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

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

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.

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