How can I treat these tiny bumps on my face? (Photo)

Question

Hi could you help me with my skin condition. What could these tiny bumps be I have a history of eczema. From past 9months i have been consulting dermatologist. As per her suggestion i have used Elidel, atonide, tacromiz and got chemical peels twice and i have been put on tretinoin for two months and two weeks back got fractional skin resurfacing done but nothing is helping me much. It would be much appreciated if you could help me. Thanks in advance

Anna Chacon, MD, FAAD · Answer

Thank you for reaching out and sharing such a detailed history of your treatments. It really helps me understand your journey so far. Tiny bumps on the skin, especially in someone with a history of eczema, can sometimes be due to a variety of causes, such as clogged pores, keratosis pilaris, post-inflammatory changes from eczema, or even a reaction to certain treatments.

Since you’ve already tried several topical medications, chemical peels, tretinoin, and even fractional resurfacing without much improvement, it may be worth re-evaluating the exact diagnosis to ensure we’re treating the right underlying cause. Sometimes, bumps that look like eczema-related changes could be something else entirely, like folliculitis or milia.

I recommend a fresh assessment possibly with dermoscopy or even a skin biopsy if needed—to pinpoint the cause. In the meantime, gentle skin care (avoiding over-exfoliation), good moisturization, and continuing to protect your skin barrier will be important.

You’ve clearly been very proactive about your care, and with the right tailored approach, we should be able to get you closer to relief.

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

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