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

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.

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

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.

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.