Case Report

Introduction: Pores are openings of the sebaceous gland on the skin’s surface that secrete oil, acting as the skin’s lubricant and protection. Pores can appear tiny funnel-shaped structures found on most of the body but most commonly seen on the face. Fac

Sinta Murlisyarini, Wuriandaru Kurniasih

Sinta Murlisyarini
Departemen Dermatologi dan Venereologi, Fakultas Kedokteran, Universitas Brawijaya/ Rumah Sakit Umum Daerah dr. Saiful Anwar, Malang, Indonesia

Wuriandaru Kurniasih
Departemen Dermatologi dan Venereologi, Fakultas Kedokteran, Universitas Brawijaya/Rumah Sakit Umum Daerah dr. Saiful Anwar, Malang, Indonesia. Email: wuriandaru@gmail.com
Online First: April 30, 2021 | Cite this Article
Murlisyarini, S., Kurniasih, W. 2021. Introduction: Pores are openings of the sebaceous gland on the skin’s surface that secrete oil, acting as the skin’s lubricant and protection. Pores can appear tiny funnel-shaped structures found on most of the body but most commonly seen on the face. Fac. Intisari Sains Medis 12(1): 385-390. DOI:10.15562/ism.v12i1.946


Introduction: Pores are openings of the sebaceous gland on the skin’s surface that secrete oil, acting as the skin’s lubricant and protection. Pores can appear tiny funnel-shaped structures found on most of the body but most commonly seen on the face. Facial enlarged pores can be a cosmetic problem, especially for women. There are various factors involved in developing enlarged facial pores. However, sebum production and facial skin’s elasticity are the main factors. Botulinum toxin type A injection can reduce enlarged pore with three mechanisms. Therefore, there are inhibit acetylcholine, reducing sebaceous follicles glands, paralyzing the muscular erector pilli, reducing sebum secretion, and assuming increasing collagen.

Case: The following reported two cases with grade 6 enlarged facial pores in a 38-year-old man and a 35-year-old woman. Patients have been given Botulinum Toxin A injection therapy with intradermal small bolus injection of botulinum toxin in one-time therapy and evaluated after four weeks of therapy. At the fourth week of evaluation of the first patient, there was a decrease in facial enlarged pores’ severity from 6 to 3 and a decrease in the sebum score from 3 to 1. Whereas in the second case, the pores severity degree decreased from 5 to 3, and the sebum score decreased from 3 to 2.  Dermoscopy examination before and after therapy showed reduced pore size.

Conclusion: Botulinum toxin type A intradermal injection is effective in reducing sebum production and facial pore size.

 

Pendahuluan: Pori-pori merupakan lubang dari kelenjar sebaceous pada permukaan kulit yang mengeluarkan minyak yang berfungsi sebagai pelumas dan perlindungan kulit. Pori-pori dapat tampak sebagai struktur berbentuk corong kecil yang dapat ditemukan pada hampir seluruh tubuh tetapi paling sering tampak pada wajah. Facial enlarged pore dapat menjadi masalah kosmetik terutama bagi wanita. Berbagai macam faktor dilaporkan dapat terlibat dalam perkembangan facial enlarged pore, tetapi produksi sebum dan elastisitas kulit wajah merupakan faktor yang paling sering berperan. Injeksi botulinum toksin tipe A memiliki mekanisme kerja menurunkan facial enlarged pore dengan menghambat asetilkolin sehingga menurunkan aktivitas kelenjar folikel sebaceous, melumpuhkan musculus arector pilli sehingga mengurangi sekresi sebum, dan meningkatkan kolagen.

Kasus: Berikut ini dilaporkan dua buah kasus facial enlarged pore pada wajah dengan tingkat derajat 6 pada laki-laki berusia 38 tahun dan wanita berusia 35 tahun. Pasien diberikan terapi menggunakan injeksi Botulinum Toxin A metode multiple intradermal small bolus injection of botulinum toxin selama 1 kali terapi dan dilakukan evaluasi hingga 4 minggu terapi. Evaluasi pada minggu ke-4 pada pasien pertama didapatkan penurunan derajat keparahan facial enlarged pore dari 6 ke 3 dan penurunan skor sebum dari 3 ke 1. Sedangkan pada kasus kedua didapatkan penurunan derajat keparahan pori-pori dari 5 ke 3 dan penurunan skor sebum dari 3 ke 2. Pemeriksaan dermoskopi pada sebelum dan sesudah terapi memperlihatkan ukuran pori-pori menurun.

Simpulan: Injeksi intradermal botulinum toksin tipe A dinilai efektif dalam menurunkan produksi sebum dan ukuran pori-pori wajah.

References

Roh M, Goo B, Jung J, Chung H, Chung K. Treatment of enlarged pores with the quasi long-pulsed versus Q-switched 1064 nm Nd:YAG lasers: A split-face, comparative, controlled study. Laser Ther. 2011;20(3):175–80. Available from: https://pubmed.ncbi.nlm.nih.gov/24155526

Lee SJ, Seok J, Jeong SY, Park KY, Li K, Seo SJ. Facial Pores. Dermatologic Surg. 2016;42(3):277–85. Available from: http://dx.doi.org/10.1097/dss.0000000000000657

Sun JY, Kim SW, Lee SH, Choi JE, Ko SJ. Automatic facial pore analysis system using multi-scale pore detection. Ski Res Technol. 2016;23(3):354–62. Available from: http://dx.doi.org/10.1111/srt.12342

Kim SJ, Shin MK, Back JH, Koh JS. Pore volume is most highly correlated with the visual assessment of skin pores. Ski Res Technol. 2014;20(4):429–34. Available from: http://dx.doi.org/10.1111/srt.12135

Flament F, Francois G, Qiu H, Ye C, Hanaya T, Batisse D, et al. Facial skin pores: a multiethnic study. Clin Cosmet Investig Dermatol. 2015;8:85–93. Available from: https://pubmed.ncbi.nlm.nih.gov/25733918

Sayed KS, Hegazy R, Gawdat HI, Abdel Hay RM, Ahmed MM, Mohammed FN, et al. The efficacy of intradermal injections of botulinum toxin in the management of enlarged facial pores and seborrhea: a split face-controlled study. J Dermatolog Treat. 2020;1–7. Available from: http://dx.doi.org/10.1080/09546634.2019.1708241

Lee S-K. Multiple intradermal small bolus injection of botulinum toxin: The limit and the potentiality. J Cosmet Laser Ther. 2012;14(6):304–6. Available from: http://dx.doi.org/10.3109/14764172.2012.738914

Roh M, Han M, Kim D, Chung K. Sebum output as a factor contributing to the size of facial pores. Br J Dermatol. 2006;155(5):890–4. Available from: http://dx.doi.org/10.1111/j.1365-2133.2006.07465.x

Shaiek A, Flament F, François G, Lefebvre-Descamps V, Barla C, Vicic M, et al. A new tool to quantify the geometrical characteristics of facial skin pores. Changes with age and a making-up procedure in Caucasian women. Ski Res Technol. 2016;23(2):249–57. Available from: http://dx.doi.org/10.1111/srt.12330

Kim BY, Choi JW, Park KC, Youn SW. Sebum, acne, skin elasticity, and gender difference - which is the major influencing factor for facial pores? Ski Res Technol. 2011;19(1):e45–53. Available from: http://dx.doi.org/10.1111/j.1600-0846.2011.00605.x

Katsuta Y, Lida T, Inomata S, Yoshida S. Improving the appearance of facial pores. Cosmet Toilet. 2004;119(10):59–64.

Hameed A, Akhtar N, Khan HMS, Asrar M. Skin sebum and skin elasticity: Major influencing factors for facial pores. J Cosmet Dermatol. 2019;18(6):1968–74. Available from: http://dx.doi.org/10.1111/jocd.12933

Francois G, Maudet A, McDaniel D, Giron F, Bazin R. Quantification of facial pores using image analysis. Cosmet DERMATOLOGY-CEDAR KNOLLS-. 2009;22(9):457–65.

Dong J, Lanoue J, Goldenberg G. Enlarged facial pores: An update on treatments. Cutis. 2016;98(1):33–6.

Shuo L, Ting Y, KeLun W, Rui Z, Rui Z, Hang W. Efficacy and possible mechanisms of botulinum toxin treatment of oily skin. J Cosmet Dermatol. 2019;18(2):451–7. Available from: http://dx.doi.org/10.1111/jocd.12866

Rose AE, Goldberg DJ. Safety and Efficacy of Intradermal Injection of Botulinum Toxin for the Treatment of Oily Skin. Dermatologic Surg. 2013;39(3):443–8. Available from: http://dx.doi.org/10.1111/dsu.12097


Article Views      : 43
PDF Downloads : 18