Brief Answer:
Kindly upload few good resolution pictures

Detailed Answer:
Hello,

Welcome and thanks for posting your query to the forum.

I can understand the concern for wrinkles and increasing pore size.

I request you to kindly upload few good resolution pictures of the face area from front, left and right so that I can analyze it better. Kindly send good resolution pictures focusing the area of concern which can be seen on higher magnification. For uploading the pictures you have a facility on the right side of the page or can send on:

YYYY@YYYY

with "attention:Dr Sanjay Kumar Kanodia"

Hope to hear soon from your side.

With regards,

Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases

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Brief Answer:
Diet + Fillers + medications.

Detailed Answer:
Hello young buddy,

Welcome again to the forum and thanks for the follow up with pictures.


After analyzing the pictures I can make out that the condition is not that poor as I was expecting. You are a smart young man of just 30 years and looking to your facial appearance I can get that you must be thin built.

I am not able to find a big deal of skin atrophy and as a complete analysis I reassure you that it is mild to moderate one rather than sever atrophy.

I have analyzed both the pictures and in your case and my approach would be to provide you a regimen of diet + Fillers + medications.

If I were your treating dermatologist then would preferred for "dermal fillers". These are Hyaluronic acid compounds which fills the hollow gaps under the thin skin. You know there are innumerable types of fillers available each one different for different kind of thin areas, lines and different facial regions.

In your kind of situation I can divide the concerned regions into two basic areas:

- the one area below the eyes: If I were your treating doctor then would have preferred for Esthelis soft filler which is basically meant for under-eye hollowness. Around 1 ml each is sufficient in initial course and if required in one sitting and can be further increased after a period of 3 months in touch up.

- For the area around cheeks: I would have preferred for Juvederm -Voluma filler to fill the hollowness of cheeks. Around 2 ml each side is sufficient in initial course.

For around 2-4 weeks it may give you slight unusual appearance but if done by experienced hands it is one of the best and safest suited therapy without the use of knife.

As you must be knowing that fillers are not the permanent solution but works only for 1-2 years. So during this time I would have utilized with best diet and topical medications.

In diet I suggest you to take small but nutritious feeds multiple times a day. Try to eat small amounts of good nutritious food.

For the betterment kindly follow the suggestions below:

1. Eat at least 3-4 different fruits saplings per day. Every fruit is good but you can make a combination of sour with sweet fruits such as oranges, papaya and other of seasonal fruits. I specifically suggest you to take vitamin C containing fruits as are the best in developing collagen which is the main anchoring fiber in dermis.

2. Pulses are good source of proteins. So everyday have a small bowel full of mixed pulses. Add green leafy vegetables additionally in the pulses which contain lot of iron and vitamins in it.

3. Sprouts are the best source of fibres, minerals especially iron, vitamins and proteins too. So add it at-least alternate day if you cannot make in every-day's part of meal.

4. Overnight soaked and peeled almonds will give you good vitamin E which is good for the hair growth.

5. Milk and milk products should be included in every-day's schedule.

6. Do light exercises, reduce your stress as all these have bit impact on skin so also in reducing thinning of skin.

Now last but not the least medications:

I preferred for "tretinoin" based creams for your kind of situation. These are the best creams suited for improving the collagen content of the skin. As I said earlier, collagen is the main anchoring fiber for the skin. Tretinoin based creams helps in increasing the collagen development and therefore improving the status of the skin slowly but permanently.

In the intial course of application it is to be started with very low concentration of 0.025 % for few months and then can be increased up to 0.1 % according to the response of the skin.

An important point of guidance is that a pea size amount is sufficient for palm size area. Initially it may give redness so I suggest my patients to apply very thinly for 1 hour only for few weeks and then as the cream is adjusted then can be applied overnight.

I hope I am able to provide the best possible information for solution regarding your condition. I reassure you fully that it is not that bad which you think in your mind. It is quite common to see a self bad image and even me myself can see my own facial appearance to be bad at certain times - which is normal human thinking. So for you also I suggest to see the positive side of your face. I can see sharp features in you with smart young man.

So do not worry and start the regimen by eating well from now onwards!!!

Hope these informations will help you. If you have further queries I will be happy to help.

"Wish you good health"

Regards,
Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases

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