Lasers Doesn't Work on my Large Nose Pores? (photo)

Question

What would you recommend for these large pores on my nose? I tried co2 laser but it hasnt improved it :(. What would you suggest? I got them after getting bad cystic acne on my nose that finally went away but left me with these large holes. I appreciate your help. Thanks!

Ron Shelton, MD · Answer

Ice pick scars from acne and large nasal pores can be treated similarly. The scars can be treated sequentially with a doctor meticulously applying 100% TCA (trichloroacetic acid) vua the point of a wooden applicator (CROSS technique).  This creates a wound which when healed may rise toward the surface. A few weeks later this is repeated and then repeated again as needed. Dermabrasion (sanding with a diamond wheel) or fraxel laser resurfacing can help improve the surface chanes after the scar approaches the skin surface. Punch grafts are another way in which to treat ice pick scars. The scar is removed surgically with a sharp core-like 'punch" and a skin graft harvested with a barely greater in diameter punch, usually from behind the ear, and placed into the new hole created by the removal of the scar. The punch grafts may be needed to be done over a few sessions as they will not live side by side usually until new blood flow grows to feed oxygen to the graft.

	All of these procedures are done in our NYC cosmetic dermatology practice after patients are evaluated in consultation to determine what's best for them and to discuss the risks of the procedure.

	The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

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. 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

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Eric M. Joseph, MD · Answer

The scar appears to be an "ice-pick" scar, and these do not respond well to lasers or fillers. A reputable cosmetic dermatologist may recommend excision of the scar with a punch biopsy and a suture. You should consult several reputable specialists to see what might be best for you.

	Hope this helps you.

	Dr. Joseph

Debra Irizarry, MD · Answer

This is an acne scar. It can be treated with 100% Trichloroacetic Acid applied with a toothpick, (by a medical professional ONLY), to convert it to a more shallow scar that can be treated with dermabrasion or laser resurfacing. A dermatologist or Plastic Surgeon that is familiar with this technique can do this for you. I hope this information is helpful Jenny. Best Regards, doctordeb.co

Davin Lim, MBBS, FACD - Account Suspended · Answer

Punch excision to large pore, TCA Cross to smaller ones, and then full laser resurfacing any you WILL have almost NO PORES. This is a tried and proven technique to remove/ reduce the appearance of large pores, especially on the nose. Fractional laser will do almost NOTHING for this kind of scarring. The simple use of TCA 70-100% is extremely effective, if conducted correctly. RegardsDr Davin Lim Laser DermatologistBrisbane, and Gold CoastAustralia

Lasers Doesn't Work on my Large Nose Pores? (photo)

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