Crepe skin on neck - will intense C02 laser help or will I need a neck lift? (Photo)

Hello, my name is Ranen and I am an aesthetic nurse here at Shah facial plastics. You’re asking a really thoughtful and important question — and you’re not alone. Treating crepey or lax neck skin can be challenging, especially when non-surgical treatments haven’t made a noticeable difference. Radiofrequency microneedling (Morpheus8, etc.) and non-ablative Fraxel primarily stimulate collagen remodeling, but their impact is modest — especially on the neck, where: Skin is thin and less sebaceous (so it heals with less collagen response), There’s often true laxity (loose skin and platysmal banding) rather than fine textural change, Collagen and elastin reserves are already lower at midlife. After multiple sessions without improvement, it’s likely that your issue is more structural (skin laxity and thinning) rather than just superficial texture. In summary CO₂ laser: May slightly improve texture, but limited tightening and higher risk on the neck. Neck lift: The most effective and predictable solution if laxity is significant. Combination approaches: Often yield best results if you’re not ready for surgery.

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Neogen Plasma would be a great option for treating the concerns on your neck. This uses a combination of nitrous gas and radio frequency energy to stimulate collagen production to tighten and plump the skin. With Neogen Plasma there is little to no pain or downtime! Results can take 6-8 months to show optimal results leading in a more natural outcome. Neogen differs from other treatments like CO2 as there is no major damage to the epidermis!

For advanced crepey skin on the neck, CO₂ laser treatments rarely deliver noticeable improvement. A surgical neck lift is generally the only option that provides significant tightening and long-lasting results.