Large pores, uneven skin texture and color, birthmark - is laser my best option? (Photo)

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

A combination approach will give the most improvement. These types of scars need a combination of Cosmelan, lasers, microneedling/prp, subcision, salt facials and fillers. It may take a series of treatments and may need some treatments to maintain. I recommend getting a formal evaluation with an acne scarring expert. Best, Dr. Emer

Before jumping to relatively expensive and aggressive treatments, simpler, less expensive treatments with proven records for safety and efficacy might be considered. These include a series of superficial chemical peels using high concentrations of glycolic or salicylic acid, Jessner's solution or low concentrations of TCA, accompanied by the at-home use of prescription topical medications to address the pigmentation and skin quality. Alternatively, professionally performed manual microneedling accompanied by the application of prescription bleaching agents may be used to address both the enlarged pores, as well as the pigmentary issue. Fraxel lasers and other expensive energy-based devices lack the hard science to back up the heavy marketing claims to promote their use. And stronger lasers, like the CO2 run the risk of scarring and/or giving rise to troubling dyspigmentation problems. Make sure to do your due diligence and consult with an experienced, board certified cosmetic dermatologist and not just any venue or medspa hawking this or that "bells and whistles" gizmo they have to offer. Best of luck.