Generality
Large pores are very common skin blemishes, affecting women and men without distinction.
Usually, the pores of the skin are not problematic, unless they increase their size and become so obvious as to be unsightly. In fact, it may happen that these structures become obstructed and widen, constituting an evident change in the skin surface.
One of the main causes of dilation is oily skin: often, the pores of the skin tend to widen in case of overproduction of sebum and when they are no longer able to contain an excess of waste substances and dead cells.
The problem of large pores can be difficult to treat, but can be kept at bay by adopting a healthy diet and regular facial cleansing. Then there is a whole series of dermatological and cosmetic treatments that can help make this defect less obvious.
What are
The enlarged pores are skin blemishes that affect individuals of a wide range of ages (10-70 years), of both sexes and of all races. This condition can be defined:
a visible circular dilation and dimensions between 0.1 and 0.6 mm2, which makes the skin tone uneven .
The enlarged pores are not stable but dynamic (continuously changing) skin structures.
The possible causes of large pores are numerous and include many exogenous and endogenous factors, such as genetic predisposition, aging, chronic exposure to ultraviolet light or comedogenic xenobiotics (environmental toxicants, alcohol, drugs, pesticides, chlorinated hydrocarbons, etc.). ), acne and seborrhea.
Although this blemish is not a cause for medical concern, enlarged pores are an aesthetic defect that is experienced with anxiety by a large number of people.
"Poressia" is the name by which dermatologists have renamed the symptoms related to the presence of large pores on the face .
Causes
Pores are microscopic openings through which the skin releases sebum (matter that is produced by glands in our body). These structures are therefore indispensable for the normal tropism of the skin and it would not be possible to get rid of them permanently. Some pores appear, however, more dilated and larger than others.
The causal mechanisms of enlarged pores are mainly three:
- Excessive sebum production (it is no coincidence that the problem mainly affects people who tend to have a generally oily skin );
- Decreased elasticity around the pores (secondary to the loss of elastic fibers, collagen and proteins from the extracellular matrix);
- Increased volume of the hair follicle (therefore, also the size of the dermal papilla and the thickness of the hairs affect the dilation of the pores).
The possible exogenous and endogenous factors that contribute to the dilation of the pores are:
- Chronic acne;
- seborrhea;
- Action of sex hormones (including androgens and, in women, progesterone during ovulation);
- Genetic predisposition;
- Damage associated with exposure to ultraviolet light;
- Exposure to comedogenic xenobiotics (environmental toxicants, alcohol, drugs, pesticides, chlorinated hydrocarbons, etc.);
- Little daily attention given to the care of the skin surface (eg use of inadequate cosmetics and insufficient hygiene).
Pore dilation can be influenced by the application of occlusive or unsuitable tricks for your skin type. Another wrong habit is that of many women, not to remove make-up before going to sleep; in this way, the already opened pores become blocked.
An additional factor that tends to worsen this blemish is aging, especially in combination with damage caused by excessive sun exposure. Over the years, in fact, the skin loses the usual elasticity and integrity it has at a young age; this may predispose to pore enlargement.
Symptoms, signs and complications
The face is the part of the body most affected by the problem of large pores.
Clinically, the skin appears shiny above all in the central-facial area of the face (cheek area and T-zone: forehead, nose and chin), "greasy" and thickened with the typical appearance of "fat" skin.
The enlarged pores can be associated with blackheads and pimples.
Diagnosis
Before establishing the appropriate treatment for enlarged pores, it is useful to identify the underlying causes. First of all, it would be advisable to perform a skin check-up immediately after puberty, so as to get to know your skin type early. This allows you to adapt your daily cosmetic habits to suit your needs, in order to limit or prevent the appearance of large pores.
If this targeted strategy is insufficient, the doctor may suggest the use of real drugs. In the latter case, a prescription and constant medical supervision are required.
Treatment
Given the various factors that can cause pores to expand, the most appropriate treatment must be established "tailored" for each patient.
Options include medications and therapies that can:
- Reduce sebum production;
- Improve skin elasticity.
Oral and topical pharmacological treatment
In the presence of dilated pores, a treatment based on isotretinoin (13-cis retinoic acid), a powerful inhibitor of sebum production, may be indicated.
This drug works by suppressing the activity of the sebaceous gland and normalizing the pattern of keratinization inside the follicle.
The use of drugs with an anti-androgenic action can instead induce a reduction in the secretion of sebum by acting on the cells of the pilosebaceous unit (including follicular and sebocyte keratinocytes) sensitive to the action of these hormones.
Medicines that can affect sebum production also include combined hormonal contraceptives, spironolactone (synthetic steroid compound with a similar structure to progesterone and aldosterone) and cyproterone acetate (progestin with anti-androgen effect).
As far as topical solutions are concerned, it is possible to try using ingredients that can improve the trophism of oily skin. To reduce the oily appearance of the skin and the imperfections associated with excess sebum, the leaf extract of Orthosiphon stamineus may be useful.
Other active ingredients that can contribute to the reduction of sebaceous secretion and improve the appearance of the skin, if applied topically, are salicylic acid, L-carnitine and 2% niacinamide .
In the presence of large pores, the recommended detergents are simple solutions of surfactants, free of oils (oil-free), waxes or greasy agents that could aggravate the condition.
Furthermore, it is always necessary to check that moisturizing creams, sunscreens and other topical products do not contain comedogenic substances, ie substances that favor the formation of comedones (blackheads). These agents can be found in different cosmetic preparations (emulsions, dyes, solar shielding, preservatives, excipients etc.).
Laser treatment and botulinum toxin
Possible options that can be considered to reduce enlarged pores include: photodynamic therapy, diode laser and non-ablative radiofrequency . These interventions aim to induce a selective necrosis of the sebaceous glands.
Recently, the use of intradermal botulinum was also suggested to manage the problem of large pores. This toxin can be useful to reduce sebum production and the formation of related skin blemishes.
Finally, there are also dermabrasion treatments, which make it possible to even out the skin surface and eliminate pores in a few sessions.
Diet
Diet can be an important source of substrate for sebum synthesis.
In particular, dietary regimens rich in carbohydrates with a high glycemic index and dairy products can predispose to the formation of large pores. These foods should therefore be limited or, if possible, eliminated.
Anti-age interventions
The treatments useful for improving skin elasticity are different.
Retinoids increase the collagen content in the upper papillary dermis, increasing its synthesis and inhibiting its degeneration; these compounds include tretinoin and tazarotene.
The aesthetic medicine treatments used to minimize pores include IPL (pulsed light), fractional bipolar radiofrequency and 2790 nm wavelength laser with an yttrium crystal scandium gallium garnet as an active medium. Also in this case, the goal is to act on the collagen that characterizes our skin and thus determine a narrowing of the pores.
Finally, sun protection is essential at any age and must necessarily be used in addition to all other interventions implemented to counteract skin aging.
Hair removal
In some cases, the size of the enlarged pores can be reduced with epilation. Among the most useful techniques for skin improvement is photothermolysis (laser and pulsed light epilation).
Natural Remedies and Advice
To reduce the problem of large pores or prevent it, you can take some precautions:
- First of all, it is important to always proceed with an accurate and routine cleansing of the facial skin, since the accumulation of impurities tends to make the pores widen in an attempt to expel them. Cleansing milk, tonic and make-up remover that respect the physiological pH and the hydrolipidic balance allow to remove any residue left by make-up and atmospheric agents (such as pollution or smog), reducing the risk of large pores, blackheads and blackheads. Be careful, however, not to overdo it with aggressive products and too frequent washing: the stronger the cleansing will be, the faster and more abundant the reappearance of sebum.
- In combination with daily hygiene, a scrub performed regularly, about two or three times a week, can help remove dead cells and is particularly suitable for those with oily and oily skin, therefore more easily subject to the appearance of large pores.
- To reduce enlarged pores, skin care is very important: light moisturizers can be used in aqueous or gel solution, based on proteins, glycosaminoglycans, elastin and collagen. In the case of oily skin, sebum regulators can help you keep the problem of blackheads under control.
- Limit the consumption of fatty and preservative rich foods, preferring fruits and vegetables, which help to regulate the elasticity and production of sebum in the skin.
- Once a week, make a green clay mask : this ingredient absorbs sebum and tightens pores, but it should not be used too often, to prevent the skin from becoming dry.
- Apple vinegar has a natural astringent effect. Just create a solution of water and vinegar in equal parts and dip a cotton pad in it; apply to the pores as a tonic, leave for a few minutes and rinse.
- Lemon juice is also an excellent astringent. Apply to face, leave for 10 minutes, then rinse. To be repeated three times a week.
- One last attention to remember for the management of large pores: in case of seborrheic or oily skin, tanning lamps or prolonged and repeated sun exposure should not be abused. These quickly lead to a further thickening of the stratum corneum with a worsening of the situation.
