I am 21, female. Why do I have visible pores and mild rashes?

Question

Hello doctor,

I am a 21-year-old woman, weighing 187 pounds and standing 5 feet 7 inches tall. I have a severe skin condition: my face has visible pores, a mild rash, and a burning sensation from time to time. I have been using Fenegin cream for the past six years, and whenever I try other products, my rash worsens.

I also sweat excessively and have been told that I have high blood pressure, which runs in my family on my mother’s side.

Please advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for trusting me with something that has clearly been distressing for you.

I can hear how uncomfortable and worrying this has been, burning, rashes, visible pores, and reacting to almost every product can really take a toll, especially when it has been going on for years. I can see that you are having a visible force in the picture (attachments removed to protect the patient’s identity).

I am not sure if the cream you are using has a steroid because the spelling does not match any product online. Please feel free to send a picture of the product so that I can guide you better. If you are using any steroid or not for now, please stop using it.

Your frustration is completely valid, and I want to reassure you that you are not alone and that this condition is manageable with the right approach. gradually and repair the skin barrier.

To help calm the skin and manage the visible pores, start with Azelaic acid 15% cream. Use a pea-sized amount for the entire face once daily at night. If your skin burns initially, use it on alternate nights for the first one to two weeks. Azelaic acid is non-steroidal, anti-inflammatory, and very suitable for sensitive, damaged skin.

Moisturisation is extremely important. Use twice daily, morning and night. If your skin feels very sensitive, apply the moisturiser first at night and then apply Azelaic acid after a short gap; this “buffering” method reduces irritation. Every morning, apply a broad-spectrum sunscreen for sensitive skin, as sun exposure significantly worsens burning and redness in compromised skin.

Cleanse your face gently using a soap-free, mild cleanser once daily only. Avoid scrubs, exfoliants, facial brushes, toners, alcohol-based products, fairness creams, fragrance-heavy skincare, and hot water on the face, as these will worsen irritation. Your excessive sweating and recently diagnosed high blood pressure can also contribute to facial flushing and sensitivity, so gradual weight reduction, reducing salt intake, managing stress, and maintaining good sleep will benefit both your skin and overall health.

You may experience mild burning or tingling during the first two to three weeks of treatment, which is expected. Visible improvement usually starts after four to six weeks, but full skin barrier recovery takes time, so patience and consistency are essential. Please arrange a follow-up after six to eight weeks so your progress can be reviewed and treatment adjusted if needed.

Your skin can heal, and with the right care, this condition can significantly improve. Stay consistent and hopeful.

I hope it helped with your query.

Thank you.