Pulverize Pores: The Ignored Sign of Aging

shutterstock_344957471Enlarged pores are a consistent cosmetic concern that can be difficult to treat and can cause significant distress to each individual.  They tend to be overlooked and are a tell tale sign of aging.

“Enlarged pores” really isn’t a medical term.  It is even hard to tie down within the medical literature, but generally means any circular structure that can be seen with the naked eye.  Most are caused by enlarged oil glands (pilosebaceous units) that can become enlarged or plugged with skin debris (horny follicular plugs) that may appear as black heads (comedomes) or simply enlarged circles.

Complete understanding of this phenomenon is not known, but the most common factors are felt to be sebum production (basically oil from the glands), loss of skin elasticity and tension, along with hair follicle size.  Other less common factors include genetic predisposition, acne, comedogenic xenobiotics, chronic photo damage, chronic radiodermatitis, and vitamin A deficiency.

Men tend to have higher sebum output than woman due to testosterone.  However, the data is contradictory on whether sex affects pore size.  Women also have changes in sebum production due to hormonal factors with the highest production happening during the ovulation phase of the menstrual cycle.

Treatments:

Treatment of enlarged pores focuses on decreasing sebum production, rejuvenation of the skin, hair removal, and decreasing the follicular size.  Hard core evidence based studies are lacking, but the general accepted therapies are reviewed.

Topical therapies:

Topical vitamin A derivatives such as tretinoin (Retin-A), isotretinoin, and tazarotene.  Although all these improve the skin’s collagen and elastin, many studies reference improvement in the face of active acne.  However both Retin-A and tazarotene have show independent improvement of pore size with consistent use.

Chemical peels have also shown improvement in pore size.  These can either be light, consistent application of peels (such as glycolic acids) or deeper peels such as trichloroacetic acid (TCA) peels.

Newer novel treatments include botanicals such as plant derived copper chlorophyll complex sodium salt (CHLcu) and tetra-hydro-jasmonic acid (LR2412).  Clinical trials are limited on these treatments, but are ongoing.

Oral Therapies:

Anti-androgens are most commonly used for enlarged pores due to their direct effect on sebum production. These include oral contraceptives, spironolactone, and cyproterone acetate.

Lasers, Radiofrequency, and Ultrasound devices:

These treatments have become very common place for rejuvenation of the skin.  It is felt that these modalities improve pore size due to remodeling of collagen fibers near the pilosebaceous openings to increase skin elasticity and reduce sebum production.  Other treatments include micro needling and exfoliation.

Conclusion:

Pore size remains a challenging problem, however with the various treatments available most people can see good improvement.  For the average individual, multi-modality treatment is recommended as no one treatment is a silver bullet.

 

For more information, please refer to the original article here:

http://www.mdedge.com/cutis/article/110032/acne/enlarged-facial-pores-update-treatments

Enlarged Facial Pores: An Update on Treatments

Cutis. 2016 July;98(1):33-36

Author(s): Joanna Dong, BA Julien Lanoue, MD Gary Goldenberg, MD

From the Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

 

 

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