Open Pores - Cause and Management
Open pores are the dilated opening of sebaceous glands(oil glands) concentrated mainly on the T zone and the cheeks adjoining the nose.
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.
In the younger population, open pores are generally a result of recurrent and excessive oil gland secretion of what is called sebum. The excessive undrained sebum results in inflammation and persistent swelling within the oil gland which in turn 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 dermis support of the sebaceous/oil gland and premature increase in pore size. This is an early sign of aging.
Cleansing with a 1 – 2 % salicylic acid based face wash twice a day can help wash out 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.
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 0.025% tretinoin.
While exfoliation is very popular, using a right exfoliant is important. For example, an alfa hydroxyl acid(glycolic 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 at a dermatologist clinic will be preferable over chemical exfoliants.
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.
A night time 0.025% tretinoin cream not just helps with stasis within the sebocyte but also initiates cell turnover and hence collagen regeneration to some extent. On long term use, it can give anti-aging benefits.
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.
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. This is specifically indicated for people who do not see results with applications. The above mentioned procedures, done by a dermatologist induce therapeutic controlled wounding and subsequent healing with neocollagenesis (new collagen formation). There is a definite pore reduction over a period of time.
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.