I am 39 years old. I have very large pores and skin is loose on my face with frown lines and fine wrinkles. Will Botox help?

Botox is an excellent choice for your horizontal forehead wrinkles. These dynamic lines occur when you make certain facial expressions. Botox is a neuromodulator that relaxes the muscles that form wrinkles, smoothing the surface of the skin in the process. 

As effective as Botox is in treating dynamic wrinkles, it does not do much to reduce pore size or tighten skin. This would likely require a collagen induction therapy like RF microneedling or Ulthera micro-focused ultrasound, which would boost collagen levels for thicker, smoother skin. Some of the larger pores may also respond well to a light Fraxel laser called Clear and Brilliant to put the finishing touches on your complexion. Make sure the doctor you choose for your treatment is both board certified and an expert in skin rejuvenation techniques to ensure the best possible results. 

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

I appreciate your question and your images. Botox is a neuromodulator that reduces the appearance of wrinkles by relaxing the facial muscles that lead to their formation. The lines caused by muscle activity are known as dynamic wrinkles. The horizontal lines on your forehead are perfect examples of dynamic wrinkles that can be effectively treated with Botox. 
Your skin concerns, including enlarged pores and laxity, are better treated through another process like laser resurfacing. This treatment works at a cellular level to stimulate collagen production. As collagen levels in the dermal structure increase, the skin becomes smoother and firmer. I recommend scheduling an in-person assessment with a board-certified dermatologist who can examine your skin and discuss your concerns and goals at greater length. With a treatment plan tailored to your precise needs, you should be able to achieve significant improvement.

Botox is used to relax facial muscles to improve the appearance of wrinkles such as crows feet, horizontal forehead lines and frown lines on the forehead. So it can treat the vertical lines between your brows (the elevens, also known as frown lines) as well as the wrinkles in your photo which appear when you raise your eyebrows. However, it will not treat large pores, an issue caused by the fact that the collagen around the edge of these openings has become lax due to aging processes. At my office, the Dr.U Hair and Skin Clinics in Los Angeles, we are able to use lasers, such as Fraxel Dual to help patients see a real difference in the tightness of their skin pores. With laser energy, it is possible to reach deeper skin levels and apply specific forms of heat. This causes the fibroblast cells to produce new collagen and improve overall firmness.

Thank you for your question and for providing pictures. I would recommend Bellafill to treat all your concerns. The main ingredients in Bellafill are bovine-sourced collagen combined with polymethylmethacrylate microspheres. These microspheres provide structural support and will even out the skin.  I recommend scheduling a consultation with an experienced physician for optimal results.  All the best.