Female, 38, what can I do to make the enlarged pores after Accutane less visible? (Photos)

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hi! Thank you for your question about enlarged pores and reducing the size and appearance of your enlarged pores. I definitely suggest microneedling to address your concerns. Microneedling creates little micro-injuries in the skin to help produce collagen and fill in those dents/scars and to tighten your pores. I typically suggest 3 sessions to start, about 4-6 weeks apart. Downtime is minimal - you will be red for about 3-5 days and need to protect your face from the sun. I hope this helps!

Two issues here: one is the proper use of Accutane and the second is the treatment of the enlarged pores. In general, using Accutane to treat mild acne is like using an elephant gun being used to kill a tiny mosquito; the elephant gun will get the job done, but it will likely cause a whole lot of scatter and collateral damage. A fly swatter might be a much safer alternative. My general philosophy, therefore, when it comes to the elephant gun of Accutane can be summarized as, Why make the whole body pay for the sins of only the face?" You might wish to discuss stopping the Accutane with your dermatologist. There are many safe and effective topical anti-acne medications that can treat even severe cases of acne without the need to resort to the elephant gun. As to the dilated pores, professionally performed manual medical microneedling (no need for the added expense and risks of RF microneedling) can be helpful as can a series of superficial peels using high concentrations of either glycolic or salicylic acid, Jessner's Solution, or low concentrations of TCA. You would be wise to make sure to consult a board certified cosmetic dermatologist who would be able to help you with both issues. Best of luck.