Orange Peel Skin and Open Pores on my Nose, Cheeks and Between My Eyebrows? (photo)

Enlarged, dilated, patulous pores and small pit scars can be quite aesthetically distressing. Although microdermabrasion, peels and even fraxel lasers have their proponents for the treatment of these problems, the results in my experience tend to be disappointing.

In such cases, a series of medical microneedling treatments might be considered. Medical microneedling, which may be performed mechanically using rollers (e.g. Dermaroller) or electrically operated (Dermapen) essentially consists of going over the area with an array of needles that penetrate and break up the surface of the pore or scar and of any underlying abnormal fibrous tissue that may be contributing.

Disrupting the surface of the dilated pore, pit, or small scar allows for the possibility healing with a smoother surface texture.  Breaking up any fibrotic or abnormal collagen in this manner below the skin surface sets the stage for new, normal collagen synthesis (neocollagenesis), which improves the overall appearance of the overlying skin.

Following medical microneedling, the treated area may appear sun-burned for about 12-24 hours. There is little to no downtime, however, and I permit patients to return to routine skin care and makeup the following day.

Not all aesthetic physicians perform medical microneedling, so, should you wish to explore this simple, minimally-invasive option, you should screen carefully for a board certified aesthetic physician with training and expertise in the procedure.

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your question.  CO2 laser skin resurfacing treatment is very beneficial for making acne scars diminish.  This is done by removing deeper layers of damaged skin and stimulating the regeneration of healthy skin underneath. This treatment is also beneficial for uneven pigmentation, photodamage, fine lines and wrinkles, precancerous spots, and a host of other skin imperfections and benign lesions. If you believe you may be a candidate for CO2 laser skin resurfacing treatment, a qualified cosmetic surgeon or dermatologist can carefully analyze your skin and determine if the procedure is right for you

Hi LG,

I am not familiar with the ReAura.  We have seen some improvement in large pores with intr-dermal injection of Botox and with the use of Ulthera, micro-focused ultra-sound therapy.  With true Fraxel repair laser skin resurfacing there has also been improvement in most patients. Good luck and be well.

Dr. P

These really are a difficult problem to treat, but needling seems to offer the best chance of significant improvement.  Dermarolller (or pen) is my preferred method - but sometimes does need to be repeated.  Combining Dermaroller with dermabrasion and a cell suspension (ReCell) gives the best chance of a really refreshed appearance.

The enlarged pores are often associated with excess oiliness of the skin. I'd suggest a review of your skin care to begin with.In theory, any treatment which heats the skin (which I assume it's what the Phillips device does) and triggers some degree of inflammatory response can stimulate collagen production and remodeling which will improve the elasticity of the skin.At the present state of the arts, I think your money may be better spent on treatments carried out by professionals or at least supervised by professionals.I have seen good results with problems like yours with the CO2 laser.

We like to offer Dermapen treatments to help improve large pores and orange peel appearance of the skin.  Typically we recommend a series of treatments and there is no downtime.  Watch the video to see how this technology works.  It is one of our most popular treatments.  Good luck and hang in there.

Keep up with the Retin A.
Your skin is Ideal for Carbon Dioxide laser resurfacing if you can tolerate the down time of 10 days.

This video
covers all the questions regarding pore size.

I choose a
particular laser based upon the size of the pore, skin type of the patient, and
expectations.

I find that
the most reliable method is with INFINI RF, micron needling using energy. This
beats all my Fraxel lasers and chemical peel techniques. Very little downtime,
and it is ideal for small to medium size pores.

Chemical
peels such as TCA (70-100%) placed focally in the pores is an excellent
treatment for large pores.

Pore size
reduction treatments should be tailored according to the patient IMO.

Regards

Dr Davin Lim

Laser and
aesthetic dermatologist

Brisbane,
Australia.

Because Retin-A Micro dermabrasion exfoliate and remove excess surface skin it is not unusual for the pores to not shrink and in some cases enlarge.Non-ablative fractional erbium laser treatments build new deep collagen and the skin and can reduce the size of pores.  Non-ablative fractional erbium laser treatments in this 1540, 1450, and 1585nm range are most effective.  For more information read the following link: