I have extremely large open pores and I’m only 34. I use SPF everyday and use a retinol. What is the best in-office treatment?

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of acne scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic acne scars and indented acne scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

A combination approach will give the most improvement. I recommend lasers, microneedling/PRP, Peels like Cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, I suggest getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Hi sophies100

Microneedling is a medical spa procedure that has the ability to improve and rejuvenate the quality of your skin. Microneedling, particularly when combined with Plasma Rich Protein PRP has the ability to restore some of the changes associated with age and environmental exposure. These include adding and reorganizing collagen and improved smoothness. For more detailed information about this cosmetic procedure, please visit our website.

Pores can't actually be made smaller, but they can be made to look smaller.

Several reasons for enlarged pores:
Genetic predisposition to larger pores
Stretching from embedded oil and skin cells (though retinols are helpul in keeping pores clear)
Collagen loss - aging allows the "walls" of the pores to lose their tightness

Be mindful of the products you use. Salicylic acid lotion can sometimes be helpful. Be sure your sunscreen is not one that is pore-clogging. Stay well hydrated by drinking an ample amount of water.

Microneedling is good in that it increases the collagen fibers which in turn can firm up the pore "wall". PRP boosts the effect.

The gentle lasers such as clear and brilliant are also helpful. Be sure you co ordinate with your doctor prior to any procedure that is combined with retinol and follow directions post treatment about products.

Fraxel is a great treatment for superficial layers of the skin and pigmentation. You can use it in combination with microneedling. Stop using Retinoic Acid two weeks prior to your treatment.

Hello, we use vivace in our office which is microneedling with radio frequency. It works really well at shrinking the pores, as well as tightening the skin and reducing fine lines. Retinol is good for shrinking pores as well but shouldn't be used while pregnant. You can get regular microneedling without radio frequency while pregnant but you would not be able to numb before the procedure. Generally, while pregnant you want to be conservative with your products and treatments. Chemical peels are a good option for shrinking pores as well but again not while pregnant.