Fraxel Restore Vs Botox for Large Nose Pores

In my experience, utilizing non-ablative Fraxel restore, ablative Fraxel repair, IPL, SmoothBeam, GentleYag, among other laser and light-based devices in my office, non-ablative Fraxel restore and ablative Fraxel repair work the best. Botox and fillers will not affect your pores at all. Skin care products containing retinoids and glycolic acids may temporarily reduce the appearance of pores.

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. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. 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

 Depending on how dark your skin is, I would either choose Fraxel Re:Pair – an ablative CO2 laser – or the gentler Fraxel Re:Store or Dual to help you improve the quality of skin on your nose. Re:Pair is the best laser for skin tightening and works with just one session. Yearly updates are recommended. Darker skin may do better with Re:Store, which is gentler but takes more than one session. Botox, Juvederm, and other fillers cannot help reduce the look of your pores.
Please note that while laser resurfacing will improve your skin and tighten the pores, you will never have fine-grained skin; that's a matter of genetics. Please consult a board-certified dermatologist to be evaluated for Fraxel.

Unfortunately, the size of your pores is determined at conception. The pore is a physical opening with a specific diameter in the epidermis overlying a hair follicle's opening.  If there is sebum and dead skin cells that pile up in this opening, it can make an appearance of a black head (open comedone) but at least the "hole" is plugged and the skin surface even.  Once the pore is cleaned out, which some people try to do to minimize the prevalence of acne, the opening will be more apparent.  Dermabrasion which is a sanding procedure, takes off layers of skin but can uncover a wider diameter of the follicle below the skin making the pore look bigger!  I have found that Fraxel Restore is the only treatment that has helped make some patients' pores look less noticable but unfortuantely, this is not universal, nor guaranteed.  Some patients do not get improvement and some can get worse.
 

The combination of both Botox Cosmetic via microinjections, laser treatment and retanoid treatments will give you the best result.  While none will completely remove the pores, they may improve the appearance.

 

Good Luck.

Ablative services including Fraxel, CO2, chemical peeling are at best neutral on pore size.  However, the non-ablative services like fotofacial (IPL) appear to stimulate collagen around the pore and subjective make pores look less large.  One issue of concern is Asian skin which can be burned by these treatments when the amount of skin melanin is underestimated.  Generally, 5 to 6 fotofacials are needed to obtain maximal pore improvement and these are done at 3 week intervals.  The treatment will not make the pores disappear but subjectively the treatment is helpful.

Yes, firstly I would recommend a full skin care regimen for Oily skin. Obagi Nu-Derm (Normal to Oily) will greatly help keep your pores clean and suppress sebum oil production. Furthermore, laser genesis or radiofrequency microneedling Vivace or, even, regular chemical peels can help minimize and refine the appearance of pores. Remember, pore size is genetically determined so regular treatment is key.

First it is important for you to realize that you do not have to 'clean' your pores.  In fact, excessive washing or scrubbing or extractions can aggravate your skin and may even make the pores more prominent.  Using tretinoin regularly is a great start.  Think of it as 'sweeping' the cells out of the pores and from the skin surface as well as improving your skin's collagen.  If you feel your results have plateaued on your retinoid treatment results, you may want to speak with your dermatologist about increasing the strength of your tretinoin or switching to tazarotene to boost your effect. Washing with a salicylic acid cleanser is also helpful.To reduce the size of the pores, you have a few options.  The clear & brilliant procedure is like 'baby fraxel' and is indicated for the reduction of pores.  Most patients have 4 - 6 treatments at 2 - 4 week intervals to start and then may return at 1 - 2 month intervals to maintain results.  The treatment is safe for all skin types and has no downtime -- patients may be red for a few hours at most.  If you prefer to see results faster and don't mind some downtime, the Fraxel restore or dual laser using the erbium wavelength can be used.  Depending on the starting point and degree of improvement needed, you may want anywhere from 1 - 3 treatments each with 3 - 5 days of swelling, redness and a sandpaper feel to the skin.  For any treatment, sun protection is critical all year round.  Thats a recommendation for all skin types but asian skin in particular is prone to hyperpigmentation.Best wishes

Pore size reduction is one of the conditions I consider the "Holy Grail" of dermatology, with its unending pursuit.  My most consistent results come from a combination of Fraxel, topical retinoids (tretinoin) and sometimes oral isotretinoin - it all depends on skin-type and the cause for your pores to be prominent.  Even then there are no guarantees for this one.  See a dermatologist, they will be able to give you the ideal combination treatment plan for your skin

I would definitely recommend Fraxel DUAL or Pearl Fractional.  I have both lasers in my office and my physician assistants get excellent results with both in improving the reduction of pore appearance in patients. 

Please make sure you go to someone who has a lot of experience and is well trained with these types of resurfacing lasers especially when treating your face. 

Good luck. 

Dr. Grant Stevens