Do you have advice to improve crinkling and corduroy texture skin? (Photos)

Question

Had IPL 3 years ago and something bad happened to my skin, new laxity, and weirdly I no longer sweat from my face when I exercise. Anyways, I am 40 and now I have crinkling, corduroy texture under my cheekbones, near corner of mouth and up through temples and forehead. I have tried TCA only 13 percent multiple layers but got some good peeling and slight improvement. Wondering what else I can do, CO2, aquagold? When I pull up bottom of my face, crinkles get better! Thanks for your opinion.

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Alan B. Brackup, MD, FACS · Answer

Thank you for your question and your photos. You have great skin for 40. Have you tried some deep peels? I think a really good acid peel would help some of your issues. You could always start with a medium depth and see if that helps, then move on to something more intense.

William Groff, DO · Answer

Thank you for your question and photos. At your age, it is likely you would benefit from a collagen induction therapy like RF microneedling or a fractional laser. These devices create micro-injuries in the skin that trigger the body’s natural healing responses, including collagen production. As collagen levels rise, the skin becomes smoother and more youthful from the inside out. I encourage you to schedule a consultation with an experienced, board-certified dermatologist for further evaluation and a customized treatment plan.

Jason Emer, MD · Answer

at home peels like cosmelan, enlighten and aerify along with dermarolling (emeragecosmetics MTS roller with anteage MD ampules weekly) should be started now to prevent further aging. I recommend all my patients do at home peels like cosmelan , enlighten or aerify (see link).

For facial rejuvenation,  I would suggest a combination approach of 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

Do you have advice to improve crinkling and corduroy texture skin? (Photos)

Answers (4)

Answer: Facial Rejuvenation -- PRP/Microneedling, Laser (Fraxel/Clear+Brilliant, Halo/Erbium/Co2), COSMELAN, Fractora/Morpheus

Answer: Facial Rejuvenation -- PRP/Microneedling, Laser (Fraxel/Clear+Brilliant, Halo/Erbium/Co2), COSMELAN, Fractora/Morpheus

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Everything you need to know about CO2 Laser

Our mission is to create a world where every investment in modern beauty is Worth It.

Do you have advice to improve crinkling and corduroy texture skin? (Photos)

Answers (4)

Answer: Facial Rejuvenation -- PRP/Microneedling, Laser (Fraxel/Clear+Brilliant, Halo/Erbium/Co2), COSMELAN, Fractora/Morpheus

Answer: Facial Rejuvenation -- PRP/Microneedling, Laser (Fraxel/Clear+Brilliant, Halo/Erbium/Co2), COSMELAN, Fractora/Morpheus

Browse related questions

Recommended reading

Everything you need to know about CO2 Laser

Our mission is to create a world where every investment in modern beauty is Worth It.