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What Causes Large Pores?

THE SCIENCE BEHIND LARGE PORE FORMATION: In the past, enlarged facial pores were regarded as an irreversible aging process rather than a correctable cosmetic problem. However, with significant advances in dermatologic devices, we are now able to treat them. But, how are these nuisances formed in the first place? Read to find out: 1. HIGH OIL PRODUCTION Both facial pore size and sebum production are linked to the genetics we inherited from our parents. Variation in pore size is also correlated with ethnicity. Asian women have smaller pore sizes when compared with other racial groups. African Americans demonstrate substantially larger facial pores than any other racial group. 2. GENETICS If your main goal of the treatment is to improve superficial concerns like fine lines, hyperpigmentation, and wrinkles then the microneedling pen may be the best course of treatment. Vivace is an excellent option for desired goals of skin tightening, lifting, contouring, and severe acne scarring and wrinkles. The right procedure should be chosen based on treatment goals.  SLK Clinic offers both the microneedling pen and RF microneedling. Need help deciding? Book a complimentary consult to help you learn more: 3. GENDER Females are predisposed to larger pore size than males are. Why? This is believed to be a result of the monthly menstrual cycle when hormones influence sebum production. Sebum output level becomes elevated during a woman’s period and thus the pore size becomes larger in the ovulation phase. 4. SUN DAMAGE Repeated exposure to ultraviolet rays from the sun will damage the collagen and elastin fibers in the skin, which will decrease collagen density, damage the elastin structure, and increase the size of pores. NOW, HOW TO SHRINK PORES: No pore strip, face mask, or facial will ever minimize pore size; these modalities simply disguise the appearance of pores. To truly shrink pores, follow these steps: 1. USE A RETINOL Use a retinol or retinoid such as tretinoin every day or every-other-day. This will increase collagen synthesis to minimize pore size. At SLK we recommend the Neocutis Nouvelle retinol to our patients because the slow time-release microsphere formulation is the most gentle form of medical-grade retinol and won’t result in redness or skin flaking. 2. RADIOFREQUENCY MICRONEEDLING Pores before and after 3 Vivace RF Microneedling treatments Undergo periodic radiofrequency microneedling to shrink pores rapidly. The energy waves will stun the sebaceous glands into producing much less sebum, resulting in smaller pore openings. Treatments every 8-12 weeks (4-6 times per year) will keep the sebum at bay all year long. Our favorite RF microneedling device is Vivace because it has the least amount of pain and downtime. 3. MICRONEEDLING PEN WITH PRP TREATMENTS Microneedling will rebuild collagen, plus the channels can be used as an entryway for PRP which will rebuild elastin fibers which are essential for elasticity and to keep pore openings tight. 4. SUNSCREEN Use SPF 50 (Better yet PA+++) or higher every morning to block UV radiation from further widening of pores due to collagen degradation. We recommend keeping a Colorescience sunscreen brush or two at your desk or in your car to re-apply throughout the day. To purchase the Neocutis Nouvelle retinol or Colorescience brush, or to speak with a SLK expert about microneedling, PRP, or Vivace, contact us for a complimentary consultation now! book now

Hyperpigmentation Part I: 3 Over-The-Counter Ingredients That Are Clicinally Proven To Reduce Unwanted Dark Spots

HOW TO TREAT HYPERPIGMENTATION FROM SUN, SCARS, AND HORMONES Melanin, the brown molecule that gives skin its tan color, plays an important role in protecting our DNA from the harmful effects of UV sun radiation. However, it tends to accumulate over the summer months, often in the unwanted form of sunspots or freckles, and it can even darken pre-existing skin conditions like melasma or hyperpigmented acne scars. Without treatment, these dark spots may take months to years to resolve. Read on to learn 3 nurse-recommended over-the-counter ingredients to look for on skincare labels. A NOTE ON HYPERPIGMENTATION Before we discuss the following 3 ingredients, it is important to note that hyperpigmentation is one of the most complex and stubborn conditions to treat in aesthetic dermatology, sometimes requiring several adjustments to the treatment plan. Thus, if over-the-counter therapy doesn’t appear to be working for you (which is common), you should begin a patient-provider relationship with a licensed professional who can review your progress every 1-3 months. 1. KOJIC ACID Kojic acid is one of the most effective over-the-counter skin-brightening ingredients on the market. This molecule was first isolated in Japan from steamed fermented rice (called “Koji” in Japanese.) Clinical studies have shown that kojic acid acts by inhibiting the principal enzyme in melanin synthesis. This action is the same as that of hydroquinone, the gold standard in prescription-grade hyperpigmentation therapy (see our “Hyperpigmentation Part II” post for more thoughts on hydroquinone). While kojic acid has long been the most popular skincare ingredient in Eastern Asia for treating melasma, it has more recently gained popularity in the US for all types of pigmentary conditions. It is important to note is that kojic acid has been known to cause skin sensitivity in some individuals, and should be decreased or discontinued if redness or irritation occur. 2. NIACINAMIDE Clinical trials using 2% niacinamide have shown that it significantly reduces the total size of hyperpigmented areas and lightens baseline skin color after 4 weeks of treatment. Niacinamide’s action is to block the transfer of melanin from the base skin layer where it is synthesized by the body, to the superficial layer that gives us our skin color. Niacinamide also has anti-inflammatory properties, prevents water-loss from the skin, and is very stable in formulation, so overall it is considered very useful by skincare chemists and can be found in a wide array of cosmeceuticals. 3. LICORICE EXTRACT Licorice extracts, derived from the roots of licorice plants, are the safest over-the-counter pigment-lightening agents with the fewest side effects. The active agents in licorice extract are known as glabridin and liquiritin. Glabridin acts similarly to kojic acid, in that it inhibits the principal enzyme in melanin synthesis, and liquiritin facilitates dispersal and removal of melanin by the body. Additionally, licorice extract has anti-inflammatory properties which aid in reducing any redness or irritation. Tatcha Deep Brightening Serum containing licorice extract-$185.00 These 3 ingredients are all well-studied with superb safety profiles, hence why they are all available over-the-counter at your local sephora or department store. However, these ingredients cannot be compared to prescription grade ingredients which are by far the most clinically-effective at reducing pigmentation. See our next blog post for part 2 of 3 on hyperpigmentation: “3 of the Best Prescription-Strength Dark Spot Creams According to a Nurse”. DISCLAIMER : THIS CONTENT IS FOR INFORMATIONAL PURPOSES ONLY AND IS SOLELY THE OPINION OF JENNIFER STIEBER, NP WHICH MAY DIFFER FROM THE OPINION OF OTHER HEALTHCARE PROFESSIONALS. IT SHOULD NOT BE USED AS A SUBSTITUTE FOR PROFSSIONAL DIAGNOSIS OR TREATMENT.

Hyperpigmentation Part II: 3 Of The Best Prescription-Strength Treatment Creams According To A Nurse

1. HYDROQUINONE Hydroquinone is the gold standard for treating hyperpigmentation in dermatology. Its effectiveness and safety is so well-documented in clinical studies that almost all dermatology providers will recommend 4% hydroquinone as a first step for anyone with significant pigment concerns. This ingredient works by interrupting the same step of melanin synthesis that kojic acid and licorice extract do (2 ingredients mentioned in our previous blog post: Hyperpigmentation Part 1) however on a much more significant, medical-grade scale. It is important that anyone using hydroquinone consult regularly with a nurse practitioner or physician, because very rare cases of overuse or misuse have resulted in unsightly side effects. Oftentimes, your nurse practitioner will schedule you for a “hydroquinone vacation” during which you take time-off from using the drug. 2. RETINOIDS Retinoids like tretinoin, tazarotene, and adapalene, are powerful synthetic versions of retinol which is a naturally-occurring vitamin that plays a role in maintaining many organs in the human body, including the skin. Numerous clinical studies have shown that when applied to the skin, retinoids are very successful at reducing freckles and sun spots. The effectiveness of retinoids results from their ability to interrupt multiple steps of melanin production. Furthermore, retinoids are an excellent choice for treating hyperpigmentation because they increase skin cell turnover and shedding, allowing for greater penetration of other active melanin-suppressing ingredients like hydroquinone. Although there are a handful of FDA-approved retinoids on the market, the most studied and well-vetted of all is tretinoin, which is why it is the prescription retinoid cream of choice for many dermatology providers. Topical over-the-counter retinol is also effective, however these formulations are not as stable and have a short shelf-life. 3. TRI-LUMA Now that we’ve discussed retinoids and hydroquinone, this brings us to another favorite tool amongst dermatology providers, Tri-Luma, a combination cream of hydroquinone, tretinoin, plus a small dose of fluocinolone which is a steroid anti-inflammatory. As we mentioned above, retinoids like tretinoin have the ability to act as a penetration-enhancer, augmenting the effectiveness of hydroquinone. Although this combo is quite powerful, both tretinoin and hydroquinone have the undesirable side effects of redness, irritation, and dryness. This is why the added anti-inflammatory is important – it counters these unwanted side effects, increasing patient comfort and convenience. Even with the use of prescription-strength creams, improvements in pigmentation can take months, and not all pigmentation will always resolve. For more rapid improvement, in-office elective dermatology procedures are a wonderful supplement to any topical therapy. In fact, when high quality topicals are used in conjunction with procedures like chemical peels or microneedling (discussed in our next blog post Hyperpigmentation Part III), dramatic improvements in pigmentation can successfully be achieved. DISCLAIMER : THIS CONTENT IS FOR INFORMATIONAL PURPOSES ONLY AND IS SOLELY THE OPINION OF JENNIFER STIEBER, NP WHICH MAY DIFFER FROM THE OPINION OF OTHER HEALTHCARE PROFESSIONALS. IT SHOULD NOT BE USED AS A SUBSTITUTE FOR PROFSSIONAL DIAGNOSIS OR TREATMENT.

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