Best facial rejuvenation procedure to address my aging skin texture, pigment and laxity? (Photo)

Greeting and thanks for your information.to improve Sagging, Texture and pigmentation we provide a combination treatment in our clinic that works great.to address different layer of your skin ,you can combine RF Microneedling with Fractional laser(not necessarily CO2 laser/NeuvaDerm laser does the same effect without being too aggressive or having that long downtime).If you consider Agnes RF Microneedling, It provides a beautiful lower face lift with no downtime.

Most chemical peels remove the top layers of skin through exfoliation. Although this may initially thin the skin, the goal is to stimulate new skin with denser collagen to form. Deep chemical peels and lasers tend to give you more collagen-rich skin that is healthier and more youthful.
The amount of skin recovery really depends on the depth of your chemical peel. Light chemical peels have little to no downtime, whereas deeper chemical peels may penetrate the dermis and cause 7-10 days of skin recovery and peeling. During the initial dryness and peeling stage, your skin may become noticeably darker as the pigment is driven towards the surface of your skin. Redness, skin tightness, mild discomfort, and itching are all normal elements of recovery. We encourage patients to use a lightening SPF sunscreen during the day. It is advisable to avoid direct sunlight and picking of any dried or peeling skin.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for sharing your photo and concerns. At 67, it’s understandable to want effective results without going through a very aggressive procedure like a full CO2 laser again.

There are several options that can help improve skin texture, pigmentation, and laxity with less downtime:

Fractional or non-ablative lasers: These can stimulate collagen, improve pigmentation, and refine texture, but are gentler than full CO2 resurfacing. Multiple sessions are usually needed for optimal results.

Microneedling with radiofrequency: This is great for improving skin firmness and texture while promoting collagen production, with moderate recovery time.

Chemical peels: Medium-depth peels can help with pigmentation and surface texture, but may need to be repeated for cumulative results.

Injectables or threads: Dermal fillers and PDO threads can help lift and restore volume, complementing the skin’s texture improvements.

Topical and maintenance therapies: Prescription-strength retinoids, antioxidants, and pigment-targeting treatments can help maintain results long-term.

For someone looking to avoid very aggressive resurfacing, a combination approach of gentle lasers, microneedling RF, and targeted skincare usually gives the best balance of safety, efficacy, and recovery time.

The good news is that even with gentler treatments, we can see noticeable improvements in texture, pigmentation, and skin laxity, and layering these approaches over time often yields results that feel both natural and refreshed.

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. At age 67, if you’re looking to improve skin texture, pigmentation, and mild laxity without the downtime and intensity of another CO₂ laser, a Pico laser treatment—such as PicoSure or PicoWay—can be an excellent option. Pico lasers use ultra-short pulses of energy to target pigmentation, stimulate collagen, and refine skin texture with minimal heat, which means less discomfort and recovery time compared to ablative lasers. They effectively fade sun spots, age spots, and uneven tone while improving overall skin smoothness and brightness. Although Pico lasers don’t tighten skin as aggressively as CO₂ resurfacing, they do promote gradual collagen remodeling, which can subtly improve firmness and fine lines over time. For best results, a series of sessions is usually recommended, and combining Pico treatments with complementary noninvasive tightening options (like radiofrequency or ultrasound-based therapies) can further enhance lift and contour. This combination approach gives you rejuvenated, more even-toned skin with less downtime and a more natural recovery process. I hope this helps!

A treatment series of superficial peels, either high concentrations of glycolic or salicylic acid or Jessner's Solution, have been used for decades with a proven history of safety and efficacy for improving the quality of aging skin and addressing pigmentary problems. A series of between two to six treatment sessions are usually required to achieve optimal results and these peels typically engender little to no significant downtime. I have personally been performing these peels for issues such a as yours for over thirty years with gratifying results.
You would be wise to consult with an experienced, board certified cosmetic dermatologist and best of luck.