What's Best for Large Pores, Obagi Nu Derm or Laser Resurfacing?

Certain topicals such as glycolic acid (which is the #4 or Exfoderm Forte in the Obagi NuDerm sysmte) or retin-A can help with pores.  By cleaning out the pores they do make them look smaller.  However, this is not as noticeable as the effects of laser resurfacing.  If you want to start out conservatively, the Obagi system is a wonderful choice.  The next step might be to do microdermabrasion or glycolic peels (a light chemical peel).  If those are not satisfactory, you might want to then consider laser resurfacing.  There are many different resurfacing options ranging from minimally invasive to highly invasive.  CO2 is the most invasive, Fraxel is the least invasive of the resurfacing options.  Fractional CO2 and Erbium fall in-between.  There are many different companies and brands of these lasers (ie: ActiveFX, DeepFX, Repair, Mixto are fractional CO2 lasers.  Pearl and Contour are Erbium lasers.  Fraxel is actually a fractionated Erbium.  Profractional, Affirm, and eMatrix are similar to Fraxel.)  All resurfacing lasers do have some downtime--the more invasive the laser, the more pain and downtime is associated with it.  The topicals definitely have less side-effects and much less expensive but results not as dramatic as laser resurfacing.

It depends on the case. Sometimes we start out with OBAGI NuDerm if someone has pigmentation issues. The NuDerm will help pre-treat before the laser resurfacing, and also give a better result. However, many times if someone has very large pores, or acne scars, we will use the laser resurfacing and then go over home product maintenance after the procedure to keep the skin as firm and tight as possible. They both help with minimizing the appearance of large pores. OBAGI NuDerm is an 18 week overall regimen typically used for discoloration, melasma, acne, and anti aging.
With the OBAGI NuDerm, patients usually experience redness, peeling, flaking, itching, and dryness during the first 6-10 weeks. The laser resurfacing procedure that we do is the Mixto Fractional CO2 laser and that is done in 1-2 treatments for sun damage, lines, wrinkles, and overall tightening. Depending on the depth we use, the downtime for this procedure is 5 days to 3 weeks. They are both great treatments.

This video
covers all the questions regarding pore size.

I choose a
particular laser based upon the size of the pore, skin type of the patient, and
expectations.

I find that
the most reliable method is with INFINI RF, micron needling using energy. This
beats all my Fraxel lasers and chemical peel techniques. Very little downtime,
and it is ideal for small to medium size pores.

Chemical
peels such as TCA (70-100%) placed focally in the pores is an excellent
treatment for large pores.

Pore size
reduction treatments should be tailored according to the patient IMO.

Regards

Dr Davin Lim

Laser and
aesthetic dermatologist

Brisbane,
Australia.