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dermdoc19
dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 3887
Experience:  30 years practice in general and cosmetic dermatology
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Is there any procedure (laser treatment -If so, please be

Resolved Question:

Is there any procedure (laser treatment? -If so, please be specific about what type/name of specific laser treatment) that will successfully slow down -or even stop, the flow of, or over-production of, sebum oil from flowing to the surface of facial skin, through my skin's pores?

For years, I have had pores on my nose become very enlarged by a white, paste-like substance (sebum) that I have had to routinely purge from my pores, every few days. What I squeeze-out of almost every pore on my nose, are; thick, semi-hardened, rice-shaped plugs of white/yellow sebum oil. If I crush those thick semi-hardened plugs between my fingers, and then smell it, it has a foul, cheesy odor.

If I don't "purge" the clogged pores, every few days, you can see that the rice-like plugs enlarge the pores, and form a dome, making the clogged pores look stretched-out and unsightly, and the hardened sebum plugs and surrounding skin then resemble the seeds on the the surface of strawberries.

For about 30 years, I have used Benzoyl-Peroxide on my face, every night, as well as "Sea Breeze". That regime has kept my face virtually clear of pimples, but has done nothing to stem the flow of the pore-clogging oil, underneath my skin.

It's a vicious cycle, and I'm really tired of it. I need to do something about it. My squeezing-out the sebum plugs from my pores has caused some scarring in spots, over the years, from over-squeezing. Also; elsewhere on my face, that same white sebum oil has become trapped under some pores where skin has grown over those pores.

I've been seeing a dermatologist who has zapped (liquified?) those white spots with some sort of tool with a hot, needle-like tip to it. It works, temporarily, but it permanently makes the treated pores appear larger, and the sebum oil then just plugs up those bigger pores, again, in a few days, and the oil then collects under the skin, surrounding those treated pores, forming small white-looking rings around those pores.

Those tiny white rings are not made up of scar-tissue. They are made up of trapped sebum oil that builds up under the skin. I know that, because I once pierced the surrounding skin which covered that trapped oil, with a sterilized pin, and what came out was a thick, semi-hard white substance, as I described, above. The white mark disappeared for a few days, because the oil was purged by me, but then it filled right back up with sebum.

I am currently also getting dermabrasion treatments, and I have had 2 laser treatments (called "Inlight"?) on my face, with each laser treatment costing me $500., but I don't see results from those 2 treatments, yet -although I do notice that a few of the areas of trapped sebum oil spots, are now slightly painful to the touch, as if they are zits under pressure, needing to be purged from the pores. The last time I felt zits hurt like that -as if they were under pressure, was when I was a teenager. What might be causing this new sensation? If it's caused by my 2 recent laser treatments, is that good, or bad?

The dermatologist says that I should get about 3 more laser treatments. I'm a 49 year old Italian/Norwegian, caucasian male, and I have no other health, or weight issues, except for a slightly high cholesterol level, which has only recently been high, and over a year ago, I was told by a doctor that my triglycerides were high. I'm currently not under any triglyceride-lowering medication, or diet, although I know that I should do that, soon.

I've had this same skin issue, for decades. My facial skin is not pot-marked. It appears smooth, except where the oil is trapped under the skin, which slightly raises the skin in those areas (small white-colored bumps), and except for where the pores have enlarged, especially on the tip of my nose. I do not have Roseacea.

Any promising advice on available treatments for my skin condition would be greatly appreciated. If lowering my triglyceride level is the only answer to effectively slowing the sebum flow (as well as to -more importantly, decrease the possible health risks associated with high triglyceride levels), I would still like to know the most effective/more permanent way to reduce the appearance of large facial pores, and the most effective/more permanent way to reduce the appearance of white trapped sebum, under my facial skin. Also; I would like to know if there is a treatment (laser) to help reduce the appearance of scarred facial skin, caused by over-squeezing, to purge clogged zits/pores. That scarring is mostly on both sides of my nose, near it's tip. In those 2 places, there are 2 raised skin patches (not filled with sebum) which are whiter than the rest of my skin. It's scar-tissue.

Sorry for my lengthly email, above, but I wanted to cover everything, in order to be accurate, so that I can get a more-accurate response. Thank you, XXXXX XXXXX for your time and advice!

Chris
Submitted: 3 years ago.
Category: Dermatology
Expert:  dermdoc19 replied 3 years ago.

dermdoc19 :

It would seem that Accutane would have been considered. Were you not placed on this due to you high triglyceride level?

dermdoc19 :

My advice would be to be placed on Accutane at a low dosage for a longer period of time. You would also go on a low carb diet, which would both help your acne and prevent the triglyceride level which would be a danger with Accutane. After six months off of Accutane, you could have a laser oor IPL treatment. I personally prefer Isolaz or PDT treatment for acne.

dermdoc19 :

I am not familiar with the INLIGHT laser. Perhaps, you could enlilghten me.

Customer :

I may have the name of that laser ("InLite" / "iLight"(?)) incorrect. What specifically are "solaz" and "PDT" treatments for acne?

Customer :

Your question: "It would seem that Accutane would have been considered. Were you not placed on this due to you high triglyceride level?"

Customer :

Answer: No.

dermdoc19 :

Isolaz is a pneumatic device which pulls the skin uphard, while a blue light IPL is emitted. PDT combines a blue light with a photosensitizing chemical (8 amino-levulinic acid) which penetrates the skin. They both kill the bacteria that causes acne. and helps with inflammation.

dermdoc19 :

I just think Accutane gives excellent results and would help both the zits and excess oil.

Customer :

My dermatologist has not brought up the use of Accutane, as an option in my treatment. I did not mention my high triglyceride level to him, but I will, during my next appointment. Is there a high incidence of patients having heart attacks, or sudden death, from using Accutane, if a person also has a high triglyceride level? is there a risk that Accutane also trigger those things, even if a patient does not have a high triglyceride level?

dermdoc19 :

Triglyceride levels need to be followed. No sudden death. They are mainly followed because if they become very high they can lead to pancreatitis. This can be a serious condition. The blood should be checked once a month. There is an elevation in one third of patients taking Accutane. Usually it is mild. In 28 years of using this drug, I have had maybe three people who had to come off of it due to a TG elevation. I have managed others as I mentioned above...diet and have used a drug called Lopid to keep it down...Nia-span can also be used. It would not cause heart attacks or sudden death though.

Customer :

Thank you for your help and advice, doctor. I'll reach out to you, again, in the future if I have any more questions. Take care. ~Chris

dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 3887
Experience: 30 years practice in general and cosmetic dermatology
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