I am 71 years old. Is laser resurfacing my only option for decreasing facial lines and dark spots long term?

Question

71 year old woman in pretty good shape - my face looks older than my body I have dry skin that noticeably improves with drinking a lot of water but declines daily- I eat greens and protein - walk daily but the skin on my face seems not to improve with creams I have linescaround my lope crows feet and lines on my cheeks from sleeping . At 49 I had a hysterectomy and have not been offered estrogen therapy due to family hostility of breast cancer Sculptura did not work on me a year later so I’m considering laser therapy - people tell me I am old and should just accept that sculpture is very expensive so I can’t keep adding vials my skin is fair even though I’m Italian Botox works but lasts a short time any advice?

Anna Chacon, MD, FAAD · Answer

First, I want to say—you’re clearly taking thoughtful care of your health, and it shows. It can feel discouraging when your skin doesn’t seem to reflect how vibrant you feel, but there are multiple effective options beyond just “accepting it” or relying on a single treatment.

Laser resurfacing is a powerful tool, but it’s not your only option, and in many cases, the best results come from combining approaches in a way that fits your skin, lifestyle, and comfort level.

1. Why Your Skin Is Changing

At this stage, several factors are contributing:

Natural collagen loss and slower skin renewal
Dryness, which makes lines look deeper (you’ve already noticed how hydration helps)
Hormonal changes after hysterectomy, which can affect skin thickness and elasticity
Sun exposure over time, contributing to dark spots and texture

These are all very common—and importantly, they are treatable to a degree.

2. Laser Resurfacing – Helpful, But Not the Only Path

Laser treatments can improve:

Fine lines
Sun spots
Skin texture

However, they can be intense, require downtime, and results still depend on maintaining skin health afterward. Think of laser as a reset button, not a standalone long-term solution.

3. Alternatives and Complements to Laser

If you’re looking for improvement without jumping straight into aggressive resurfacing, here are meaningful options:

• Medical-Grade Skincare (Foundation Matters)
At this stage, creams can help—but they need to be the right ones:

Retinoids (gentle, well-tolerated forms) to stimulate collagen
Vitamin C for brightness and pigmentation
Rich moisturizers with ceramides for dryness

Dry skin alone can exaggerate wrinkles significantly, so strengthening your skin barrier is key.

• Light-Based or Gentle Energy Treatments

IPL (for dark spots and redness)
Non-ablative lasers or radiofrequency (for gradual tightening)
These have less downtime and build improvement over time.

• Neuromodulators (like Botox)
You mentioned Botox works but doesn’t last long—this is not uncommon. Adjusting dose, placement, or frequency can sometimes improve longevity.

• Biostimulatory Treatments (Alternatives to Sculptra)
Even though Sculptra didn’t meet your expectations, other collagen-stimulating approaches (including microneedling or different injectables) may still be helpful in a more tailored way.

4. A Thoughtful, Realistic Approach

You do not need to choose between “doing nothing” and “doing everything.” A very effective approach often looks like:

Consistent, targeted skincare
Periodic maintenance treatments (light-based or injectable)
Optional laser resurfacing if you want a more noticeable reset
5. A Personal Note

I want to gently push back on something you were told—you don’t have to simply accept changes if they bother you. Aging is natural, but wanting to feel more comfortable and confident in your skin is just as valid. The goal isn’t to look 30 again—it’s to look like the best version of yourself at 71.

Bottom Line laser resurfacing can be helpful, but it’s not your only long-term solution. With the right combination of treatments and skin support, you can absolutely improve lines, texture, and pigmentation in a way that feels natural and sustainable.

Lawrence Kass, MD · Answer

I agree that facial resurfacing is your single best option. But it is a little known fact that in my opinion chemical resurfacing (see "Hetter Peel" is vastly more effective and infinitely safer than deep ablative lasers. I think that this non incisional procedure would give you the results you are seeking. Good luck!

I am 71 years old. Is laser resurfacing my only option for decreasing facial lines and dark spots long term?

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