Ep 29: Causes and Treatment of Enlarged Pores
Hi guys, welcome to my podcast Dermatologist Talks: Science of Beauty. I’m Dr. Teo Wan Lin, accredited dermatologist practising at TWL Specialist Skin and Laser Centre and in this week’s dermatology flash briefing, we’re going to talk about the causes of enlarged pores.
This is a complaint that I hear quite a lot in my practice. A little bit of background to me. I am a dermatologist with my own private practice in Singapore at TWL Specialist Skin and Laser Centre. I see patients with both medical and cosmetic dermatological conditions. Enlarged pores is actually a colloquial or laypersons description of increased prominence of the follicles on your face.
What are the causes of this?
I would state the following three as the tops causes of enlarged pores. Firstly, acne prone individuals tend to have oilier skin and this means that their sebaceous glands, or oil glands are much more active. The sebaceous glands are connected to the hair follicles. When there is increased activity of the sebaceous glands, it can overall cause increased prominence of the appearance of the follicles on the face. Blackheads, also known as open comedones, is a type of acne that can lead to the appearance of enlarged pores.
Blackheads appear as little bumps on the skin with an opening to the surface. This opening is often filled with skin debris that has undergone oxidation, which is why it appears black. It consists of a mixture of oil, dead skin and grime, other types of material that I’ve collected in the skin’s follicles over a period of time.
The second commonest cause of enlarged pores is actually a condition which looks a lot like acne, but isn’t acne. In fact, it has been mistaken for acne in a lot of patients. This condition is what we call rosacea. Acne rosacea is a subtype of rosacea that looks very similar to acne vulgaris. However, there are a few distinct characteristics of rosacea, which can help us differentiate between the two conditions.
First of all, there is an increase in background redness – what we call erythema. This is when blood vessels are highly reactive to temperature changes. An individual with rosacea will find their skin persistently flushed, as opposed to an ordinary individual who simply has flushing after exertion in warm weather, but the facial flushing subsequently resolves when the skin’s temperature is cool. In individuals with rosacea, the skin remains persistently flushed.
It is often mistaken for acne because there are papules and pustules in certain variants of rosacea. In fact, the flushing and the skin swelling can also look like sensitive skin or eczema. Most importantly, when you suffer from rosacea for a long period of time, over many years, the prolonged increase in blood flow to the skin surface can result in skin thickening. The end stage of rosacea is the condition rhinophyma, which can be disfiguring. The skin thickening that occurs in rosacea occurs over many years, often decades. Individuals with rosacea often complain that the skin texture is rough, irregular and having enlarged pores.
Photoaging and oxidative stress
Another cause of enlarged pores is related to photoaging. Biological ageing is a process that correlates with your chronological age. Photoaging and environmental-related ageing such as oxidative stress from ultraviolet exposure or from environmental pollutants. All that generates free radicals at the surface of the skin. This results in oxidative stress. As a result, when skin ages you also find changes in the skin texture. If you have pre existing conditions like rosacea, acne or have some form of scars from these conditions from when you had them when you were younger, you’ll find that as you grow older, these facial pores may become more prominent as a result of ageing, as well as scarring.
Tips to prevent and treat enlarged pores
Now that we’ve covered the commonest causes of enlarged pores, I’m going to give some general skincare tips which can prevent and also hopefully treat some of your concerns. First of all, if you do have untreated acne or rosacea, it is important for you to visit an accredited dermatologist who likely will start you on prescription medication to get the condition under control. Skincare is an important part of the treatment of any dermatological condition. Specifically for addressing the case of enlarged pores in acne, I find that it’s important to incorporate home treatments such as microdermabrasion.
Microdermabrasion used to be only practised in the clinic or office setting by clinic personnel using diamond tips. These are fairly abrasive. With the advent of vacuum microdermabrasion such as the hydrofacials as well as the Korean Medifacials, we realised that non-abrasive ways of microdermabrasion can effectively increase the absorption of antioxidants at the same time, resurfacing the skin. Enhancing cellular renewal is one way to minimise the appearance of pores. However, if you do suffer from rosacea, microdermabrasion is likely going to trigger off a flare up. This is only applicable for individuals who do not have active acne, who have enlarged pores due to acne scarring, or overproduction of sebum hyperseborrhea and also in individuals who have photo ageing.
At-home chemical peel: vacuum microdermabrasion
The concept of vacuum microdermabrasion is best described as a form of microscopic skin exfoliation. Usually dermatologists would recommend chemical peels using acids such as glycolic acid, salicylic acid, and lactic acids. These help to resurface the skin by enhancing cell renewal. This should only be performed by trained medical personnel and at concentrations which are effective in the clinic setting. These should not supply to home users. However, using a home device such as a vacuum microdermabrasion device can offer a form of home-based facial peeling that is gentle. Ideally, the vacuum should also be adjustable to different settings in order to cater for individuals who may have sensitive skin or slightly drier skin.
The SilkPeel Home Medi-facial Kit utiliizes polyglutamic acid based solutions with potent antioxidants delivered via vacuum microdermabrasion that helps to achieve a translucent appearance of the skin, reducing the appearance of pores,
Well that’s it for this week’s dermatology flash briefing. We’ve spoken about the top three causes of enlarged pores, as well as my favourite intervention for effective home treatment – which is vacuum microdermabrasion. I hope you enjoyed today’s podcast episode. You can follow me on my Instagram at @drteowanlin for the latest podcasts updates and also visit us on our website at www.scienceofbeauty.net.