In short. CO2 resurfacing improves the texture of sun-damaged skin and lightens surface pigment on the treated area, but it does not erase lines etched into the skin or restore volume. It softens rather than removes lines around the mouth and beneath the eyes, and it is not a lift. The neck, hands and décolletage carry more risk for a smaller return.
Key points
- Resurfacing improves rough, thickened, uneven sun-damaged surface texture.
- Surface freckling and sun spots on the treated area usually lighten considerably.
- Deeper structural lines soften rather than vanish, and volume is not replaced.
- Lines that flatten when the skin is lifted gently may respond to resurfacing.
- The neck, hands and décolletage carry more risk for a smaller return.
Two complaints that respond differently
Sun damage and lines are two different complaints that often arrive together, and resurfacing treats them unequally. Working out which of them is actually bothering you decides whether the treatment is worth the week it costs.
What resurfacing improves on sun-damaged skin
It improves the texture of sun-damaged skin: the rough, thickened surface, the fine crêpey lines, the unevenness that makes light sit badly. It removes surface pigment along with the surface itself, so freckling and sun spots on the treated area usually lighten considerably. Skin looks fresher and reflects light more evenly, and that change is the one most people are actually asking for.
| Area or problem | What resurfacing does | What it does not do | What to plan for |
|---|---|---|---|
| Rough, thickened surface | Improves the texture | Does not change the deeper structure | A real healing week |
| Surface freckling and sun spots | Usually lighten considerably | Does not settle deeper or melasma-type pigment predictably | Among the more reliable improvements |
| Lines etched around the mouth and beneath the eyes | Soften | Do not vanish | A different plan if you need them gone |
| Lines from lost support underneath | No change | Still there afterwards | The surface was never the problem |
| Sagging | No change | Not a lift or a facelift | A different plan |
| Neck | Possible in carefully chosen patients, usually lighter | Higher scarring and pigment risk | Not the same depth as the face |
| Hands and décolletage | Do respond | Slower healing, higher risk for a smaller return | More caution than the face |
What it cannot erase
It does not erase the deeper structural lines, and it does not replace volume. Lines etched into the skin, particularly around the mouth and beneath the eyes, soften rather than vanish. Lines that exist because the face has lost support underneath will still be there afterwards, because the surface was never the problem. Nor does it tighten a face that has sagged: resurfacing is not a lift and not a facelift.
Is the line in the surface or beneath it?
Two questions help before booking. Can you point at what bothers you? And when the skin is lifted gently upwards, does it improve? If the line flattens when the skin is lifted, the surface is part of the problem and resurfacing may help. If it stays, the problem sits deeper than the treatment reaches, and a different plan is the honest one.
Why the neck needs its own decision
The neck skin is thinner, has fewer oil glands, and heals with more risk of scarring and pigment change. It also ages differently from the face, with laxity rather than texture as the main change. Treating face and neck together is possible in carefully chosen patients, but the neck is usually treated more lightly or left alone, and asking for both at the same depth is asking for trouble.
Do the hands and décolletage respond?
The hands show sun damage earlier and more visibly than almost anywhere else, and they do respond to resurfacing, though healing there is slower and movement pulls at the healing skin. The décolletage and the forearms are treated with more caution still. Areas outside the face generally carry a higher risk for a smaller return, which is why many plans stay on the face.
When resurfacing is the wrong plan
Resurfacing is the wrong plan when what bothers you is sagging rather than surface, which resurfacing does not change. It is also the wrong plan when you expect the deep lines around the mouth to be gone rather than softened, or when you want the face and the neck treated at the same depth in the same session.
What the treatment can honestly promise
Resurfacing is good at the surface and honest about its limits. If the surface is what bothers you, it is a reasonable treatment with a real week attached. If what bothers you is shape and support, the appointment should end with a different plan.
Sources
- American Academy of Dermatology: patient information on laser resurfacing and sun-damaged skin
- American Society for Laser Medicine and Surgery: patient information on ablative laser treatment
- Cochrane Library: systematic reviews on laser resurfacing for photoageing
Source links open each organisation's search results for the topic. Document-level confirmation is pending the reviewer's sign-off.
Internal links
Frequently asked questions
Will resurfacing remove sun spots as well as lines?
Surface pigment on the treated area usually lightens considerably, because removing the surface removes the pigment sitting in it. That is one of the more reliable improvements resurfacing produces. Pigment that sits deeper, or pigment that is a melasma-type condition rather than sun damage, responds far less predictably and can darken instead.
Why are the neck and hands a different decision from the face?
The skin is thinner, has fewer oil glands, and heals with more risk of scarring and pigment change. The neck also ages with laxity rather than texture, so resurfacing addresses the wrong problem. Treated at the same depth as the face, these areas carry more risk for a smaller return, which is why many plans treat them lightly or not at all.
Do the lines around the mouth respond to resurfacing?
They soften rather than disappear, and the softening is real. Lines etched into the skin improve because the surface that carried them is replaced. Lines that exist because the face has lost support underneath will still be there afterwards, because the surface was never the problem. The honest test is whether the line flattens when the skin is lifted gently.
Risks & Limitations
- The treated surface is usually open for five to seven days, weeping and crusting, with redness that persists for weeks afterwards.
- Post-inflammatory hyperpigmentation is the commonest unwanted effect; it is more frequent and more stubborn in darker skin and can take months to settle.
- Pigment loss (hypopigmentation) is uncommon but can be permanent, and there is no reliable way to restore pigment that has been lost.
- Infection of open skin, which is why antiviral cover is ordinarily prescribed; increasing pain after the third day, spreading redness or fever needs same-day review.
- Scarring, uncommon but real, and more likely after infection, after treatment that was too deep for the skin, on the neck, and in people with a keloid tendency.
- The improvement is long-lasting but not permanent, and sun exposure after treatment fades it faster than anything else.
When to Seek Care
- Increasing pain after the third day, or one area much hotter and more swollen than the rest of the treated skin.
- Fever, spreading redness, or discharge from the treated area.
- Blistering, dusky or grey patches, or a sore that is not crusting like the rest of the face.
- A cold sore erupting across healing skin, which should be reported the same day.
- Swelling that makes it difficult to see, or any new change in vision, which needs urgent review.
References & Further Reading
- American Society for Laser Medicine and Surgery (ASLMS) — patient information on laser and energy-based treatment
- American Academy of Dermatology (AAD) — guidance on laser resurfacing and post-inflammatory hyperpigmentation
- National Institute for Health and Care Excellence (NICE, UK) — relevant guidance on skin treatments
- Cochrane Library — systematic reviews in skin resurfacing and scar management
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.