OPEN PORES
Authors : Dr. Vrushali Rane Khan .
It’s interesting to know that open pores is a term commonly used by the general public, especially women at some point in their lives but there is no dermatological terminology for the same. Open pores are the dilated opening of sebaceous glands concentrated mainly on the glabellar region, nose and adjoining cheeks.
While some notice it at young age due to oily skin, others notice it in their 30’s and often equated as an early sign of aging.
Etiology :
In the younger population, open pores are generally a result of recurrent and excessive sebaceous secretion. The excessive undrained sebum results in inflammation within the glands and the resultant edema reduces the elasticity of its walls over a period of time causing dilated pore openings or what are popularly known as open pores. Ultraviolet light causes collagen degradation and solar elastosis which reduced the dermal support of the sebaceous gland and premature increase in pore size. The same etiology stands true for open pores in aging skin in the elderly.
Treatment :
Cleansing
Cleansing with a 1 – 2 % salicylic acid based face wash twice a day can help control the oil secretions and limit the clogging of pores. While a young skin will bear it well, a mature skin might feel dry with salicylic acid. In that case, a milder cleanser needs to be used.
Sebostasis
While a salicylic acid based face wash will serve the purpose of washing away the sebaceous secretion, some patients will need additional sebostatic agents like 2.5 – 5 % benzoyl peroxide or a retinoid. One can also use 1 % salicylic acid based creams but salicylic acid being slightly harsh is best suited as face wash.
Exfoliation
While exfoliation is very popular, using a right exfoliant is important. For example, an alfa hydroxyl acid can cause excessive dryness, wont affect much the sebaceous gland and instead initiate compensatory oil secretion. Additionally, the microbeads that are present in commercially available preparations can get stuck within the pores, further blocking pores and aggravating the condition. A diamond microdermabrasion will be preferable over chemical exfoliants.
Toners
While toners act by pore contraction, it is a temporary phenomenon which disappears in a short time. Additionally, most toners are alcohol based which might aggravate a rosacea patient. Alcohol free toners may be advised for temporary benefit.
Regeneration
A night time retinoid most often helps with the turnover of keratinocytes hence the cellular stasis within the sebocyte is prevented in addition to the sebaceous secretion. Additionally, it delays and even reverses skin aging on the whole.
Sunprotection
While it’s been proven that UV B is implicated in the etiology of open pores, wearing a sunscreen with spf 40 and UVA +++ and repeating application every 2-3 hourly is mandatory.
Chemical Peels
Beta hydroxyl chemical peels work well for pore size reduction by sebaceous secretion regulation and alfa hydroxyl peels will work for cellular turnover and collagen rebuilding. Alternating these two peels will work well for open pore reduction.
Fractionated ablative Lasers / Radiofrequency / Microneedling
These are probably the only procedures that provide definitive results in pore reduction. By therapeutic wounding and subsequent neocollagenesis, they provide definite pore size reduction albeit with the downtime.
Newer molecules
A study by Inui et al it has been reported that the topical vitamin C derivative ascorbyl 2-phosphate 6-palmitate (APPS) decreased conspicuous facial pores.
Another study recommends that use of 1 % Fullerene lotion applied twice a day significantly decreases conspicuous facial pores after an 8-week treatment possibly through the suppression of PGE2 production in the epidermis.
Conclusion :
Oil regulation (sebostatic agents), sunscreen and chemical peels can prevent / delay the appearance of open pores. Invasive procedures like ablative lasers and radiofrequency can provide definite reduction in advanced cases of open pores.
It’s interesting to know that open pores is a term commonly used by the general public, especially women at some point in their lives but there is no dermatological terminology for the same. Open pores are the dilated opening of sebaceous glands concentrated mainly on the glabellar region, nose and adjoining cheeks.
While some notice it at young age due to oily skin, others notice it in their 30’s and often equated as an early sign of aging.
Etiology :
In the younger population, open pores are generally a result of recurrent and excessive sebaceous secretion. The excessive undrained sebum results in inflammation within the glands and the resultant edema reduces the elasticity of its walls over a period of time causing dilated pore openings or what are popularly known as open pores. Ultraviolet light causes collagen degradation and solar elastosis which reduced the dermal support of the sebaceous gland and premature increase in pore size. The same etiology stands true for open pores in aging skin in the elderly.
Treatment :
Cleansing
Cleansing with a 1 – 2 % salicylic acid based face wash twice a day can help control the oil secretions and limit the clogging of pores. While a young skin will bear it well, a mature skin might feel dry with salicylic acid. In that case, a milder cleanser needs to be used.
Sebostasis
While a salicylic acid based face wash will serve the purpose of washing away the sebaceous secretion, some patients will need additional sebostatic agents like 2.5 – 5 % benzoyl peroxide or a retinoid. One can also use 1 % salicylic acid based creams but salicylic acid being slightly harsh is best suited as face wash.
Exfoliation
While exfoliation is very popular, using a right exfoliant is important. For example, an alfa hydroxyl acid can cause excessive dryness, wont affect much the sebaceous gland and instead initiate compensatory oil secretion. Additionally, the microbeads that are present in commercially available preparations can get stuck within the pores, further blocking pores and aggravating the condition. A diamond microdermabrasion will be preferable over chemical exfoliants.
Toners
While toners act by pore contraction, it is a temporary phenomenon which disappears in a short time. Additionally, most toners are alcohol based which might aggravate a rosacea patient. Alcohol free toners may be advised for temporary benefit.
Regeneration
A night time retinoid most often helps with the turnover of keratinocytes hence the cellular stasis within the sebocyte is prevented in addition to the sebaceous secretion. Additionally, it delays and even reverses skin aging on the whole.
Sunprotection
While it’s been proven that UV B is implicated in the etiology of open pores, wearing a sunscreen with spf 40 and UVA +++ and repeating application every 2-3 hourly is mandatory.
Chemical Peels
Beta hydroxyl chemical peels work well for pore size reduction by sebaceous secretion regulation and alfa hydroxyl peels will work for cellular turnover and collagen rebuilding. Alternating these two peels will work well for open pore reduction.
Fractionated ablative Lasers / Radiofrequency / Microneedling
These are probably the only procedures that provide definitive results in pore reduction. By therapeutic wounding and subsequent neocollagenesis, they provide definite pore size reduction albeit with the downtime.
Newer molecules
A study by Inui et al it has been reported that the topical vitamin C derivative ascorbyl 2-phosphate 6-palmitate (APPS) decreased conspicuous facial pores.
Another study recommends that use of 1 % Fullerene lotion applied twice a day significantly decreases conspicuous facial pores after an 8-week treatment possibly through the suppression of PGE2 production in the epidermis.
Conclusion :
Oil regulation (sebostatic agents), sunscreen and chemical peels can prevent / delay the appearance of open pores. Invasive procedures like ablative lasers and radiofrequency can provide definite reduction in advanced cases of open pores.