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If you’ve ever looked closely in the mirror and wondered, “Why are my pores so big?” you’re definitely not alone. Large or visible pores are one of the most common skin concerns we hear about at NicholsMD, especially around the nose, cheeks, and T-zone. And if you’ve spent any time on TikTok or browsing the skincare aisle, you’ve probably also seen countless products promising to “open,” “close,” or “shrink” your pores.
So, can you actually shrink your pores? The short answer: not exactly. Your pores don’t open and close like tiny doors, and you can’t permanently erase them. But you can absolutely make enlarged pores look smaller and less noticeable.
The key is understanding why your pores look enlarged in the first place.
Pores are normal openings in the skin associated with hair follicles and sebaceous, or oil, glands. Everyone has them, and they serve an important function. What we commonly call “large pores” are simply follicular openings that have become more visible. Pore size and appearance can be influenced by several factors, including:
That’s why treating large pores isn’t as simple as finding one miracle “pore-shrinking” product. The best treatment depends on why your pores are noticeable.
If you have naturally oily skin, you may be more likely to notice enlarged pores, particularly around the nose and central cheeks. Sebum travels through the follicle to reach the surface of your skin. Higher levels of oil production are associated with more visible pores. This is also one reason someone with oily or acne-prone skin may notice larger-looking pores at a younger age.
Think of this less as your pore physically “growing” and more as it becoming increasingly noticeable. Oil, dead skin cells, and debris can accumulate inside a pore. As the follicle becomes congested, the opening can appear larger. Blackheads can make pores particularly noticeable because the dark material inside the follicle creates more contrast against the surrounding skin.
This is the part people often overlook. Large pores aren’t always an oil problem. As we age, our skin gradually loses collagen and elasticity. When the skin surrounding a pore has less structural support, the pore can begin to look larger or more elongated. This is why someone who never struggled with noticeable pores in their 20s may suddenly start seeing them in their 30s, 40s, or beyond.
Another reason to wear your SPF. Repeated UV exposure contributes to collagen breakdown and changes in skin elasticity. As the support around the pore decreases, pores can become more visible over time.
No. Despite what you may have heard, pores do not contain muscles that allow them to physically open and close. Hot water or steam can help soften oil and debris, which may make it easier to cleanse the skin, but they don’t “open” your pores. Similarly, splashing your face with cold water does not permanently “close” them.
What we can do is keep pores clear and improve the skin surrounding them so that they appear smaller. That distinction matters.
If your goal is to minimize the appearance of large pores, we typically think about three things:
Depending on the cause and severity of your enlarged pores, this may involve a combination of at-home skincare and in-office treatments.
Retinoids are one of our favorite ingredients for improving overall skin quality. They help normalize cell turnover, prevent pores from becoming clogged, and support collagen production. Over time, this can improve skin texture and make pores appear less prominent.
Depending on your skin, your dermatologist may recommend an over-the-counter retinol, like our favorites from SkinCeuticals, or a prescription retinoid such as tretinoin.
If clogged pores and oil are the primary issue, salicylic acid can be especially helpful. Because salicylic acid is oil-soluble, it can penetrate into the follicle and help remove excess oil and dead skin cells. Keeping the pore clear can make it look less noticeable.
Yes, SPF belongs in the pore conversation. Because chronic UV exposure contributes to collagen loss and reduced skin elasticity, daily broad-spectrum sunscreen is one of the simplest ways to prevent pores from becoming more noticeable with age.
If large pores are bothering you, take a look at what you’re putting on your skin. Products labeled “non-comedogenic” are formulated to be less likely to clog pores. This can be especially important if you have oily, acne-prone, or congestion-prone skin.
And remember: more skincare isn’t always better. Using too many harsh or irritating products can disrupt your skin barrier without actually addressing what’s causing your pores to look enlarged.
This is where we can go beyond what your skincare routine can accomplish at home. If pores remain noticeable despite a consistent skincare routine, in-office treatments can address some of the underlying factors that contribute to their appearance, particularly texture, acne scarring, oil production, and collagen loss.
At NicholsMD, your treatment plan may include one or a combination of treatments depending on your skin.
For patients concerned with enlarged pores and excess oil, Pore-Minimizing MiniTox is one of our favorite options for creating a smoother, more refined-looking complexion.
Unlike traditional Botox injections that target deeper facial muscles to soften expression lines, MiniTox involves more superficial placement of a neuromodulator within the skin. This technique can help temporarily reduce oil production and improve the appearance of enlarged pores, leaving the skin looking smoother and more polished.
It can be especially helpful for patients who notice persistent oiliness, visible pores through the T-zone, or skin that quickly becomes shiny throughout the day.
While MiniTox cannot permanently shrink your pores, it can help make them appear smaller and improve overall skin texture, making it a great option when your goal is that smooth, filtered-looking finish without the filter.
The Greenwich Secret™ is our signature treatment that combines radiofrequency microneedling with a customized topical infusion. Microneedling stimulates the body’s natural healing response and collagen production, while radiofrequency delivers energy deeper into the skin.
For patients concerned about enlarged pores, uneven texture, acne scarring, or overall skin quality, improving the collagen and support surrounding the pores can help make them appear less noticeable.
Traditional microneedling can also be an effective option for improving the appearance of large pores and uneven texture. By stimulating collagen production, microneedling helps improve the overall quality and smoothness of the skin.
It’s particularly helpful when enlarged pores are accompanied by acne scars or textural concerns.
Depending on your skin type and concerns, laser treatments may also be incorporated into a pore-minimizing treatment plan. Resurfacing and fractional laser technologies can help improve texture, stimulate collagen, and address sun damage, all of which can contribute to the appearance of enlarged pores.
The right laser depends on your skin tone, sensitivity, downtime preferences, and other concerns you’re hoping to address at the same time.
Chemical peels can help exfoliate dead skin cells, improve congestion, and smooth uneven texture. For patients whose pores look larger because of oiliness, congestion, or acne, a customized peel may be incorporated into a broader treatment plan.
If your skincare hasn’t changed but your pores suddenly seem more noticeable, collagen may be the missing piece. Younger skin generally has greater elasticity and structural support around each follicle. As collagen and elastin decline with age and accumulated sun exposure, that support weakens.
The result? A pore that once looked tiny can begin to appear wider, longer, or more noticeable. This is why our approach to treating enlarged pores can change with age. For younger patients with oily or acne-prone skin, controlling oil and congestion may be the priority. As we get older, treatments that improve collagen, elasticity, and skin quality may become equally important.
No treatment can completely eliminate your pores, and we wouldn’t want it to. Pores are a normal part of healthy skin.
The goal isn’t “poreless” skin. The goal is to make enlarged pores less visible by addressing the factors contributing to their appearance.
Results also require maintenance. Oil production, aging, sun exposure, and collagen loss don’t simply stop after a treatment. A combination of daily skincare, sun protection, and strategically selected in-office treatments typically provides the most comprehensive approach.
There isn’t one universal best treatment for large pores because not everyone’s pores are enlarged for the same reason.
If you’re younger with oily, congested skin, your plan may focus more heavily on salicylic acid, retinoids, chemical peels, and acne management.
If you’re noticing large pores alongside fine lines, laxity, or changes in skin texture, collagen-stimulating treatments like microneedling, radiofrequency microneedling, or laser resurfacing may make more sense.
And if you have acne scarring in addition to enlarged pores, we may create a combination treatment plan to address both.
This is where having your skin evaluated by a dermatology provider can make all the difference. Instead of simply treating the pore you see in the mirror, we can determine why you’re seeing it.
You cannot permanently change pores into tiny, invisible openings, but you can make them appear smaller. Keeping pores clear, controlling excess oil, protecting collagen, and improving skin texture can all reduce their visibility.
The nose contains a high concentration of sebaceous glands, so pores in this area can be particularly noticeable. Oil production, congestion, blackheads, and genetics can all contribute.
Sometimes pores become more visually noticeable because of changes in hydration, lighting, or temporary irritation. Over-cleansing or using harsh products can also disrupt the skin barrier. Your cleanser should leave your skin clean, not stripped or tight.
Aging can contribute. As collagen and skin elasticity decrease, the structural support surrounding the follicle changes, which can make pores appear larger.
Facials can help with congestion, hydration, and overall skin texture, which may temporarily make pores look less noticeable. However, they cannot permanently eliminate pores. For more significant concerns, your provider may recommend collagen-stimulating or resurfacing treatments.
If there’s one thing we want you to remember, it’s this: Pores are normal.
You don’t need perfectly “poreless” skin, regardless of what a filter, beauty ad, or social media trend might suggest. But if enlarged pores, congestion, acne scars, or uneven texture are bothering you, there are effective ways to improve their appearance.
At NicholsMD, we take a dermatologist-led approach to understanding what’s actually happening in your skin and creating a personalized treatment and skincare plan around it. Because the best treatment for large pores isn’t necessarily the newest viral product, it’s the one that addresses why your pores look enlarged in the first place.
If you’re searching for how to tighten loose skin above the knees, the good news is that we now have more options than ever. The right treatment depends on what’s actually causing the appearance of your knees. For some patients, the primary concern is skin laxity. For others, it’s crepey texture, wrinkles, collagen loss, excess skin, or a combination of several factors.
At NicholsMD, we take a personalized approach to knee rejuvenation and may recommend one or a combination of treatments based on your skin and goals.
One of the most exciting advancements for sagging knees is Ultherapy PRIME. Ultherapy PRIME recently received FDA clearance to improve the appearance of skin laxity on the knees, giving patients a non-invasive option specifically cleared for this notoriously difficult-to-treat area.
Using microfocused ultrasound with real-time visualization, Ultherapy PRIME delivers energy beneath the skin to stimulate the body’s natural collagen-building process. Over time, that new collagen can help improve the appearance of lax, sagging skin around and above the knees.
Unlike treatments that work primarily at the skin’s surface, Ultherapy PRIME allows us to visualize the layers of tissue we’re treating and precisely deliver ultrasound energy at targeted depths. There are no incisions or injectable fillers involved, and results develop gradually as your body produces new collagen.
For patients whose biggest complaint is, “The skin above my knees is starting to sag,” Ultherapy PRIME may be an especially exciting option.
If your knees are looking more crepey, wrinkled, or texturally uneven, we may also want to focus on improving the quality of the skin itself. The Greenwich Secret™ is our signature treatment combining radiofrequency microneedling with a customized topical serum.
Radiofrequency microneedling delivers controlled energy into the skin to support collagen remodeling while addressing concerns like laxity and texture. For the knees, this can be particularly helpful when the concern isn’t simply loose skin, but that thin, crinkled appearance patients often describe as “crepey knees.”
For patients with more noticeable loose or excess skin, Ellacor may be another option. Ellacor uses micro-coring technology to remove tiny cores of skin without traditional surgical incisions.
By physically removing small amounts of excess skin, micro-coring offers a different approach than treatments that rely primarily on energy or collagen stimulation. Because every degree of knee laxity is different, your NicholsMD provider can determine whether Ellacor, an energy-based treatment, or a combination approach makes the most sense for you.
If all three treatments can potentially play a role in knee rejuvenation, how do you know which one you need?
Think about what you actually see when you look at your knees.
If the primary concern is loose or sagging skin, we may focus on deeper collagen stimulation with Ultherapy PRIME.
If you’re seeing crepey texture, fine lines, or changes in the quality of the skin, The Greenwich Secret™ may be incorporated to address the skin more directly.
For more noticeable excess skin, we may discuss whether Ellacor micro-coring is appropriate.
And oftentimes, the answer isn’t choosing just one. Combining treatments that work in different ways can allow us to address both deeper laxity and the quality of the skin at the surface.
Your treatment plan should ultimately depend on your anatomy, degree of laxity, skin quality, goals, and the amount of downtime you’re comfortable with.
We spend so much time thinking about collagen loss and skin aging on the face, but the same changes are happening everywhere else, including your knees. Whether you’re starting to notice subtle crepiness or more visible skin laxity above the knees, today’s treatment options allow us to address these changes in ways we simply couldn’t before.
With Ultherapy PRIME now FDA-cleared to improve the appearance of skin laxity on the knees, alongside treatments like The Greenwich Secret™ and Ellacor, we can create a personalized approach based on your skin, your goals, and the results you’re looking for.
Ready to give your knees a little more attention? Schedule a consultation at NicholsMD to discover the right treatment plan for you.
If you’re serious about your skincare routine, chances are you’ve heard that you “need a retinol.” But then come the questions: What about tretinoin? Is tretinoin better than retinol? Which one is stronger? And which one should you actually be using?
Both retinol and tretinoin belong to the retinoid family, a group of vitamin A derivatives widely used in dermatology for concerns ranging from acne to signs of skin aging. But they aren’t the same, and stronger doesn’t automatically mean better for your skin.
Here’s what to know before choosing between them.
Retinol is a type of retinoid commonly found in over-the-counter skincare products. Once applied, it goes through conversion steps within the skin before becoming retinoic acid, the form that can interact with retinoic acid receptors.
Because of this conversion process, retinol generally works more gradually than prescription tretinoin. That doesn’t mean it isn’t effective. A well-formulated retinol can be a great option for patients looking to improve the appearance of fine lines, uneven tone, texture, and other visible signs of skin aging while easing into a retinoid routine.
Tretinoin is a prescription topical retinoid and is already in the active retinoic acid form. Dermatologists have used tretinoin for decades, and it has extensive research supporting its use for acne and photoaging.
Depending on your skin and treatment goals, your provider may prescribe different strengths or formulations. Because tretinoin is more potent, however, it may also cause more irritation, particularly when you first begin using it.
Yes. Tretinoin acts directly as retinoic acid, while retinol needs to be converted by the skin first.
But here’s the part that matters: stronger doesn’t necessarily mean better. If a product is so irritating that you’re constantly stopping and restarting it, you may be better served by a gentler retinoid you can use consistently.
Your skin type, sensitivity, current routine, goals, and previous experience with retinoids all matter when deciding which option makes sense.
Depending on the formulation and your individual skin, retinoids may be used to help address:
This is why retinoids are often considered a cornerstone of a well-designed skincare routine. But know that they aren’t an overnight treatment. Consistency over time is key.
Both can have a place in an anti-aging skincare routine.
Tretinoin has substantial clinical evidence supporting improvement in signs of photoaging, including fine wrinkles and uneven pigmentation. However, not everyone needs prescription-strength tretinoin to have an effective skincare routine.
For someone new to retinoids or with more sensitive skin, a high-quality retinol, like our favorites from SkinCeuticals, may be an appropriate place to start.
Someone with specific concerns or who has already developed a tolerance to retinoids may be a candidate for prescription tretinoin. The goal isn’t to use the strongest product possible. It’s to find the most effective routine your skin can tolerate consistently.
More isn’t always more when it comes to retinoids. If you’re new to retinol or tretinoin, your provider may recommend starting a few nights per week and gradually increasing frequency as your skin adjusts.
Using too much too quickly can lead to dryness, peeling, redness, sensitivity, and irritation. And when your skin barrier is irritated, adding even more active ingredients usually isn’t the answer. A slow, consistent approach tends to win this race.
Yes! Dr. Nichols’ Skincare Trifecta includes vitamin C and SPF in the morning and your retinoid at night. This allows you to incorporate both ingredients without layering multiple potent actives at the same time.
Of course, your exact routine should depend on the products you’re using and how your skin tolerates them.
One of the most common skincare mistakes we see is adding too many active ingredients at once. Using a retinoid alongside multiple exfoliating acids, scrubs, or other potentially irritating products can be too much for some skin types.
A simple routine consisting of a gentle cleanser, moisturizer, daily broad-spectrum sunscreen, and thoughtfully selected active ingredients is often more effective than an overflowing skincare shelf.
And sunscreen is especially important. Retinoids are often used to address signs of sun damage, so protecting your skin from additional UV exposure should be part of the plan.
Topical retinoids are generally avoided during pregnancy. If you’re pregnant, trying to become pregnant, or breastfeeding, talk with your dermatologist or healthcare provider about which skincare ingredients are appropriate for you.
There are other skincare options that may be recommended during this stage.
There isn’t a universal winner in the retinol vs. tretinoin debate.
If you’re new to retinoids, have sensitive skin, or want a more gradual approach, retinol may be a good choice. If you’re addressing acne or more significant signs of photoaging, your dermatologist may recommend prescription tretinoin.
At NicholsMD, our board-certified providers believe your skincare routine should be just as personalized as your in-office treatments. We consider your skin type, concerns, lifestyle, current products, and treatment goals to build a routine you’ll actually use.
When it comes to retinoids, the best product isn’t necessarily the strongest one. It’s the one that’s right for your skin.
Not sure whether retinol or tretinoin belongs in your routine? Schedule a consultation at NicholsMD for personalized recommendations based on your skin and goals.
If you’ve started noticing jowls, a less-defined jawline, or looser skin along your face and neck, but you’re not looking for surgery or significant downtime, XERF may be worth considering. XERF is a non-surgical radiofrequency treatment designed to address skin laxity and support collagen remodeling for a firmer, more defined appearance. But like any aesthetic treatment, XERF isn’t necessarily the right choice for everyone.
So, who is a good candidate for XERF? Here’s what we look for.
Who Is an Ideal Candidate for XERF?
XERF may be a good option for patients experiencing mild to moderate skin laxity who want to improve facial definition without surgery.
We especially consider XERF for patients who are beginning to notice:
XERF uses radiofrequency energy to heat targeted tissue and stimulate the body’s natural collagen-remodeling process. Rather than changing your facial features, the goal is to help lift, contour, and restore definition in a way that still looks like you.
Is XERF Good for Jowls and the Jawline?
The lower face is one of the areas where patients often begin noticing skin laxity first. You might see the beginnings of jowls, notice that your jawline isn’t as crisp in photos, or feel like the transition between your face and neck has become less defined. XERF can be used to address laxity through the lower face, jawline, and neck, making it an option for patients looking for non-surgical facial contouring and skin tightening. However, not every jowl is caused by the same thing. Skin laxity, facial volume, anatomy, and even the way different areas of the face age can all contribute. That’s why an in-person assessment is important before deciding that XERF, or any single treatment, is the answer.
What Age Is Best for XERF?
There isn’t one “perfect” age to start XERF. Some patients may consider treatment when they first begin noticing subtle laxity or loss of definition, while others may use XERF to address more established changes in the face and neck. At NicholsMD, we focus less on the number on your driver’s license and more on your skin, anatomy, goals, and degree of laxity. You don’t necessarily have to wait until sagging becomes significant to start thinking about collagen-banking treatments.
Is XERF a Good Option If I’m Not Ready for a Facelift?
For the right patient, XERF can be an appealing option when you want to improve laxity and facial definition but aren’t ready for, or interested in, surgical intervention. XERF is designed for patients seeking a natural-looking, non-surgical improvement with a treatment experience that can fit more easily into everyday life.
Does XERF Hurt?
Comfort is one of the reasons we’re excited about XERF. The treatment is designed to deliver radiofrequency energy while incorporating cooling technology for a more comfortable experience. No numbing is necessary (although we do offer Journavx and Pronox as added comfort options), and there is little to no downtime afterward. For busy patients who want skin tightening without adding significant recovery time to their calendars, that can be a major advantage.
How Many XERF Treatments Will I Need?
At NicholsMD, we typically begin with a series of two XERF treatments, although your exact treatment plan will depend on your skin and goals. Unlike a treatment designed to create an overnight transformation, XERF works by supporting your body’s natural collagen-remodeling process. While you may notice an instant contour, results continue develop progressively as that process takes place. This is one of the reasons XERF can work particularly well for patients who want their results to look subtle, refreshed, and natural rather than dramatically different.
XERF vs. Ultherapy: How Do I Know Which One I Need?
XERF and Ultherapy are both non-surgical treatments that can be used as part of a skin-tightening plan, but they use different types of energy and aren’t interchangeable for every patient.
XERF uses radiofrequency energy, while Ultherapy uses microfocused ultrasound energy. Which treatment makes the most sense depends on factors including your anatomy, degree of laxity, treatment goals, and the areas you want to address.
For some patients, the answer may even be a combination approach rather than choosing one treatment in isolation.
Who Might Not Be a Good Candidate for XERF?
Certain medical conditions, implanted devices, medications, pregnancy, or other individual factors may also affect whether radiofrequency treatment is appropriate for you. This is exactly why we don’t believe in choosing aesthetic treatments based solely on what’s trending. The right treatment should be based on your anatomy and your goals.
Is XERF Right for Me?
If you’re looking in the mirror and thinking, I still look like myself, but my jawline isn’t quite as defined as it used to be, that’s exactly the kind of conversation worth having with your provider.
At NicholsMD, our board-certified providers create personalized treatment plans based on your facial anatomy, skin quality, lifestyle, and long-term goals. XERF may be recommended on its own or as part of a larger plan to help you maintain natural-looking facial definition as you age. The goal isn’t to change the way you look., it’s to help you look and feel like the best version of yourself.
Interested in XERF for your face, jawline, or neck? Schedule a consultation at NicholsMD to find out if XERF is the right skin-tightening treatment for you. (LINK TO BOOKING PAGE)
You made it through pregnancy, delivery, and newborn life, and now your hair seems to be everywhere except your head. Postpartum hair loss can feel alarming, but it’s also incredibly common.
Here’s what’s actually happening, how long postpartum shedding typically lasts, and when it may be time to get help.
During pregnancy, elevated hormone levels can keep more of your hair in its active growth phase. This is one reason many women notice that their hair looks especially full and thick while pregnant.
After delivery, hormone levels shift dramatically. Many of those hairs transition into the resting and shedding phases around the same time, resulting in what is known as postpartum telogen effluvium. That can mean noticeably more hair coming out while showering, brushing, or styling your hair.
Postpartum hair shedding commonly becomes noticeable a few months after giving birth rather than immediately. For many women, the shedding gradually improves as the hair-growth cycle normalizes.
But because hair grows slowly, returning to your previous density can take time. Those wispy “baby hairs” around the hairline? As frustrating as they can be to style, they may actually be a welcome sign of new growth.
First, remember that postpartum hair loss is not a reason to start throwing every trending supplement and serum at your scalp.
Hair loss can have multiple causes, and the postpartum period can also coincide with nutritional deficiencies, thyroid changes, stress, and underlying genetic hair thinning. If shedding is significant or persistent, a professional evaluation can help determine whether you’re experiencing typical postpartum hair loss or something else.
Supporting overall nutrition, minimizing unnecessary stress on fragile hair, and using appropriate hair-care products can all be helpful while your normal growth cycle returns.
For patients who need additional support, a personalized hair restoration plan may include medical-grade at-home products, red light therapy, or regenerative in-office treatments when appropriate.
If your shedding feels excessive, continues longer than expected, leaves visibly thin areas, or your hair density doesn’t seem to be returning, it’s worth having it evaluated.
At The Hair Lab™ by NicholsMD, our board-certified providers evaluate hair loss and hair thinning to help determine what may be contributing to it and create a personalized treatment plan.
Depending on your needs and where you are in your postpartum journey, treatment options may include PRP hair restoration, regenerative treatments like Acorn, red light therapy with the Revian hair cap, and medical-grade hair products.
You don’t have to guess your way through postpartum hair loss.
Concerned about postpartum hair thinning or struggling to see your density return? Schedule a Hair Lab consultation at NicholsMD and let’s create a personalized plan for healthier, fuller-looking hair.
If you’ve started a GLP-1 medication and suddenly noticed more hair in your brush, shower drain, or ponytail, you’re not imagining it. Hair loss while taking GLP-1 medications has become an increasingly common concern, especially among patients experiencing significant or rapid weight loss.
The good news? In many cases, this type of shedding can improve. The first step is understanding why it’s happening.
Hair shedding associated with medications such as Ozempic®, Wegovy®, Mounjaro®, and Zepbound® may not necessarily be caused by the medication directly. Instead, significant weight loss, changes in nutrition, reduced caloric intake, and stress on the body can trigger a temporary form of hair shedding called telogen effluvium.
Hair naturally cycles through growing, resting, and shedding phases. When the body experiences a major change, including rapid weight loss, more hairs can shift into the resting phase at once. Several months later, you may begin noticing increased shedding.
This delay is why some patients are surprised when hair loss begins after they’ve already been on a GLP-1 for some time.
If your shedding is caused by telogen effluvium, it is often temporary. However, hair grows slowly, so improvement takes time.
It’s also important not to assume that every case of hair loss while taking a GLP-1 is simply from weight loss. Nutritional deficiencies, hormonal changes, thyroid conditions, genetics, and other types of hair loss can contribute as well.
That’s why determining the cause matters before jumping into supplements or treatments.
Start by making sure your body has the nutritional support it needs. Adequate protein, iron, vitamins, minerals, and overall caloric intake are all important for healthy hair growth. Your healthcare provider may recommend bloodwork if a nutritional deficiency or other underlying cause is suspected.
From there, a personalized hair restoration plan may include at-home products or devices alongside in-office treatments designed to support healthier, fuller-looking hair.
At The Hair Lab, our board-certified providers take a comprehensive approach to hair loss and hair thinning. Depending on your individual needs, your plan may include options such as PRP or PRF hair restoration, regenerative treatments such as Acorn Secretome and Plated Exosomes, red light therapy, and medical-grade hair products.
If you’re experiencing significant shedding, visible thinning, a widening part, a change in your hairline, or hair loss that isn’t improving, don’t simply wait and hope it stops. The earlier we understand what is happening with your hair, the more strategically we can approach it.
Experiencing hair loss or thinning while taking a GLP-1? Schedule a Hair Lab consultation at NicholsMD to identify potential causes and create a personalized plan to support healthier, fuller-looking hair.
From dermatologist offices to social media, exosomes are everywhere. They’re being praised as one of the biggest breakthroughs in regenerative skincare, but with all the excitement has also come a lot of confusion. Are they stem cells? Are they safe? Do they actually work? And are all exosome products created equal?
At NicholsMD, we’re committed to bringing our patients treatments and skincare backed by science, not trends. As dermatologists, we believe education is just as important as the products you choose. Here’s everything you need to know about one of the most exciting advances in skin rejuvenation.
Exosomes are tiny, naturally occurring extracellular vesicles released by cells throughout the body. Think of them as microscopic messengers. Rather than becoming new skin cells themselves, exosomes deliver important biological signals that help neighboring cells communicate, repair, and regenerate.
These vesicles carry proteins, peptides, lipids, RNA, and growth factors that support healthy cellular function. In skincare, they’re being studied for their ability to improve the appearance of aging skin, enhance skin quality, and support the skin’s natural renewal process.
No, and this is one of the biggest misconceptions we see at NicholsMD. Stem cells are living cells capable of developing into different types of tissue. Exosomes are not living cells. Instead, they are the signaling molecules released by cells, including stem cells and platelets.
A simple way to think about it is this:
Stem cells are the factory. Exosomes are the messages the factory sends out.
Those messages tell surrounding cells how to respond, repair, and function more efficiently.
While research continues to evolve, studies have shown that exosomes may help support healthier-looking skin by:
Rather than forcing change, exosomes help support your skin’s own regenerative processes, making them an exciting addition to modern skincare.
In short, yes. Exosomes have become one of the fastest-growing areas of regenerative medicine because of their ability to facilitate cellular communication. Clinical research continues to demonstrate encouraging results in improving skin quality, reducing visible signs of aging, and supporting recovery following cosmetic procedures.
That said, not all exosome products are created equal. The source of the exosomes, manufacturing process, formulation, and stability all play a significant role in how effective a product may be. That’s why choosing dermatologist-recommended products backed by scientific research is essential.
Yes, but formulation matters. Unlike injectable treatments performed in-office, topical exosome products must be formulated in a way that allows the exosomes to remain stable and biologically active. The delivery system is just as important as the ingredient itself.
That’s one reason we’re excited about Plated® Skin Science, which uses platelet-derived exosomes and proprietary Renewosome™ technology to deliver regenerative signals through expertly formulated topical skincare.
Exosomes can come from several different cellular sources, including stem cells and platelets. Platelet-derived exosomes contain naturally occurring regenerative signaling molecules released by human platelets, which play an essential role in the body’s healing process. Stem cell-derived exosomes originate from stem cells and have a different biological signaling profile.
While both are being studied extensively, Plated® Skin Science chose platelet-derived exosomes because of their well-established role in supporting tissue repair and skin rejuvenation.
When sourced responsibly and developed using rigorous scientific standards, exosomes have demonstrated an excellent safety profile in topical skincare. As with any skincare product, quality matters. Because exosome technology is relatively new, it’s important to choose products from reputable companies supported by clinical research rather than marketing hype.
At NicholsMD, we carefully evaluate the science behind every product we recommend to ensure it meets our standards for safety and efficacy.
No, and they aren’t designed to. Retinoids remain one of the gold standards for stimulating collagen production and improving signs of aging. Exosomes work through an entirely different mechanism by supporting cellular communication and skin regeneration.
In fact, many of our patients benefit from using both as part of a comprehensive skincare routine. Your dermatologist can help determine which combination is best for your skin.
Absolutely. One of the most exciting applications of exosome technology is supporting the skin following aesthetic procedures such as:
Because these procedures trigger your body’s natural healing response, regenerative skincare may help support the recovery process while optimizing overall skin health. At NicholsMD, we often recommend advanced skincare as part of a personalized post-procedure regimen.
Growth factors and exosomes are related, but they’re not the same thing. Growth factors are individual proteins that send specific signals to skin cells. Exosomes are tiny vesicles that carry a diverse collection of signaling molecules, including growth factors, proteins, lipids, RNA, and other important biological messengers.
Think of growth factors as a single letter. Exosomes are the entire package containing multiple instructions working together.
Absolutely, and this is one of the newest frontiers in regenerative skincare. While most people focus their skincare routine on their face, nearly 95% of our skin is below the neck. Areas like the neck, chest, arms, hands, and legs experience the same collagen loss, dryness, sun damage, and crepey skin that occur on the face.
That’s why we’re excited to offer Plated® BODY, designed specifically to deliver platelet-derived exosome technology to areas beyond the face. It helps improve the appearance of crepey skin, dryness, uneven texture, and visible signs of aging from the neck down.
Best for those looking to improve visible signs of aging, enhance skin quality, support post-procedure recovery, and elevate their overall skincare routine.
Designed specifically for the delicate eye area to address the appearance of crow’s feet, under-eye aging, and puffiness.
An excellent option for sensitive or reactive skin and anyone looking to support a healthy skin barrier while reducing the appearance of redness.
Perfect for improving the appearance of crepey skin, dryness, rough texture, and visible aging on the neck, chest, arms, hands, and body.
Designed to support the appearance of healthier, fuller-looking hair and improve overall scalp and hair quality.
Exosomes represent one of the most exciting advancements in regenerative skincare because they support your skin’s natural ability to renew itself. While they aren’t a replacement for daily sunscreen, retinoids, or in-office treatments, they can become a powerful part of a comprehensive skin health plan when you choose products backed by real science.
If you’re curious whether exosome skincare is right for you, our team at NicholsMD can help create a personalized regimen that combines physician-grade skincare with advanced in-office treatments to help you achieve healthy, radiant skin for years to come.
Hair loss has a cause. Finding it early can make all the difference.
Most people assume stress is to blame when they notice changes in their hair. And while stress can absolutely trigger temporary hair shedding, it’s far from the only cause.
As dermatologists, we often see patients months, or even years, after they first noticed something wasn’t quite right. By then, they’ve changed their hairstyle, bought every supplement on the market, and convinced themselves it will get better on its own.
The reality? Hair thinning is incredibly common, but it’s not “normal.” Understanding why it’s happening is the first step toward treating it successfully.
Here are six signs your hair thinning may be more than just stress.
Stress-related hair shedding, known as telogen effluvium, usually begins a few months after a stressful event and gradually improves as your body recovers.
If your hair has been thinning for six months or longer, or it continues to worsen, it’s worth looking beyond stress. Persistent hair loss may be related to genetics, hormonal changes, nutritional deficiencies, thyroid disorders, scalp inflammation, or other underlying medical conditions.
The sooner these causes are identified, the more options we have to preserve your hair and encourage healthier growth.
One of the biggest misconceptions about hair loss is that you’ll see handfuls of hair in the shower. Many patients don’t.
Instead, they notice their hair simply doesn’t feel as full as it once did. Their ponytail feels smaller, they have less volume, or they can see more of their scalp under bright lighting.
This gradual thinning is often caused by miniaturization, where hair follicles begin producing finer, weaker hairs over time. It can happen quietly for years before significant shedding ever occurs.
One of the earliest signs of female pattern hair loss is a widening part. You may not notice excessive shedding at all. Instead, your center part gradually becomes wider, more scalp is visible, or your hairline looks less dense in photos.
Patients often tell us, “I don’t think I’m losing hair… it just doesn’t look as thick anymore.”
Because this type of hair loss develops gradually, it’s easy to dismiss. But catching it early can make a significant difference in slowing progression and preserving the hair you have.
Hair loss often becomes noticeable in subtle ways first.
Maybe you’ve started:
If you’ve quietly adjusted your routine to make your hair look fuller, your hair may already be telling you something.
Healthy hair starts with a healthy scalp. If you’re experiencing itching, burning, flaking, tenderness, redness, or excess oil, your scalp may be contributing to your hair thinning.
Inflammation can disrupt the normal hair growth cycle and create an environment where hair struggles to thrive.
Treating the scalp is often one of the most overlooked, yet most important, steps in successful hair restoration.
If your mother, father, grandparents, or siblings experienced thinning hair, genetics may be playing a larger role than stress.
Pattern hair loss is one of the most common causes of hair thinning in both women and men, but that doesn’t mean it’s untreatable.
Today’s dermatologist-led treatments can help preserve existing hair, stimulate healthier growth, and slow future progression, especially when started early.
Hair is skin, and dermatologists are uniquely trained to diagnose conditions affecting both the hair and scalp.
At The Hair Lab by NicholsMD, we don’t believe in guessing. We begin by identifying why your hair is thinning before recommending a personalized treatment plan.
Depending on the cause, that may include PRP hair restoration, regenerative therapies, physician-grade supplements, prescription medications, REVIAN® red light therapy, advanced scalp treatments, or a customized combination of therapies.
No two patients lose hair for the same reason, so no two treatment plans should be exactly alike.
If you’re noticing some of these signs, we’d love to see you for a consultation at The Hair Lab.
