How to treat damaged/enlarged pores and hypertrophic scarring (papular) on the nose? (Photos)

Question

Had cystic rosacea acne and the habit of picking so now i have these dilated pores on my nose that create uneven texture. I also have hypertrophic scaring (papular) on the nose, what kind of treatment is available? Willing to travel a bit further if neede

Nelson Lee Novick, MD · Answer

For many years, I've had very gratifying results treating individuals with papular scars using Low Intensity electrocautery. 
TCA CROSS, which I have been using for over a quarter of a century, has a proven safety and efficacy record for treating dilated pores and ice pick scars.
You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist. Hope this helps and best of luck. 
Exercise a good deal of buyer beware caution when being offered the expensive light and energy-based gizmos out there, since the hard science to back up their use lags well behind the heavy marketing hype and social media buzz to promote them. Hope this helps and saves you lots of money and frustration.  Best of luck.

Anna Chacon, MD, FAAD · Answer

First, I want to say that you're not alone in dealing with this. Cystic rosacea acne can be incredibly frustrating, and many patients find themselves picking at lesions simply because they are painful, persistent, or cosmetically bothersome. Unfortunately, the nose is one of the most challenging areas to treat because it has a high concentration of oil glands and thicker skin compared to other parts of the face.

From your description, it sounds like you may be dealing with two separate issues:

Enlarged Pores and Uneven Texture

When severe inflammation damages the surrounding skin and pore structure, pores can become permanently enlarged and create an irregular texture. While we cannot literally "shrink" pores back to their original size, several treatments can significantly improve their appearance.

Fractional ablative lasers, such as CO2 or Erbium lasers, are often among the most effective options because they stimulate collagen remodeling and smooth the skin's surface. Radiofrequency microneedling can also help improve texture and tighten the surrounding tissue. For some patients, a combination approach produces the best results.

Papular or Hypertrophic Scarring

The raised, papular scars on the nose are often more difficult to treat than depressed acne scars. These scars are caused by excess collagen production during healing.

Depending on the exact type of scar, treatment options may include:

Intralesional corticosteroid injections to flatten raised scars
Laser resurfacing
Radiofrequency treatments
Surgical scar revision for select lesions
Combination therapies that gradually reduce scar thickness while improving texture

The nose is an area where aggressive treatment must be performed carefully because the skin heals differently than other facial regions.

The Importance of Controlling Rosacea

Before pursuing scar revision, it is essential that the rosacea itself is well controlled. Ongoing inflammation can continue to damage collagen and create new texture changes, making cosmetic treatments less effective.

My Overall Thoughts

For patients with enlarged pores, textural irregularities, and papular scarring on the nose, I typically see the best results from a customized combination of treatments rather than a single procedure. Fractional resurfacing and scar-directed therapies tend to provide the most meaningful improvement, although multiple sessions are often necessary because the nose can be particularly resistant to treatment.

The encouraging news is that these types of scars and texture changes can often be improved significantly, even if complete elimination is not realistic. The key is selecting treatments that specifically address both the enlarged pores and the raised scar tissue rather than focusing on only one aspect of the problem.

How to treat damaged/enlarged pores and hypertrophic scarring (papular) on the nose? (Photos)

Answers (2)

More Scar Removal Questions

How can I treat an 11 year old scar? (Photos)

How can I treat scar on my penis from a nail puncture? (Photo)

Best Procedure for 8 - 10 year old scar removal? (Photos)

36, 2 years post facelift - What can be done about this scarring? (Photos)

Scar on frown line - scar healing or correction required? (Photos)

What are the best options to treat surgical scar on stomach? (Photos)

WE SEND PRETTY
EMAILS