Objective To explore the application effect of recombinant collagen skin repair solution in wound repair after carbon dioxide fractional laser surgery and its improvement effect on pigmentation. Methods A total of 126 patients who underwent carbon dioxide fractional laser surgery in our hospital from June 2022 to June 2023 were randomly divided into observation group and control group, with 63 patients in each group. The control group was treated with routine repair, and the observation group was treated with recombinant collagen skin repair solution after operation. The acute inflammatory response, pain (VAS), wound healing time, VISIA skin image and incidence of adverse reactions were compared between the two groups. Results The erythema burning sensation scores of the observation group at 0.5 h and 1 d after operation were lower than those of the control group (P <0.05). The wound healing time of the observation group was shorter than that of the control group (P <0.05). The VAS score of the observation group at 0.5 h, 1 d and 3 d after operation was lower than that of the control group (P <0.05). The erythema, brown spots and texture scores of VISIA skin images in the two groups at 1 month after operation were lower than those before operation (P <0.05), and those in the observation group were lower than those in the control group (P <0.05). The incidence of adverse reactions in the observation group was 4.76%, which was lower than 15.87% in the control group (P <0.05). Conclusion Recombinant collagen skin repair solution can effectively promote the wound repair of patients after carbon dioxide fractional laser surgery and reduce the occurrence of pigmentation.