Fraxel Restore Vs Botox for Large Nose Pores

I am a 34 year old Asian female. The pores around my nose are very large, much line the skin of an orange..yuck! I clean my pores, but they just appear more visible when "unclogged." Additionally, I'm EXTRA oil after I've unclogged my pores. I've been using tretinoids for years, but doesn't reduce the size of my pores. Please help! What is the most effective and longest lasting procedure for pore reduction, Botox, Fraxel Restore, Juvederm, other lasers, obagi nu-derm, anything?? THANKS!!!

Doctor Answers 10

CO2 Fraxel Laser for Pores

My suggestion is to be careful not to strip all the oils off the skin when cleansing, this just causes the glands to get hyperactive and put out excess oil. Also constant manipulation of the pores can cause permanent enlargement and stretching, so go easy on them. I am a big fan of the CO2 fraxel for this problem, the other items you mentioned i.e. Botox, Juvederm and other lasers are not indicated for this and will not help.

Miami Facial Plastic Surgeon
4.6 out of 5 stars 11 reviews

Fraxel restore works best to reduce pore size

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.

Lorrie Klein, MD
Laguna Niguel Dermatologic Surgeon
4.9 out of 5 stars 216 reviews

Lasers and skin care for enlarged pores.

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. Enlarged skin pores are especially common in ethnic skin types, including Asian patients. 

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.

The second part of your solution lies in deceasing excessive oil production known as seborrhoea. The use of Vitamin A creams or tablets can easily achieve this, as can anti-hormone medications. 

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

Dr Davin Lim
Laser and aesthetic dermatologist
Brisbane, Australia.

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 77 reviews

Fraxel Can Tighten Pores on Nose

 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.

William Groff, DO
San Diego Dermatologist
4.8 out of 5 stars 48 reviews

The Holy Grail of Dermatology

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

Shobhan Manoharan, MBBS, FACD
Brisbane Dermatologist
5.0 out of 5 stars 10 reviews

Fraxel or Pearl Fractional...great option for resurfacing and reducing pore appearance

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    

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 147 reviews

Botox for Pores

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.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 77 reviews

Treatments for large pores

The size of the pores is genetically determined.  Occasionally acne scars can appear to look like large pores as well.

Temporarily, topical retinoids can shrink the size of pores slightly, but the best treatment we have available for large pores is fractional resurfacing. Laser light esentially vaporizes tiny columns of skin, and the remaining skin shrinks around those vaporized areas, and there is also deposition of new collagen in the treated areas.

Botox has no effect on large pores at all.  Botox interrupts the signal from a nerve to a muscle to contract.

Emily Altman, MD
Short Hills Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Fotofacial and other non-ablative light based services are probably best.

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.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Pore size and treatment

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.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

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.