Comparison

Moxi vs CO2 Laser

The gentlest resurfacing laser against the most aggressive one. What each is cleared to treat, the honest downtime, and why they are not really alternatives.
Written & medically reviewed by the Dermapedia team
At a Glance

These sit at opposite ends of the same category. Moxi is about as gentle as resurfacing gets. A fractional CO2 laser is about as aggressive as it gets.

The difference is whether the surface is removed. Moxi is non-ablative — it heats columns of tissue under the skin and leaves the surface intact. CO2 is ablative — it vaporises microscopic columns of skin, surface included.

That decides the downtime and the result. Moxi costs you a few days looking sunburnt and sandpapery. CO2 costs you a week or two of real recovery, and does considerably more for deep lines and scarring.

Moxi
Sciton, 1927 nm
Fractional CO2
10,600 nm

What it is

Non-ablative fractional laser

A thulium laser at 1927 nm, absorbed by water very near the surface.

Ablative fractional laser

Vaporises microscopic columns of tissue.

What it is cleared to treat

Soft tissue coagulation, actinic keratosis, and benign pigmented spots

Lentigines, solar lentigines and freckles are named in the clearance.

Resurfacing, including wrinkles and scars
Both
Moxi is widely used for texture and fine lines, but those are not in its FDA clearance. That is off-label, which is legal and normal — it just means the claim was not reviewed.

How deep it reaches

Very shallow — Sciton puts it at roughly 100 to 200 microns

It works in and just under the epidermis.

Into the dermis

Which is why it can remodel scars and deep lines.

Downtime

Redness the first day, then a bronzed, sandpapery texture for a few days

Most people are presentable within a few days.

A week or two, with raw skin, oozing and peeling early on
Both
This is the single biggest practical difference. Do not book CO2 with a social event in the same fortnight.

What it is good at

Brown spots, dullness, early sun damage
Deep wrinkles, acne scarring, significant sun damage

Number of sessions

A series — commonly three or more
Often one, sometimes two
Both
Moxi trades depth for repeatability. CO2 does more in one go and asks more of you.

Risk profile

Low, but not zero

In a retrospective study of 856 non-ablative fractional treatments — mostly at 1550 nm, in Fitzpatrick III–IV skin — about 5% had a side effect and darkening afterwards occurred in about 1%.

Higher, and some of it is permanent

Longer healing means more opportunity for infection and scarring. The complication that defines this treatment is delayed hypopigmentation — patches that are permanently lighter, appearing months afterwards. Prolonged redness lasting weeks to months is also common.

Who tends to be happy with it

Best for
Sun spots and a dull surface, with a life you cannot pause.
The mindset
Gradual, low risk, repeatable.
Best for
Deep lines or scarring where a gentle laser will not move the needle.
The mindset
One serious treatment, real recovery, bigger change.

How to choose

Look at what actually bothers you in the mirror.

Colour — brown spots, freckling, a dull uneven surface. Moxi is built for this, and it is what its clearance names.

Structure — deep lines, indented acne scars, crepey texture. Moxi will soften these a little at best. CO2 is the tool that changes them.

If you are not sure which category your complaint falls into, that is a good question for a consultation rather than a booking.

The risks worth understanding before CO2

Ablative resurfacing is an effective treatment with real complications, and they deserve naming rather than a phrase like "pigment change."

  • Delayed hypopigmentation. Patches of permanently lighter skin that can appear months after treatment. This is the one that cannot be undone.
  • Prolonged redness. Weeks to months, not days.
  • Infection and cold sore reactivation. Antiviral medication before ablative resurfacing is standard practice, not an optional extra — tell your provider if you get cold sores.
  • Scarring, particularly off the face.
  • Recent isotretinoin is a question your provider should ask you about before booking.

None of this is a reason to avoid CO2 where it is the right tool. It is a reason to have the conversation properly.

About skin tone

Any laser that heats pigment can also provoke pigment. In deeper skin tones, the risk of darkening after treatment is higher, and it rises with how aggressive the treatment is.

That is not a reason to rule either out. It is a reason to see someone who treats your skin tone often, and to ask directly what settings and what pre-treatment they use.

Before you book

If you get cold sores, tell your provider. Both treatments can reactivate the virus, and before ablative resurfacing in particular, antiviral medication started in advance is standard.

Call your provider if

  • Skin is still weeping or crusting beyond what you were told to expect
  • Pain, redness or swelling increases after day three instead of settling
  • You get a cluster of small painful blisters — a cold sore flare can be triggered by either, and needs treating quickly
Questions people ask+
Is Moxi as good as a CO2 laser?For brown spots and surface dullness, it does that job with far less downtime. For deep wrinkles and indented acne scars, it is not in the same class — CO2 reaches the dermis and Moxi does not.
How much downtime does each need?Moxi is redness on day one and a bronzed, sandpapery texture for a few days. Fractional CO2 is typically a week or two, with raw skin and peeling early on.
Can Moxi replace a CO2 laser?Not for structural problems. Several Moxi sessions do not add up to one CO2 treatment, because they act at different depths.
Which is safer?Moxi, straightforwardly. Its risks are lower because it leaves the skin surface intact. In a large series of non-ablative fractional treatments about 5% had any side effect, with darkening afterwards in about 1%.
Is Moxi FDA-cleared for wrinkles?No. Its clearance covers soft tissue coagulation, actinic keratosis and benign pigmented spots. Treating texture and fine lines with it is off-label — common and legal, but not a reviewed claim.
Which is better for acne scars?Fractional CO2, by some distance. Scarring is a dermal problem and Moxi works above that level.
How many sessions?Moxi is usually a series of three or more. CO2 is often a single treatment.