Help with Enlarged pores/orange peel texture after Fraxel. Is there anything which could help heal the effects? (Photo)

Pores are a necessary structure of the skin. The opening of the skin that allows the exit of a hair, sweat gland or oil gland content can be plugged up with dead skin cell debris and oils so that the pore looks less open. When someone uses Retin A or other acne medications that clear out the debris, the pores may be more visible. this is a trade-off that's necessary for healthier skin.  The pore hasn't become wider, it's just that the pore is more visible as the "plug" is removed.  There is not one treatment, whether a topical agent, chemical peel, dermabrasion or laser of any kind, that can guarantee pores to be minimized.  In fact, I have not found any treatment to be as good as Fraxel laser, whether the Clear & Brilliant or Fraxel Restore. Some patients may see improvement, while others may not.  Usually a series of treatments is needed to see improvement but I would not continue treatment if the patient or physician thinks the pores are more visible after some treatment.  SkinMedica's Essential Serum helps minimize pore size in many patients when studied by the use of skin casts that were analyzed with magnification.

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. 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 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 scars and indented 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 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

The Fraxel laser is great for treating acne scars. Pores can be the most difficult area to treat and may require a combination of treatments. You may require topical creams such as Retin-A or Differin gel if you are still breaking out and your pores are clogging. These creams will help keep this under control. Please see an experienced physician for a consultation. 

The Fraxel laser is fabulous at treating sun damage and acne scars.  Pores are the most difficult area to treat since it may require a combination of treatments.  If you are still breaking out and your pores are still clogging then you may require topical creams such as Retin-A or Differin gel to keep it under control.  Clear & Brilliant works very nicely with no down time at minimizing the appearance of pores.  The other lasers that can help are the Fraxel and eMatrix laser.  Please consult a board certified dermatologist with experience with Fraxel and other lasers for the best cosmetic results.