What can be done to clear up my pores / sebaceous filaments? (photo)
Doctor Answers 2
Ehlarged Facial Pores May Respond To Chemical Peels, TCA CROSS, Medical Microneedling
Enlarged facial pores are essentially dilated openings of the pilosebaceous units visible to the naked eye. The openings may be impacted with horny follicular plugs consisting of sebacous gland secretions and cellular debris. Acne, seborrhea, aging and chronic photodamage all may diminish skin elasticity and tensile strength and give rise to increased facial pore size and number.
Topical prescription retinoids may help by diminishing acne, pore clogging and photoaging, but are not uniformly effective, as your story confirms. One of the easiest in-office treatments is to simply clean out the clogged pores, which, by itself decreases their visibility and allows for some degree of shrinkage. Additionally, the use of a series of superficial peels containing full-strength glycolic acid, salicylic acid, or Jessner's solution may be helpful. Larger, more dilated pores, like pit scars, may benefit from TCA CROSS. Although relatively expensive lasers, radiofrequency, and ultrasound devices have been hyped for this purpose (and without strong scientific justification for a lot of other conditions, as well), the medical literature supporting their value for minimizing pores is limited. One such study of twenty individuals treated with six treatments of a fractional laser over a two week period of time demonstrated a hardly convincing 17% average improvement. Fractional microneedle resurfacing (aka medical microneedling, skin needling, dermal rolling) is a quick and inexpensive modality that may be worth trying.
Make sure that you seek consultation and treatment with a board certified aesthetic physician. Best of luck.