What are enlarged pores?
We call the external mouth of the pilosebaceous follicle the “pore”, whose mission is to pour the sebum on the skin surface so that it remains hydrated. In certain circumstances these openings can be especially wide and become very noticeable. In these cases we popularly refer to them as “enlarged pores” or “open pores”.
Why do open pores appear?
They do not involve any health disorder beyond the undesirable aesthetic appearance they may have. There are several factors that, in combination, cause pores to open and become more noticeable, such as age, genetic predisposition, chronic sun exposure, excess sebum, and acne. Several studies have linked a larger diameter of hair follicle opening to age, sebum production, male gender, and hormonal disorders in women.
Therefore, it is not uncommon for enlarged pores to be found accompanying seborrheic skin, with comedones (pimples) and other acne-like lesions.
In which areas are enlarged pores most common?
They are usually located on the nose, cheeks and chin, although they can settle in any area that is especially seborrheic (face, thorax and dorsal area).
How are open pores treated?
There are different published methods with varying results, such as intense pulsed light, tretinoin, isotretinoin, and chemical peels .
Glycolic and/or pyruvic acid peels are not very lipophilic and have a relatively discreet action on the pilosebaceous follicle, so they are not the most effective. On the other hand, salicylic acid is more effectively fixed to the pilosebaceous gland and is more effective in removing excess sebum present in comedones. Although it does not reduce the size of open pores, it may be advisable to first perform a salicylic acid peeling to remove sebum from comedones and then proceed to the use of a non-ablative laser.
In a study by Cho et al., it has been described that the application of non-ablative fractional laser improves the appearance of enlarged pores by more than 50% in more than half of the cases treated at 4 months. For their part, Saedi and other authors observed that with 6 sessions with this device, it is possible to reduce the total area of visible pores by up to 17% without any notable adverse effects.
How does the non-ablative fractional laser work to improve enlarged pores?
This device stimulates the synthesis of dermal collagen around the exit of the pilosebaceous gland, which allows the partial contraction of its opening and the decrease of its outer diameter.
How are non-ablative fractional laser sessions performed for the treatment of open pores?
First, an anesthetic cream is applied to the area to be treated, followed by the laser head. The procedure takes between 5-15 minutes, depending on the extent of the area to be treated, and is a comfortable experience without intense discomfort. The main advantage of the non-ablative fractional laser is that, after the session, only discreet redness and swelling are observed that last for a few hours in most cases. Other devices, such as the ablative laser or pulsed light, cause scabs and wounds (in the case of the former), or an increased risk of pigmentation disorders (in the latter). If you want to know more about the non-ablative fractional laser, head over to the FAQ section here.
Can non-ablative fractional laser be combined with other treatments?
Yes, and in fact it is ideal. It is perfectly compatible with the application of salicylic acid peels in the Dermatology consultation or with formulations that contain this substance and retinoids simultaneously to be applied at home. Patients with excess sebum and/or acne lesions can benefit from taking oral isotretinoin .
Do “complexion cleanses” remove open pores?
Usually not. In the best of cases, they serve only to eliminate comedones, with the risk of leaving scars if their removal is mechanical by squeezing them. The most effective peels for the treatment of comedones are those with salicylic acid, not glycolic acid. For this reason, it is advisable to consult a dermatologist about the therapeutic possibilities to treat enlarged pores.
REFERENCES
· Cho et al. Efficacy of the fractional photothermolysis system with dynamic operating mode on acne scars and enlarged facial pores. Dermatologic surgery. 2008; 35(1): 108-113.
· Saedi et al. Evaluating facial pores and skin texture after low-energy nonablative fractional 1440-nm laser treatments. Journal of the American Academy of Dermatology. 2013; 68(1): 113-118.