What is the best laser treatment to reduce pores and acne scars? Does PicoSure work? (photo)

I've been told many different treatments are the best for minor acne scares and enlarged pores. I'm trying to understand what my best option would be. I have large pores and some minor acne scaring. Which of all the lasers is most effective?

Doctor Answers 6

Yes, Pico can reduce pore size- see video link.

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Picosure FOCUS I find reduces small pores - see the video for the before and after. For deep large pores I prefer TCA CROSS peels, and lasers. I also use microneedling. Pore treatments depend on the skin type, and pore size of the patient. I also use dermal fillers to 'hydrate the dermis' to reduce small to intermediate size pores, especially in the mid cheek area. Cheer, Dr Davin Lim. Brisbane. Australia. 

Best Laser Treatment For Large Pores and Acne Scars

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Large pores are difficult to treat.     The best treatment is a modified TCA peel combined with a CO2 fraxel (combined peel).  The TCA peel is performed over the entire face, followed by the CO2 fraxel peel to focal areas of scarring.  

For a less invasive option, a series of 6 clear and brilliant laser treatments was shown to decrease pore size by 25% in a small study.  

Isotretinoin also will decrease pore size.  

Raj P. TerKonda, MD, FACS
Phoenix Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

TCA CROSS Works Well For Pit Scars & Dilated Pores

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You start off with the apparent misapprehension that lasers are necessarily the best treatment for your pit scars (ice pick scars) and dilated pores. Frankly, it has been my experience that the results of treatment with relatively expensive lasers, including fraxels, as well as radiofrequency and ultrasound devices, have proven disappointing. Even in the medical literature, physicians are cautioned that the results of treatment with these modalities may be subtle, inconsistent, variable, and take months to appreciate. They have so far proven to be backed far more by device manufacturer supported marketing hype than hard science.

TCA CROSS is a simple and relatively inexpensive approach for treated dilated pores and pit scars. If necessary, medical microneedling may additionally be used in order to blend the treated areas better with the surrounding normal skin. For more on these procedures, check out the archives of RealSelf.com and when seeking consultation and treatment, make sure that you have receive a treatment program that is specifically tailored to your needs and be especially wary of any "one size fits all" recommendations for this or that "next best thing to come along" machine or device. Best of luck to you.


Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Acne Scars and Pores NYC

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The best combination for acne scars are fillers and lasers.  I find that the two prong approach is really necessary to achieve the best results.  Please consult an expert.  Best, Dr. Green

Pits,Ice picks and enlarged pores. ENGLEWOOD CLIFFS NJ

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In my opinion, you have pits, ice picks and large pores. Multiple modalities would give you the best results. I recommend t c a cross for ice pick scars. Pits and large pores can be treated with both ablative and non ablative laser, microneedling, as,eell as,microneedling with radio frequency. I recommend using p r p with any treatment that disturbs the epidermal surface. Good luck. 

Jeffrey Rapaport, MD
Englewood Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

Many approaches to acne scar revision/ pores

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For the scars as in the image, I would use a combination of subcision to release adhesions, and a fractional CO2 laser resurfacing, followed through with chemical peels. No one particular treatment or device, will be able to address the different types of scars, and hence it is best to go with a combination protocol.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.