Hi!
From the photo, it appears that you have acne scars rather than large pores. Physical examination in person would allow us to be more certain and advise better on the approach.
What are effective treatments for large pores on dark ethnic skin if chemical peels and fractional C02 laser does not work?
Dark ethnic skin has more melanin content and is more prone to post inflammatory hyperpigmentation (PIH), which can be persistent.
Chemical peels, with the exception of CROSS technique, are not really what I would recommend for scarring.
Fractional CO2 laser and other fractional lasers deposit energy and heat damage at the skin surface before penetrating deeper. Depending on technical parameters such as the wavelength, spot size, pulse duration and coverage of the laser, this collateral damage to the skin surface can stimulate excess melanin production as a protective response - PIH.
For dark ethnic skin, I would recommend fractional microneedle radiofrequency or fractional picosecond laser over fractional lasers or chemical peels.
- Fractional microneedle radiofrequency such as Explore, Infini, etc use microneedles to bypass the skin surface, only depositing energy in the deep skin layers. This allows aggressive treatment while sparing the skin surface, reducing the downtime and chances of PIH greatly.
- Fractional picosecond lasers produce cold photomechanical damage deep in the skin. The lack of heat damage reduces the chances of PIH.
Between the two, fractional microneedle radiofrequency seems to produce more obvious results while fractional picosecond laser has shorter downtime.
Hope this helps!
Warmest regards,
Dr Wan Chee Kwang
References:
- Mei XL, Wang L. Ablative fractional carbon dioxide laser combined with intense pulsed light for the treatment of photoaging skin in Chinese population: A split-face study. Medicine (Baltimore). 2018 Jan;97(3):e9494.
- Sobhi RM, Mohamed IS, El Sharkawy DA, El Wahab MAEFA. Comparative study between the efficacy of fractional micro-needle radiofrequency and fractional CO2 laser in the treatment of striae distensae. Lasers Med Sci. 2019 May 1.
- Dai R, Xie H, Hua W, Li XH, Li L. The efficacy and safety of the fractional radiofrequency technique for the treatment of atrophic acne scar in Asians: A meta-analysis. J Cosmet Laser Ther. 2017 Oct;19(6):337-344.
