What laser and treatment would be best for this? (Photo)

Question

What laser and treatments would be best to minimize pores, resurface skin, and give my skin a more youthful look? My current routine is Retin A almost nightly and I use an AHA 30%+BHA 2% peel twice a week along with exfoliating a few times a week. I just turned 35 and I am not sure if the Retin A is causing large pores, if I have damaged my skin barrier, or if the appearance of my skin is age related with being mid 30s?

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your routine and photos—it really helps to understand your skin’s current condition. From what you’ve described, the main concerns are enlarged pores, texture irregularities, and early signs of aging, rather than significant damage. Being in your mid-30s, some of these changes can be age-related, as collagen production naturally starts slowing down, and pores can appear larger as skin loses subtle firmness.

Your Retin-A and chemical peels are excellent for promoting cell turnover and preventing early signs of aging, but overuse or frequent exfoliation can sometimes stress the skin barrier, leading to temporary roughness or increased sensitivity. Large pores are usually more influenced by genetics, oil production, and loss of skin elasticity, rather than Retin-A alone.

For laser and procedural options to address your concerns:

Fractional CO₂ or Erbium laser resurfacing: These target texture, stimulate collagen, and can reduce pore size over time. Downtime can be moderate to significant depending on the depth.

Non-ablative fractional lasers (like Fraxel) or picosecond lasers: Provide resurfacing and collagen stimulation with milder downtime. They’re great for subtle improvement in texture and pore size.

Microneedling with radiofrequency: Improves texture, stimulates collagen, and tightens pores without removing too much skin.

Combination approach: Sometimes pairing a gentle laser or RF microneedling with continued topical Retin-A and occasional chemical peels gives the most natural and long-lasting results.

It’s important to balance treatment intensity with skin recovery—especially with your current regimen. Overdoing exfoliation or aggressive resurfacing can actually make pores look more noticeable in the short term, even if long-term results are excellent.

In summary: your skin can definitely improve in texture and youthful appearance, but the approach is gradual and tailored, combining collagen-stimulating procedures with your consistent at-home care, while being careful to protect your skin barrier.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Pozner, MD · Answer

My favorite laser for pores and texture is the Sciton Halo. Dr. Chris Robb and I published the pore reduction data with Halo. Lots of good providers in your area

What laser and treatment would be best for this? (Photo)

Answers (3)

More Laser Resurfacing Questions

WE SEND PRETTY
EMAILS

Answers (3)

More Laser Resurfacing Questions

What laser can help forehead texture and prick holes/large pores? (Photo)

Venous Lake on Lips - Laser? San Francisco Bay Area (Photo)

Can laser treatment and fat grafting help minimize the appearance of genetic under eye hollows and pigmentation? (photos)

Fractional ablative vs fully ablative - which treatment provides a greater difference in the skin?

Can sublative laser cause facial fat loss? Look dull and older, noticeable to myself and others. (photos)

White bumps on my nose, options? (photos)

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS