White bumps on my nose, options? (photos)

Question

I had this white bumps for years on my nose basically they look like elevated scars. I did 1 laser treatment years ago, basically they burned the bumps one by one with laser. I didn’t see improvement so I didn’t continue with the treatment. I want to try again now. I would like to know what treatment would be best to get right of this.

Anna Chacon, MD, FAAD · Answer

From what you’re describing—small white bumps that have been present for years and were previously treated with laser “burning” each bump—there are a few possibilities. The most common ones we see in this area include milia, sebaceous hyperplasia, or small fibrotic acne scars, and sometimes they can overlap in appearance.

Milia are tiny keratin-filled cysts that tend to feel firm and superficial, while sebaceous hyperplasia are enlarged oil glands that look like small flesh-colored or yellowish bumps, often with a subtle central indentation. Both are benign, but they can be persistent and frustrating cosmetically.

What’s important in your case is that a single laser session years ago didn’t improve them, which often suggests either:

the depth wasn’t fully targeted
the diagnosis wasn’t precisely matched to the treatment
or the technique used caused surface destruction without addressing the root structure of the bumps

That’s why results can sometimes be underwhelming with “spot burning” approaches.

What actually tends to work better now

Treatment really depends on confirming exactly what these bumps are, but in general, I approach this in a more structured way:

1. Precise in-office removal (very common for milia or small cysts)

Sterile extraction with a tiny opening of the lesion
Very controlled and targeted
Usually minimal downtime when done correctly

This is often the simplest and most effective option if these are milia.

2. Electrocautery or radiofrequency ablation

Useful for more stubborn or raised sebaceous-type bumps
Allows controlled removal without overly damaging surrounding skin

3. Laser resurfacing (fractional or CO2)

Better for texture and clustered lesions
Helps remodel the skin surface over time rather than treating each bump individually

4. If sebaceous hyperplasia is confirmed

Options can include laser, electrocautery, or sometimes topical retinoids to reduce recurrence
These lesions can come back, so maintenance skin care often matters too

5. Supportive skincare

Retinoids to improve skin turnover
Gentle chemical exfoliation (like salicylic acid) to reduce new formation
Consistent sunscreen to prevent post-treatment discoloration
My honest clinical take

When I see long-standing “white bumps” on the nose that haven’t responded well to laser in the past, I usually don’t rely on one aggressive session again. Instead, I focus on:

confirming the exact diagnosis first
then using precise, conservative removal techniques combined with skin resurfacing if needed

That combination tends to give more predictable and smoother results than simply “burning them off,” especially in the central face where texture changes are very noticeable.

The key here is accuracy in diagnosis, because once we know exactly what these are, the treatment becomes much more straightforward and effective.

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

White bumps on my nose, options? (photos)

Answers (2)

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