How to Find my Ideal Treatment for my Skin Problems?

I've noticed that there are many treatments available for skin problems (chemical peels, IPL, Fraxel, fractional CO2 resurfacing, microdermabrasion) but i'm still unsure of what would be best for my skin. I have a typical mediterranean skin which means i have olive skin colour, oily, with acne, acne scars and large pores.I'm worried that i'll get a skin with not a definitive skin tone.

Doctor Answers 8

Be careful with lasers

There are many options for you, including laser treatments. But, you must be careful with lasers because of your dark complexion. You cannot change your pore size just like you can't change your eye color. But, you can minimize the appearance of your pores by keeping the pores exfoliated and free of debris. This allows them to collapse so they appear smaller. I can't see your face, but the first question I ask patients is do you want to treat your wrinkles as well as discolorations/sun damage or are you just concerned with the color/texture/pore size. If you want wrinkles gone, then you need to consider a TCA peel 30-35% or some sort of laser resurfacing ie Fraxel, Total/Active Fx, Sciton Contour, Smartxide, etc. When you have these laser treatments to get rid of wrinkles, a doctor should be performing the treatment, you should require nerve blocks and sedation, and you should be told it will take 7-10 days to recover. A 3 day recovery from a laser treatment WILL NOT get rid of wrinkles. I mention this because the lasers I mentioned are used in spas as well as doctors offices, but in spas they are used on very low setting to buff away mild pigmentation. This sort of treatment in the spa setting will require no anesthesia, nerve blocks or sedation because it is such a mild laser treatment. My aestheticians use my Total Fx Encore laser on these setting for mild buffing of the top layer of the skin. It is often called a micro laser peel. Now, if you are only concerned with texture/sun spots /pore size, this can be accomplished with aggressive skincare, micro laser peels, mild TCA peels, and light-based lasers like the GentleLase laser which specifically removes pigment. It doesn't have to cost a fortune for this type of rejuvenation

Nashville Dermatologic Surgeon
3.7 out of 5 stars 6 reviews

Fraxel Dual for Mediterranean Skin

When I read your question, I thought you might be interested in viewing this video of a patient who fits a description similar to yours. 

We used a series of Spectra treatments to clear up her existing acne. And then we treated her acne scars with Fraxel Dual. The 1550nm wavelength of Fraxel Dual works well  beneath the skin's surface to create normal structures of collagen, in contrast to the scar tissue. Other treatments attempt to address the acne scars from the surface level, creating risks of complications and sub-optimal results for those with deep scarring. 

This patient's skin type can be described as South American or Southern European, which is prone to tanning due to her levels of melanin.  For patients of color, lasers have been a risk because there is the danger that the melanin will absorb more of the laser's light, causing the skin to overheat and produce scars. However with Fraxel Dual, the laser wavelengths used are not readily absorbed by melanin. So it is safe for ethnic skin tones. Also downtime and potential side effects are very minimal. 

Fraxel lasers work by reshaping collagen structures. This helps with shrinking the size of the pores. With smaller pores, less oil emerges onto the surface of the skin. A proper and regular cleansing regimen will continue to be of utmost importance. 

The video shows the patient in the end with flattened acne scars, still with the presence of large pores. But she only had two treatments at this stage. Subsequent refinements would help to minimize the width of the pores.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 32 reviews

Skin problems treatment

The "best" skin treatment is very individualized, so your best first step is to find a reputable clinic near you for assessement and recommendations based on your skin.

Anatoli Freiman, MD
Toronto Dermatologist
5.0 out of 5 stars 5 reviews

The First Step for Healthier, Younger-Looking Skin

One of the most effective ways to reverse skin problems including acne, large pores and chronic sun damage is by using a combination of two prescription strength medications: 4% hydroquinone and tretinoin cream. Prescription strength 4% hydroquinone is better than any OTC product for lightening dark spots in the skin. These dark spots are typically due to chronic sun damage so daily use of sunscreens is essential in your treatment. Prescription-only tretinoin cream is best for acne, acne scars, and enlarged pores. It also makes the hydroquinone even more effective. I recommend the Obagi Nu-Derm System which uses both prescription-strength tretinoin cream and hydroquinone.


Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

How to find an ideal treatment for skin problems

You describe oily skin, acne, acne scars and large pores in a mediterranean type skin.  In my opinion, the first thing that needs to be treated is acne.  Since you have acne scars, the more breakouts you have the more scars you will have as well.

If you are not pregnant or planning to become pregnant, consider Accutane.  A 6 month course of Accutane treats acne and oily skin, with an approximately 80% remission rate for acne.

The next step will have to come 2 years after finishing Accutane, and that is fractional laser skin resurfacing.  That will help with large pores and acne scarring.  Your doctor can have you use a bleaching cream for one month before and one month after each treatment to minimize any pigment disturbances and you must avoid sun exposure at all costs for at least a month after each treatment, better still permanently by staying out of the sun between 10 am and 4 pm and using a broad spectrum sunscreen every single day.

The two year period is necessary because there is an increased chance of scarring for 24 months after Accutane.  That goes for any elective procedure, including waxing or electrolysis.

Emily Altman, MD
Short Hills Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Ideal Treatment for Acne, Acne Scars and Large Pores for "Mediterranean Skin"

The ideal treatment is one customized for your skin type and skin condition. For this to occur, I recommend that you consult with an aesthetic surgeon or dermatologist to discuss your concerns and expectations. Key to control of acne break-outs is an optimal, medical-grade skin care regimen that includes daily use of SPF30 sun protection. 

Depending on your preference and skin typing, a series of peels with or without microdermabrasion or perhaps an IPL or IsoLaz series may be beneficial for you. 

Anifat Balogun, MD
Seattle Otolaryngologist

Skin Care

The first thing isa full examination of the the skin to control the acne.

Then start with a good medical grade skin care like OBAJI. Then customize the treatment plan, chemical peels or fractional CO2 laser.

Fraxel does not do any thing, Microdermaberasion removes the outer dead layer of the skin like cleaning, nothing else.

Ipl May be good for red areas. You need to cosult with a plastic surgeon or dermatologist and stick to what works


Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

The best skin treatment

What the best skin treatment for you skin would be depends on what problems you have and what you want to "fix". I would find a dermatologist that you trust and have them talk to you and have a look at your skin. Together, you can make a plan for care and any needed treatment. That is what we are here for.

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 19 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.