Which Laser is Right for Me - Huge Pores, Haggard-Looking Skin, Scars, Wrinkles, etc.

Which laser? I have haggard looking skin. HUGE pores seen from space, scars, some wrinkles, fading elasticity, sun damage, some redness . I'd like PLUMP SKIN w/elasticity, the look of smaller pores, less noticeable scars & wrinkles. I had light chemical peels, microdermabrasion treatments, & one laser treatment w/no down time at all. Those were good exfoliaters but not aggressive enough. Will a stronger laser erase some of the edges around large pores & scars, making them appear less noticeable?

Doctor Answers 14

Laser treatment needs to be DEEP for results

There is no one "magic" laser...this is why there are so many lasers out there. For skin texture irregularities, and to stimulate the dermis, (reduce pore size, thicken skin), treatments that "reach" the mid-dermis are called for. Microderms and chemical peels give some mild "stimulation" to this effect, but with all the great laser therapies out there, there is no reason to "beat around the bush"...If you do have a laser treatment, the depth needs to be at least 300 microns or deeper to have the effects that you are interested in.

Crestone Plastic Surgeon
4.2 out of 5 stars 5 reviews

Pores, wrinkles and scars.

This video covers all the questions regarding pore size.

I choose a particular laser based upon the size of the pore, skin type of the patient, and expectations.

I find that the most reliable method is with INFINI RF, micron needling using energy. This beats all my Fraxel lasers and chemical peel techniques. Very little downtime, and it is ideal for small to medium size pores. This will also address some of your wrinkles and scars. You may need 2 sessions, ideally combined with PRP. 

Chemical peels such as TCA (70-100%) placed focally in the pores is an excellent treatment for large pores.

Pore size reduction treatments should be tailored according to the patient IMO.

Dr Davin Lim
Laser and aesthetic dermatologist
Brisbane, Australia.

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 77 reviews

Laser Skin Resurfacing Likely a Good Choice

Based on the photo you've posted, it appears likely that you need treatments that are more aggressive than light chemical peels and microdermabrasion, as you mentioned. There is a range of laser treatment options that can achieve the plump, toned skin with smaller pores that you want. As many of the specialists have said, CO2 lasers are considered an excellent option. I offer the Halo hybrid fractional laser because of its versatility. It is the first laser of its kind to offer the benefits of both ablative and non-ablative laser wavelengths so I can customize treatments for specific skin types and conditions. The most important thing is to choose an experienced laser specialist who understands the various options.

Otto Weiglein, FRCSC
Burlington Plastic Surgeon
5.0 out of 5 stars 5 reviews

Which laser is right for large pores and wrinkles

For years we have heard about lasers that can give a result as good as CO2 laser resurfacing with respect to wrinkles and improvement of tone and texture of the skin but without the downtime.  Unfortunately, none of these really gave the same result which is why CO2 laser remained popular for so long.  With new fractional technologies applied to the CO2 laser, the healing time is reduced but the effect is retained.  I would encourage you to discuss the use of fractional CO2 laser to address your concerns.  There will be some downtime and redness (the duration of redness persists according to how the treatment is performed but some redness is necessary to achieve the best result).  Good luck.

Douglas M. Stevens, MD
Fort Myers Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Laser for aged skin, wrinkles, scars , etc

It sounds as if you have had multiple nonablative treatments ranging from microdermabrasion to superficial lasers.   These procedures do very little for your skin. They can sometimes make a nice glow for a week or 2 but really do not change the aging process at all.  You would need to have an ablative laser performed.  The only 2 lasers that can achieve this are the erbium yag and the CO2.  The specific laser from each company differes by strength , depth, speed, safety. If you are looking for a laser to really change the skin texture and erase lines then you need to switch to a more aggressive laser like one of these.  Just remember that the downtime will increase from none to some and with these lasers it is critical to find someone with a lot of experience and a good track record. Board-certified dermatologists with a year long fellowship in cosmetic surgery will have the most experience out there. Good luck

Shawn Allen, MD
Boulder Dermatologist
5.0 out of 5 stars 1 review

Best laser option to treat "huge pores, haggard-looking skin, scars, wrinkles, etc" is......,

Assuming there are no contraindications or pre-treatment issues to address, the UltraPulse Fractional CO2 laser, combining DeepFX for deep wrinkle improvement, scar improvement, collagen remodeling and improvement of skin tone and ActiveFX for mild to moderate wrinkle improvement and correction of pigmentary changes/ dyschromia, would be a great modality to address the bulk of your concerns.

DeepFX and Active FX treatments are performed at the same session with about 7 days of social downtime post-treatment.

The CO2 laser does not treat redness, so for our patients who have redness, we plan for 1-3 sessions of intense pulsed light (photofacial) treatments beginning 8-10 weeks after their DeepFX/ActiveFX treatment.

Anifat Balogun, MD
Seattle Otolaryngologist

The carbon dioxide laser is best for deeper skin problems...

If the more superficial treatments do not work, then a deeper resurfacing with the carbon dioxide (CO2) laser is the answer.  As long as your skin type is light enough to allow the procedure to be done, then the CO2 laser can provide a tremendous result.  You will have a recovery time of around 7 days and possibly some redness after that (it can be covered with makeup though).  Consult you board certified plastic surgeon to see if this laser would work for you. 

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 206 reviews

Right laser

Judging by your photos I would first try the new CO2 fraxel laser. The advantages here are simple topical anesthesia and quick recovery (approx. 1 week)., unlike previous fraxel lasers the CO2 fraxel is a one time treatment and truly makes a real improvement.  If you need more aggressive lasering I would consider the Erbium laser. This laser is excellent especially with an experienced surgeon. The treatment results can be varied from light to heavy depending on the patients needs. The Erbium laser will need heavier anesthesia , probably I V sedation and nerve blocks. Recovery is about 2-3 weeks. Both lasers are excellent when used for the appropriate patient and very safe when used by an experienced practitioner. I personally do not use any other lasers anymore for skin surface problems, and this is after 25 years experience.

Richard Galitz, MD, FACS
Miami Facial Plastic Surgeon
4.6 out of 5 stars 11 reviews

Laser resurfacing

Fraxel laser resurfacing may help improve the texture of your skin. Multiple sessions may be necessary. Regardless of the type of laser, you will never have the skin you had when you were a youth prior to acne, but you may get significant improvement. Risks exist so speak with your physician at length before you schedule a treatment.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Lasers for the face

There are many different kinds of lasers to treat the concerns that you have. However, without an exam it is difficult to say what would be good for you.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 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.