Treatment for Cottage Cheese Skin on my Face?

Although there are several alternatives for what you describe - ranging from dermabrasion, to deeper chemical peels, to laser peels, to laser fractional ablation (such as Fraxel re:Pair), in my experience the Fraxel re:Pair has the best track record for the greatest improvement with the greatest amount of safety. For more severe acne scarring it can even be repeated. Although there is some "downtime" - 2-3 days of being red and "raw" but without discomfort and then 2-6 weeks of redness looking like a sunburn), most patients are quite pleased to do this in one stage. The Fraxel re:Store can also be done but requires multiple stages but with minimal down time. Be sure to seek out an experienced board certified physician who has experience in all phases of skin resurfacing (i.e. peels, dermabrasion and lasers) and don't be afraid to ask questions about their experience - the number of procedures they have done of each, the results, see photos and talk with other patients. Dermatologists are not the only physicians and a board certified plastic surgeon or facial plastic surgeon (ENT) could also address your concerns, as long as they have the laser experience.

Cottage cheese skin changes often result from a combination of acne scarring, smoking and sun damage. One should start with daily sun protection, smoking cessation, acne treatment by a board-certified dermatologist. Topical retinoid should be part of maintenance therapy. Afterwards, one should seek out an experienced board-certified dermatologist for consideration of Fractional CO2 Laser resurfacing.