Has anyone had success treating blackheads, large pores, acne scars on the nose, particularly for oily Asian skin? (Photo)

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best,
Dr. Raffy Karamanoukian
Realself100 Surgeon

Thank you for your question, Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. Generally speaking, we often use:- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars. - Subcision for depressed, tethered scars. - Vascular lasers like Yellow laser, Aerolase, excel V, or IPL for redness or thick acne scars. - Lasers such as Fraxel, Erbium, CO2 or fractional radiofrequency (Venus Viva, Skinfinity, Intensif microneedling RF) for textural issues and superficial scarring. - TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.- All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time.
For darker skin types, it is important to avoid strong lasers such as CO2/Erbium and Fraxel as they can cause hyperpigmentation. Instead, scars in darker skin types can be improved with a combination of microneedling RF (Fractora, Intensif, Infini), Aerolase or Laser Genesis, microneedling with PRP, skin lightening, peels like Cosmelan, and a proper skin care protocol (hydroquinone, vitamin c, kojic acid, azelaic acid, retinol). Sun protection is essential. I recommend getting a formal evaluation with a board-certified cosmetic dermatologist and acne scarring expert. Best, Dr. Emer

Although photos are no substitute for an in-person examination that allows for up-close examination, as well as for palpation and manipulation of the tissue, it appears that the primary problems on the nose are papular acne scars, ice pick scars & dilated pores. TCA CROSS, which I have personally been using for treating ice pick scars and dilated pores for over twenty years, was actually developed in South Korea. So, it is perfectly compatible with Asian skin. Papular acne scars (the bumpy, flesh-colored spots) can be difficult to treat. However, I have had success in flattening them via the use of intralesional injection of anti-inflammatory agents either alone in combination with prior electrodessication flattening performed quickly and easily using only prior local anesthesia.  Make sure that you consult a board certified aesthetic physician with experience and expertise in acne scar treatments. Best of luck. 

TCA CROSS for deeper pores, high pass C+B 1927 or Fraxel 1927, pico can help. Prep the skin before / after with simple AHA 15 + retinoids. 2-3 sessions will give you a good outcome. Dr Davin S. Lim, Brisbane. Australia.