My big pores are turning into wrinkles! Options? (photo)

Question

I’m 36, but feel like I look older. Do I look older? I’ve had large pores for years but I feel like in the last few months they are stretching and sagging and turning into wrinkles. What can I do!?

Raffy Karamanoukian, MD, FACS · Answer

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

Camille Cash, MD · Answer

From the description of your concerns you may want to consider Morpheus8.  This treatment combines RF technology with microneedling to improve overall skin tone and texture.  I've included a video on Morpheus8 that I hope you find helpful.

Anna Petropoulos, MD, FRCS · Answer

Hello and thank you for your question! The "stretching" and "sagging" you're noticing is likely due to loss of elasticity. From age 30, our collagen and elastin production slows down, contributing to the skin aging. RF Microneedling and Laser Resurfacing are two popular treatments for improving age-related skin laxity and enlarged pores.

RF Microneedling combines microneedling with radiofrequency (RF) energy to stimulate collagen and elastin production deep in the skin. The tiny needles create controlled micro-injuries, triggering the body’s healing response, while the RF energy delivers heat to the deeper layers, tightening the skin and improving texture.

Best for: Mild to moderate skin laxity, enlarged pores, and fine lines.
How it helps: Tightens skin, reduces pore size, and improves overall skin texture with minimal downtime.
Downtime: Usually 2-5 days of redness and mild swelling.

Laser treatments use focused light energy to remove the outer layers of damaged skin and stimulate collagen production. Ablative lasers (like CO2 and Er:YAG) remove layers of skin for more dramatic results, while non-ablative lasers (like Fraxel) heat the skin without removing it, promoting gradual rejuvenation.

Best for: Moderate to severe skin laxity, enlarged pores, wrinkles, and sun damage.
How it helps: Resurfaces skin, reduces pore size, and improves tone and firmness.
Downtime: Varies; ablative lasers require 1-2 weeks of healing, while non-ablative lasers have minimal downtime.

Both treatments improve skin firmness and texture, but RF microneedling is better for tightening and pore reduction with less downtime, while laser resurfacing is ideal for more intense resurfacing and rejuvenation.

I hope this helps! 
Genie Alexander, RN BSN for Anna Petropoulos, MD FRCS at Center for Classic Beauty, Danvers & Boston, MA

Barbara Padilla, MD · Answer

Thank you for your question! There are many options to minimize pores / wrinkles. For deeper lines we recommend filler for nasolabial folds. This will smooth the appearance of your skin and reduce the harshness of the lines. In regards to your pores stretching, there are many options you can choose from. Microneedling is an effective way to help with fine lines, wrinkles, and skin tone and texture. Microneedling will help increase collagen production. Chemical peels can also help with the appearance of pores, as salicylic acid helps minimize pores. This will also help with collagen production. Laser genesis is also used to minimize pores while heating the skin to increase collagen. Laser resurfacing is a great option for fine lines, wrinkles, and collagen production. At our practice we offer Juliet. The heat from this laser stimulates new collagen production, which firms mildly lax skin over time. This procedure has 3-4 days of downtime where your skin might be red and feel tight.

Nelson Lee Novick, MD · Answer

At least from the photos provided, there appears to be volume deficits in the border regions between the under-eyes and the upper cheeks, which would explain the pronounced depression there. If this is indeed so, then the appropriate choice of volumizing HA filler when injected properly in the hands of an expert, board certified cosmetic dermatology filler expert can smooth the transition region and significantly diminish the hollows seen there. A diminution in the smile lines would likely be a much appreciated secondary benefit of this treatment, as well..The results are typically immediate and dramatic, and the treatment usually engenders little to no significant post-treatment downtime. 
For general texture and pores, combining the daily, at-home use of Rx topicals, such as retinoids coupled with in a series of superficial peels using either high concentrations of glycolic or salicylic acid, Jessner's Solution or low concentrations of TCA would be quite helpful. 
Hope this helps and best of luck.

My big pores are turning into wrinkles! Options? (photo)

Answers (7)

Answer: Minimizing pores and wrinkles.

Answer: Minimizing pores and wrinkles.

Answer: HA Filler, Superficial Peels & At-home Rx Topicals Work Well In Combo For Nonsurgical Skin Rejuvenation

Answer: HA Filler, Superficial Peels & At-home Rx Topicals Work Well In Combo For Nonsurgical Skin Rejuvenation

Recommended reading

Everything you need to know about Skin Rejuvenation

Our mission is to create a world where every investment in modern beauty is Worth It.

My big pores are turning into wrinkles! Options? (photo)

Answers (7)

Answer: Minimizing pores and wrinkles.

Answer: Minimizing pores and wrinkles.

Answer: HA Filler, Superficial Peels & At-home Rx Topicals Work Well In Combo For Nonsurgical Skin Rejuvenation

Answer: HA Filler, Superficial Peels & At-home Rx Topicals Work Well In Combo For Nonsurgical Skin Rejuvenation

Browse related questions

Recommended reading

Everything you need to know about Skin Rejuvenation

Our mission is to create a world where every investment in modern beauty is Worth It.