How to repair micro pin holes all over face from laser (orange peel texture)? (photo)

I do not use the Emerge laser in my practice, so I cannot comment on it, but it is normal to have some irregularities of the skin and visible pinpoint holes after most fractional laser resurfacing treatments. Over time, these usually fade and the skin surface becomes smooth as it heals. Be sure to discuss any specific post-laser concerns with the doctor who performed the treatment. All the best,

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of acne scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic acne scars and indented acne scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Fractional lasers drill columns of holes into the skin which allows a higher depth of ablation with less healing time since there is live tissue around the holes.  I would suggest to always follow up at the location where you received treatment for a timeline of healing.  Patients can initially see the columns of holes post treatment which will heal and fade over time. 

Emerge is a
non-ablative fractional laser which is used for skin rejuvenation and has shown
to have some effects on melasma. The fact that you are having this skin
reaction is quite unusual and I would recommend that you go back to the person
that treated you and see what they recommend you do now. I always recommend
that these procedures be performed under the auspices of a board-certified
dermatologist or plastic surgeon as we can best determine how to handle any
untoward events, even the one that you are showing now.



When we do these
kinds of procedure we always recommend a very good skin care routine – and in
your case one that also treats the melasma as well. So we hope that you are on
a good skin care routine as well.



From the picture,
this will probably resolve over time, but with skin care, this should not be a
major issue.

I don't know when you had this procedure so this is sort of hard to answer. The tiny holes are from the pins where the energy is exerted under the skin. The holes will resolve themselves with time. "This answer has been solicited without seeing this patient and cannot
be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."