Treatment to improve skin texture and tone to achieve 'glass skin' and brighter complexion? (Photo)

Question

My skin colour always appears to be dull, lifeless and uneven. Texture is very bumpy and rough to the touch. With large pores they often get clogged and cause white/black heads which leads to uneven texture. Since turning 31, I'm even noticing fine lines and deeper nasolabial folds. I've considered CO2 laser, chemical peel, microneedling but unsure which is more suited to my case or what the latest technology/ best treatment to go for? And anything to also reduce marionette lines? Thank you!

Nelson Lee Novick, MD · Answer

Additional close up photos would have been extremely helpful for evaluating your pores and comedones. In the absence of this, I would say that in general, clogged pores (whiteheads and blackheads) can be easily cleaned out. A series of superficial peels, using high concentrations of glycolic or salicylic acid; Jessner's solution or low concentrations of TCA can go a long way to creating a more youthful, glowing and light reflective skin. The skillful use of a volumizing filler placed over the cheekbone regions would likely create a more youthful heart-shaped face and diminish the tear troughs, smile lines and incipient marionette lines. The results of this treatment are typically immediate and elicit a "Wow!" reaction, Forget the hype about this or that laser or other energy-based devices, since the science to support these expensive bells and whistles lags well behind the marketing and advertising for their use.  As with most things, the simplest solutions are often the best. Hope this helps.

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Treatment to improve skin texture and tone to achieve 'glass skin' and brighter complexion? (Photo)

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