Skin tightening and your age.

I've had Smartskin Co2 Fractional laser around 3 yrs ago. I am contemplating having again for light lines around mouth & eyes and tightening of skin. I this laser the best for this type of outcome? I will be doing my face & neck. The "tightening" is the most desired--I can probably get the desired result with fillers/botox otherwise.

You didn’t mention your age. 🙂  I’m mentioning that because for tightening the device is trying to tighten existing collagen and elastic fibers and then…help you build new collagen and elastic fibers.  Here’s some of what we do know:

  • The thicker your dermis to start with the more tightening because you have more collagen and elastin as a base.
  • Older patients – over 60 – tend to have less response for this reason.  Younger patients tend to have a better response.
  • Radiofrequency devices and CO2 lasers (you want fractional ablative)  so far are best for tightening….the problem is which one do you choose!

There are 3 things happening in the skin tightening world right now:

  1. We are learning more about which types of tightening devices work best for which patients, but still don’t know a lot.
  2. The demand for non surgical tightening to prevent and reverse signs of aging is really increasing
  3. There are more confusing options than ever for consumers

The device companies that make these devices don’t want to test them against any of the ones in existence……..because what if the study didn’t show any real benefit?   So they don’t do what would be called “split face” studies (one side with their device/one side with another device) and they don’t generally do “observer blinded” studies, where a dermatologist usually is given before and after photos to look at without knowing which is which.

Bottom line (my opinion):

  • If you are under 50 or have thicker skin, try Thermage full face (and possibly eyelids) first because it has the most data and is the most comfortable.  The provider doing it should know how to “vector.”  (I have no financial interest in Thermage!)
  • If you are over 50, have great skin and a thicker dermis consider the above as well.
  • If you are over 50, or have a lot of sun damage or wrinkles, consider full face fractional, ablative CO2 because you can address both problems at once.  You need deeper settings to get the tightening, so plan on 5-7 days off, or whatever your doctor advises.
  • Keep a close eye on the developments with Profound. More on this here in the fall.  It’s basically “radiofrequency 2.0.”
Hope this helps,
Dr. I
Founder, SkinTour
Director, Madison Skin & Laser Center
Follow my skin tips and travels on Instagram!


Dr. Brandith Irwin, MD

Ask me your skincare question!

Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

  • All our content is written and researched by myself.
  • My medical office in Seattle has treated thousands of patients for 15+ years.
  • This site is not affiliated or financially tied to any product, treatment or device.
Ask Me Something
SkinTour Skincare
One of the best investments in your skin is your daily skincare. Why? Because you can prevent many problems with blotchy skin color, lack of glow, texture, some types of acne, and fine lines with good skincare products. You can also correct some of these problems with effective skincare products. Great skincare is often more expensive because quality ingredients are expensive. Some companies spend on research/development which benefits all of us and adds to the cost. Are they worth it? In general - yes! I have handpicked some of what I consider to be the best skin care products, and offer them for sale on SkinTour's shop. This is based on my team and I's testing and research at our clinic. Many of the products are in my own regimen. What could be better than using skin care products a dermatologist uses?!