There are several possibilities when it comes to explaining problems with your pores. The trouble may be hereditary or caused by hormonal fluctuations, inflammation, a skin condition, or the aging process. Or, you might just be a person whose skin produces excess oil. The thing is, no matter what’s behind your pore issues, the result is probably acne in one form or another. Here’s an overview of the types of blemishes you might encounter and how to treat them.
- Blackheads: Anyone can get these annoying little black spots, but they’re more common in people with oily or combination skin and large pores. Blackheads occur when open pores, a.k.a. comedos or sebaceous follicles, get clogged with excess oil, dirt, and/or bacteria. That gooey mix builds up inside the pore then gets oxidized by the air and turns a blackish color. Blackheads continue to collect sebum (oil), dead skin cells, dirt, etc., until they become hard and start to stretch out the pores. And that’s when you might be tempted to pick, poke or pop that sucker. But don’t — dermatologists do not recommend performing your own extractions, since squeezing can cause bacterial infections, not to mention scabs and scars. A safer approach is to battle those blackeads by washing your face daily with a pore-refining cleanser and exfoliating a few times a week. If you’ve got a particularly nasty outbreak or your blackheads are resistant to your cleansing routine, ask your dermatologist about a chemical peel or microdermabrasion, or a prescription-strength topical retinoid.
- Whiteheads: Like blackheads, whiteheads also form inside the sebaceous follicle, or comedo. The difference with whiteheads is the opening to the comedo is either closed or so narrow that air cannot get in to oxidize the dead cells and oil that are blocking the pore so the gooey mixture stays white. As with blackheads, popping those puppies is a no-no; extractions should be performed only by a dermatologist or licensed aesthetician to minimize the possibility of infection. Your practitioner will use a comedone extracting tool to push down the skin that surrounds the plugged follicle and pop out the contents. Additional treatment is similar to that listed for blackheads — cleansing, exfoliating, peels, microdermabrasion, and/or topical retinoids.
- Papules, pustules, and nodules: This delightful trio is what’s behind the variety of small to medium sized bumps on your skin. Papules are very small, solid bumps that usually appear in groups. Pustules are fragile bumps that contain pus, a combination of white blood cells, dead skin cells, and bacteria; they look similar to whiteheads. Papules and pustules may be treated with one or a combination of the following therapies: professional extractions, light therapy, topical antimicrobials or retinoids, oral antibiotics, or over-the-counter acne medications. Nodules are inflamed bumps that feel solid to the touch. They go deep into the skin and can damage surrounding tissue — they can also be painful and difficult to treat. In severe cases, oral retinoids may be prescribed.
- Sebaceous Cysts: These cysts contain a pus mixture of white blood cells, dead skin cells, and bacteria in liquid or semi-liquid form. They’re larger than pustules, and like nodules they can grow inflamed and penetrate deep into the skin. They tend to be very painful and likely to scar. Cysts are resistant to many treatments, but interlesional corticosteroid injections can help relieve pressure and heal them. Sometimes draining or surgical extractions are necessary when large, painful cysts don’t respond to other treatments.
- Acne and Adult Acne:Acne isn’t just for teenagers. Yes, it may be more common during puberty when hormonal changes cause extra oil secretions, but adults get acne too — especially women. Because of hormonal shifts during menstruation, pregnancy, menopause, and when taking birth control pills (though some pills can actually improve acne), women are more likely than men to experience acne as adults. Regardless of age, the main goal in treating acne is to prevent excess sebum from plugging your pores. Once sebum gets stuck inside, it’ll trap bacteria and dirt in there too, and that’s what causes breakouts. Dermatologists typically recommend following a regular skin care regimen and treating skin with topical antimicrobials to help disinfect it. Topical retinoids can help unclog pores and prevent white- and blackheads from forming. If you have moderate or severe acne, your dermatologist may also prescribe an oral antibiotic like erythromycin, tetracycline, doxycycline, or minocycline.
Despite the many treatment options available, finding the right therapy may be challenging at first. Your best bet is to work with a dermatologist who can help pinpoint your pore problems and make recommendations for keeping your symptoms under control.