Pores and Lines All over the Face? (photo)

My facial skin is awful, rough, course texture and my pores appear stretched out and are very large over my entire face, and I have what appear to be tiny wrinkles and furrows all over my face from the stretched pores.I am 33 years old and I feel like a total and utter freak.I think I have damaged my skin through harsh cleansing/scrubbing over the years when I was in my 20's and now I think I have hit my 30's all the damage is becoming visible. Please help. Thank you

Doctor Answers 10

Fractional non-ablative Erbium laser resurfacing for fine lines and pores

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Of course she needed in person consultation for proper diagnosis and treatment plan.  However the fractional non-ablative Erbium laser resurfacing is a modern technique to build new collagen in the skin which can tighten pores and improve fine wrinkles.  Understand it takes 3-4 treatments and the final result will not be apparent for at least 6 months.

Enlarged Pores And Fines Lines Respond Well To Medical Microneedling

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 Enlarged, dilated, patulous pores and fine lines, the latter pretty common after the age of thirty, can be quite aesthetically distressing. Although microdermabrasion, peels, various light therapies, and even fraxel lasers have their proponents for the treatment of these problems, the results in my experience tend to be disappointing, as you have already discovered.

Generally speaking, in cases such as these, a series of medical microneedling treatments might be considered. Medical microneedling, which may be performed mechanically using rollers (e.g. Dermaroller) or electrically operated (Dermapen) essentially consists of going over the area with an array of needles that penetrate and break up the surface of the pore or scar and of any underlying abnormal fibrous tissue that may be contributing.

Disrupting the surface of the dilated pore, pits, and very fine allows allows for the possibility healing with a smoother surface texture.  Breaking up any fibrotic or sun-damaged abnormal collagen in this manner that may be present below the skin surface sets the stage for new, normal collagen synthesis (neocollagenesis), which improves the overall appearance of the overlying skin.

Following medical microneedling, the treated area may appear sun-burned for about 12-24 hours. There is little to no downtime, however, and I permit patients to return to routine skin care and makeup the following day.

Not all aesthetic physicians perform medical microneedling, so, should you wish to explore this simple, minimally-invasive option, you should screen carefully for a board certified aesthetic physician with training and expertise in the procedure.

Pores - what to do?

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Your pores are visible, but I think they are within the range of normal for more oily skin types.  You do look like you have some acne scarring of the temples, which although not in focus in your third picture, is an area that is slightly distracting on your face.  You also have some mild under-eye creepiness, which is more than you should for being Asian and 33 years old.

I agree with what others have said:
1) protect yourself from the sun in order to prevent sun damage, which leads to discoloration and coarse texture
2) start using a retinoid; this will improve the texture and keep the pores clean
3) use a good eye cream
4) consider doing an energy-based treatment to help with the acne scarring as well as improve the overall texture of the skin

Daily skin care makes a difference

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Your skin shows signs of ageing and sun damage that commensurate with your age.

Having the right daily skin care routine, using the right products, can make a difference. To begin with, make UV protection a daily ritual. UV exposure probably ages the sun more than gravity.
Use products with retinol and vitamin C.

You can add on treatments which encourages epidermal renewal like peels and microdermabrasion. Needling can also help promote collagen repair and production. 

Chien C. Kat, FRCS
Birmingham Plastic Surgeon
4.8 out of 5 stars 96 reviews

Good skin starts with a good skincare foundation

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Your first approach should be building a good skincare foundation. First and most importantly, sunblock! I recommend a mineral block, which provides the most broad-spectrum protection for your skin. SkinCeuticals Physical Fusion UV Defense SPF 50 is my go-to first layer, and it has a bit of color to even out your skin tone. Next, to tighten your pores and refine your skin over time, a retinoid is important. It will "normalize" your skin by improving its renewal cycle, which can help prevent formation of discoloration, whiteheads, and blackheads -- and over time, it will tighten your pores and refine your skin, and build new collagen. You are keeping your foundation strong. 

Then consider other treatments mentioned before, such as peels, lasers, and microneedling. I consider these procedures like painting the house and trimming the hedges - necessary to make the whole house look pretty, but you've got to build your foundation first. 

I hope this helps!

Andrea Hui, MD
San Francisco Dermatologic Surgeon

Skin rejuvenation and Fractional skin resurfacing

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Thank you for your question and the photos.

There is no one best answer, but Profractional Laser and Forever Young BBL treatments can make significant improvement for early signs of facial aging.

To be sure, see two or more board certified and experienced plastic surgeons in your area for a full and complete evaluation.

I hope this helps.

Pores and lines all over the face

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I have good news for you. You do not have awful skin but your skin is showing the signs of aging : pores and lines all over the face. The good news is you are interested to look better and take care of the skin and there are effective treatments.

First you need good nutrition to the skin and I would suggest TNS from Skin medica which has all the essential nutrients including growth factors.
A series of hydra facial would be helpful.
Laser resurfacing with the Pixel will remove tiny dots of old skin and new skin will form and decrease the pore size and lines.
All these treatments treat the skin from above.
The latest treatment is the LazerLift which treat the skin from below the skin with minimal downtime and pain with the use of local anesthesia. LazerLift tightens the skin and the immediate effect is improvement of the pores and lines. It also stimulate collagen formation so your skin will continue to improve for the next 6 +  months and you will look younger. I note that you also have  smile lines and it will improve your smile lines.   Good Luck

Best treatment for early signs of aging

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It's normal to start noticing the early signs of aging in your thirties.   The best treatment for texture, pores and fine lines is the microablative fractionated CO2 laser like SmartSkin. This laser is very effective for wrinkles, acne scars, and improving skin texture.  You seem to have a fair skin complexion.  This laser treatment is very precise and predictable.  You will have two days of swelling, two days of peeling and two days of redness.  To maintain your result I would consider using SkinMedica TNS essential serum with growth factors.  

Skin Rejuvenation

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There are many modalities that can be use to improve the skin.  They include prescription and non-prescription products, microdermabrasion, chemical peels as well as lasers.  It is best to be evaluated and discuss your concerns with your physician.

Craig Mezrow, MS, MD, FACS
Philadelphia Plastic Surgeon

Fractionated laser resufacing for large pores

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It's normal to start noticing the fine lines and pores in your 30s.

For enlarged pores and fine lines, multiple treatments with non-ablative fractionated lasers (such as the Fraxel re:store) are very effective. These lasers are great for wrinkles, acne scars, and improving skin texture. You can expect to be red and slightly swollen for 2-3 days. The treatments are typically spaced 4 weeks apart.

Lower energy devices (such as the Clear and Brilliant or Emerge system) can be used as well. These treatments are not as expensive and have less downtime. The results are not as dramatic but I think it is a great option for young patients.

Nazanin Saedi, MD
Philadelphia Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.