpunth S, Wanitphakdeedecha R. Efficacy and safety of a carbon dioxide ablative fractional resurfacing device for treatment of atrophic acne scars in Asians. Journal of the American Academy of Dermatology. 2010;63(2):274–283.
- Piccolo D, Zingoni T, Fusco I, Madeddu F, Conforti C. A faster CO2 fractional scanner system mode for skin rejuvenation. A clinical study. Skin Research and Technology. 2024;30(8):e13843. PMID 39164795. Retracted. Retraction notice, Skin Research and Technology, 10 January 2026 (doi:10.1111/srt.70318). The journal states the article was accepted after a peer review process that did not meet its standards, and that the research protocol was not submitted to an ethics committee before the study began. Listed here only to record its withdrawal.
- Australian Health Practitioner Regulation Agency and Medical Board of Australia. Guidelines for registered medical practitioners who perform cosmetic surgery and procedures.
This article is general information only and is not a substitute for individual medical advice. It does not take account of your health history, your skin type or your circumstances, and nothing here should be read as a recommendation that a particular treatment is suitable for you. It is written for readers aged 18 years and over.
All medical and cosmetic procedures carry risks. Outcomes depend on your anatomy, your skin type, the settings used and how your skin heals. Individual results vary, and no outcome is guaranteed. A consultation with a qualified health practitioner is required before any treatment, so the benefits, risks and alternatives can be discussed in relation to you.
About the author. Dr Fatemeh Asadi MD, FRACGP is a GP and Cosmetic Physician and the founder of Body Dezign House in Newstead, Brisbane. She has two decades in cosmetic medicine and general practice, and is a Key Opinion Leader for Merz Aesthetics and an Official Trainer for Aptos Threads. AHPRA registration MED0000975343. Last reviewed 31 July 2026.
Read more about Risks & Complications, or book a consultation at our Newstead clinic in Brisbane.
Still Not Sure
Which One?
Book a time with Dr Asadi or her team at our Newstead clinic in Brisbane. You will leave knowing which layer your concern sits in and what it would take to change it. Individual results vary.