Objective To compare the effects of CO2 laser and high frequency plasma low-power micro-ablation for the treatment of facial seborrheic keratosis. Methods From January 2022 to December 2023, 46 patients with facial seborrheic keratosis admitted to the Third People's Hospital of Danyang were collected. According to different treatment methods, they were divided into high frequency plasma group (20 patients) and CO2 laser group (26 patients). The CO2 laser group was treated with continuous CO2 laser, and the high frequency plasma group was treated with high frequency plasma low-power micro-ablation. The skin lesion elimination, trauma, skin lesion repair time, pigmentation time, adverse reactions and satisfaction were compared between the two groups. Results The skin lesion elimination rate in the CO2 laser group was 100.00%, which was higher than 85.00% in the high frequency plasma group (P <0.05). The bleeding score in the CO2 laser group was lower than that in the high frequency plasma group (P <0.05). There was no statistically significant difference in the skin lesion score, skin lesion repair, pigmentation time, scar incidence rate, pigmentation rate and satisfaction between the two groups (P >0.05). Conclusion In the treatment of seborrheic keratosis, continuous CO2 laser micro-ablation is superior to high-frequency plasma in terms of skin lesion elimination and bleeding reduction.