Rosacea, enlarged pores and 'orange peel' textured skin. Please help! (Photo)

Bear in mind that topicals and peels only affect superficial skin. To hone in on the redness from enlarged blood vessels, you need to get deeper - and this is where lasers come in.Vascular lasers go after "red" - the heat coagulates and seals off the blood vessels that expand when you "flush", whatever the cause.Lasers only get a bad rap when they are used too aggressively or the wrong laser is used for your skin type. Look into Excel V and Vbeam Perfecta/Prima vascular lasers. BBL (broad band light) is another option. Self education on which lasers treat which conditions is certainly time well invested.Very mild lasers such as Laser Genesis can be used to help skin texture on patients who have Rosacea. I'm sure you're familiar with managing triggers and using sunscreen and staying away from harsh products. It's frequently only a combination of treatments and products that help improve skin condition and it's usually an ongoing process of management.

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, rosacea, 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

I recommend getting a formal evaluation with a cosmetic dermatologist. For rosacea, I like a combination approach, using lasers (ProYellow, Pulsed Dye/Vbeam, Excel V), peels and botox to the cheeks. This makes dramatic changes in color and symptoms. See an expert. Best, Dr. Emer

The issues that you are describing can be effectively addressed through the use of laser treatment. Rosacea is caused by tiny red blood vessels which can be eliminated through the Vbeam laser, using a special energy wavelength precisely targeted for this redness. 
Another laser called Fraxel Dual is able to promote the production of new collagen fibers which then is able to then reduce the size of your pores. 
You might be interested in learning about a patient from our office at the Dr.U Hair and Skin Clinics in Los Angeles who noticed that her large pores had been drastically improved following her treatment with the Fraxel Dual laser. See the article link below. 

Hello and thank you for your question. In my professional opinion you need a good skincare treatment. A good facial will work , but also try to keep an open mind on fractional Erbium Laser and IPL Skin Rejuvenation (in your case i would go with textural setting). Feel free to book an appointment with a board certified doctor that can better address your concerns. Best, Dr Kipervas

Hello and thank you for your question and photos. Although it is difficult to assess your skin from photos and provide an accurate diagnosis, I do see varying texture, pores, and redness to your skin. There are many effective procedures such as lasers and micro-needling, in addition to topical and oral medications. I would recommend a consultation with a board certified dermatologist for evaluation of your skin and discussion of appropriate treatment. Best of luck.