Which procedure would help reduce large pores and textured skin on the forehead and nose? 45 y/o female (photo)

Question

I am a 45 yo female experiencing large, textured pores and thick skin (genetic) in the middle of my forehead and nose (some on the inner cheeks near my nose). I've done microneedling in the past. I just had BBL to treat hyperpigmentation and redness due to Rosacea. The texture really bothers me and shows up in photos. IMO it almost looks like acne scars and gives me a "rough" look. What procedures would you suggest to reduce the look of the pores/texture in these areas?

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Donald B. Yoo, MD, FACS · Answer

Despite the abundance of RF microneedling devices available, it's crucial to thoroughly research to find the best one for your needs. Potenza stands out as the first RF microneedling device offering four distinct modes (monopolar, bipolar, 1MHz, 2MHz) and various needle tip options. This versatility allows it to cater to individual needs, providing highly personalized results. Suitable for all skin types and backgrounds, Potenza Microneedling RF is the only FDA-approved microneedling radiofrequency treatment for active acne. It is perfect for skin remodeling to diminish acne scars and minimize pores, giving a smoother appearance!

Nelson Lee Novick, MD · Answer

You may wish to consider a series of superficial peels, which include high concentration glycolic or salicylic acid, Jessner's Solution, or low concentration TCA peels for treating this problem. Note: the fact that it is a series of peels, not just one or two treatments that would be required to improve the skin texture issue here. Likewise, although you mention having undergone microneedling, you do not mention whether it was professionally performed and, once again, whether you underwent a series of treatment sessions (which is typically required to achieve improvement with this kind of issue). You would be wise to consult with a board certified cosmetic dermatologist. One word of "buyer beware" caution. In your search for treatment, you will no doubt be bombarded with marketing hype and social media buzz for this or that expensive, supposedly "next big thing" light or energy-based devices. So, it is worth noting that the hard science to back up these "bells and whistles" gizmos lags woefully behind the hype to promote them. So, be careful. Hope this helps and best of luck.

Camille Cash, MD · Answer

You will likely have the best result from a combination of treatments.  Morpheus8 can help improve the texture of the skin.  Using medical grade skin care products like Transform MD can also help to smooth the skin and enhance results from other treatments.  I encourage you to begin by scheduling a consultation with a med spa aesthetician for a skin analysis.

Which procedure would help reduce large pores and textured skin on the forehead and nose? 45 y/o female (photo)

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