What is the best laser/procedure to reduce pore size, tighter skin and improve the overall texture of the skin? (photos)

Question

I'm 37 years old and have always had large pores, but feel as if the have become more noticible with age and I'm really unhappy with the texture of my skin in general. With all of the skin treatments out there, can you please tell me which one you feel would work best for my skin? Thanks so much in advance!

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

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

Susan Van Dyke, MD · Answer

I really favor Fraxel fractionated non-invasive laser resurfacing for improvement in texture, pore size and pigment.  The treatment intensity can be adjusted for the individual needs of the patient. Downtime is manageable (2 to 5 days of redness, swelling depending on intensity of treatment). Repeat treatments can be done that increases results. If you want to start with a milder treatment then I recommend Clear + Brilliant.   C+B has no downtime and is often done in a series of 6 treatments, several weeks apart.

Anne Bode, MD · Answer

Pore size is genetically determined and while there are not many thing that we can do to change the size of the pores we do have some tools that help minimize pore appearance.  The better health the skin is in the smaller the pores will appear.  I would recommend either a CO2 fractional laser or a series of microneedling treatments in order to stimulate collagen and skin turnover.  Both of these treatments will help with texture issues.  In our practice we combine these treatments with PRP.  I would follow up with a maintenance protocol of a treatment facial or chemical peel  once per month.
Thank you for your question and good luck with your pursuit!
Anne Bode

Bryan W. Rubach, MD · Answer

I would highly recommend HALO hybrid laser.  It's a unique fractionated resurfacing laser that creates thermal channels in the skin. This results in a full field effect on the surface of the skin to generate increased collagen, improve texture tightening enlarged pores and evening out the pigment in the treatment area.  Down time is minimal with this laser treatment with no need for an occlusive topical like Vaseline or Aquaphor.  It only takes five days to reveal bright smooth even skin and the next few months you see the improvements for fine lines and skin firmness as collagen continues to increase in the deeper layers of the skin.  This treatment can be used for most skin types, across many areas of the body with minor adjustments for darker skin tones.   Our patients love the result!

Rebecca Gelber, MD · Answer

Thanks for your question. There's only one laser treatment which has proven research with improvement in pores (the company calls it Porefection) and that is Halo. Even very aggressive earliers lasers always seemed to disappoint in this metric of skin improvement. I like to combine this with BBL (to even out skin color and for benefits in antiaging), a MicroLaserPeel if there are issues with overall skin texture, and ideally also PRP injected at the same time for absolute best possible results.

Laura Riehm, MD · Answer

Thanks for your question and posting pictures, but you really need a formal consultation.  Just off the top of my head, I could come up with several different treatment plans for your generic description.  It really depends your specific needs, expectations, time to recover and budget.  You should find an experienced medical aesthetics provider in your area that is medically supervised and has several different treatment options available.  Best of luck.

Ronald Moser, MD · Answer

This is great that you are making plans for corrective and preventative skin care treatments. We like to treat skin at multiple dimensions to get the best possible outcome!
The Genesis Laser treatment
activates collagen production  with its quick, micro-pulses of laser
energy. The benefits will be noticeable reduction of fine lines and wrinkles,
unwanted dark spots and facial redness.  The results will be subtle, but
don't let that fool you, as the overall effect can provide dramatic results! 
The Cutera Limelight IPL helps to improve overall skin complexion by targeting the surfaces that accentuate the pores and brightness of the skin.  
Both treatments correct
signs of aging and help to improve overall. and  reduce. We prefer to do both treatments ---even simultaneously!

Jean M. Casello, MD · Answer

This is a very good question. Pore size is usually genetically determined.   Having said that there are things that can make the pores and texture of the skin look uneven such as clogging and debris buildup.. There are many treatments that can minimize pore size and improve the texture of the skin.  Fraxel resurfacing, microneedling or microneeding with radiofrequency (lutronic infiniti) are some of the devices we use in our office.  Sometimes we combine this with chemical peels and/or microdermabrasion.  You should be on a good skin care regimen which includes gentle exfoliation. Consult with an experienced provider who should be able to guide you.

Alain Michon, MD · Answer

Thank you for your question and pictures. Ideally, a combination approach by alternating treatments with fractional laser resurfacing and micro-needling combined with platelet-rich plasma will give you the best results. I recommend seeing an expert for a proper consultation and treatment plan. Best of luck,

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