Struggling with scars and skin texture from large pores (photo)

From your descriptions the best place to begin is a visit with a board certified plastic surgeon or experienced aesthetician for an evaluation. Morpheus8 may be a good option for you. This treatment combines RF technology with microneedling to improve overall skin tone and texture. Microneedling with Plasma may be another option. We always recommend using medical grade skin care products and wearing sunscreen every day.

I'm sorry to hear about your struggles with acne scars and skin texture. Achieving smoother skin can be challenging, especially if previous treatments haven't provided the desired results. Here are some considerations and potential next steps you might discuss with a dermatologist:

Evaluation
Comprehensive Assessment: It's crucial to have a thorough evaluation by a dermatologist to assess your skin type, the severity of scarring, and pore size. This will help tailor a more effective treatment plan.
Treatment Options
Advanced Laser Treatments:

Fractional Laser Resurfacing: This can be more targeted and might offer better results than CO2 lasers for some skin types.
Erbium Laser: This laser might be less aggressive than CO2 but can still effectively improve texture and scarring.
Chemical Peels:

TCA Cross: This technique uses trichloroacetic acid to spot-treat deeper scars and can be effective in combination with other treatments.
Dermal Fillers:

If previous fillers like Sculptra didn't work as expected, other fillers such as hyaluronic acid-based options might provide different results.
Radiofrequency Microneedling:

Combining radiofrequency with microneedling can stimulate collagen production more effectively and improve skin texture.
Platelet-Rich Plasma (PRP) Therapy:

PRP, combined with microneedling, can enhance healing and collagen production.
Customized Skincare Regimen:

Continuous use of retinoids and professional-grade skincare products can gradually improve skin texture over time.
Lifestyle and Maintenance
Sun Protection:

Consistent use of sunscreen is vital to prevent further damage and hyperpigmentation.
Diet and Hydration:

A balanced diet rich in antioxidants and adequate hydration can support skin health.
Consultation with Specialists
Seek a Second Opinion:
If previous treatments have not been successful, consider consulting another dermatologist or a specialist in cosmetic dermatology for a fresh perspective.
Remember, each individual's skin responds differently to treatments, and sometimes it takes a combination of therapies to achieve the desired results. A dermatologist can help guide you through these options to find the most suitable plan for your skin.