What to do about open pores

Good day Dr Campbell-Chambers,

I have acne and open pores. I have tried several ways of treating same, but it seems as if I am having more and more open pores. What can be done to eliminate these open pores and to prevent others? Sometimes it is advised not to squeeze pimples in the face, but what happens to what is inside them?

I think that if they are not squeezed they develop into open pores. What do you think? I have used home remedies such as drinking more water, making a paste with oats and honey, baking soda etc, but there is not much improvement. I've also used clindoxyl gel, but this only makes my face look lighter and does not do much.

Dear Reader,

In my last article, we addressed similar concerns from another reader. Some of that information may be repeated as we answer your specific questions. Acne is an inflammatory disorder involving the hair follicle and its attached oil-producing (sebaceous) gland. The oil (sebum) reaches the surface of the skin through the hair pore. While we all have pores, individuals with acne tend to have enlarged pores and oily skin. This is so because of the excess production of oil due to hormones stimulating the sebaceous gland. There is also clogging of the pores by dead skin cells, bacteria and inflammation which causes acne.

Don't squeeze

It is advised that you avoid squeezing acne lesions because this can make them go deeper and cause more scarring and dark spots. If they are not squeezed, most acne pimples are reabsorbed by the body with time. However, in some cases, scars may be left behind. A type of acne scarring called ice pick scars may be mistaken for open pores. It is best to use acne treatment to improve acne and prevent complications like scarring.

Medications like retinoids and procedures like dermal needling, chemical peels, lasers and/or surgery can improve the appearance of acne scarring and open pores. However, the scars and pores cannot be totally eliminated. Blackheads and whiteheads can be extracted by a trained skin-care professional, if desired. However, this cannot prevent new ones from forming.

Oats and honey

While water is vital to our health, drinking lots of it cannot necessarily get rid of acne. Oatmeal can help unclog pores by removing dead skin cells (exfoliating) while honey is both exfoliating and antibacterial. Baking soda might be irritating in treating facial acne. Additionally, although some of these ingredients may help, other treatments may be needed to control acne effectively.

Acne is treated on an individual basis, based on its severity and psychosocial impact. Mild to moderate acne can be treated with topical retinoids, topical benzoyl peroxide, topical salicylic acid, topical sulfur and topical and/or oral antibiotics. Clindoxyl TM (5% benzoyl peroxide and 1% clindamycin) is a medicated gel which studies have shown to be very effective at reducing acne lesions. However, some individuals may experience redness, peeling, burning and drying of the skin. It is not a skin-bleaching cream, although the benzoyl peroxide in it can fade clothing. Perhaps your face appeared lighter while on it as a result of irritation and dryness. To minimise potential irritation, these treatments may be initially used on alternate nights, with gentle cleansers and oil-free moisturisers and sunscreens in the day as supportive therapy.

In moderate to severe acne, oral antibiotics, oral anti-hormonal pills (eg some oral contraceptives for women) can be added. Severe acne can be treated with an oral retinoid. Other optional treatments include chemical peels, microdermabrasion, injectable medication into deep lumps, light therapy and lasers. Scarring, dark spots, keloids and psychosocial problems can also be treated. Although there is no permanent cure for acne, long-term treatment can give great results. So don't give up!

Dr Arusha Campbell-Chambers is a dermatologist and founder of Dermatology Solutions Skin Clinics & Medi-Spas; email: yourhealth@gleanerjm.com.