What Causes Rough Skin Texture + How To Deal, From Derms

January 1, 2023

Let’s be clear: Nobody has perfectly smooth skin all the time. While heaps of makeup and hours of photo editing may have you believing skin should look like silk, that’s not normal. Everyone has texture, and there are plenty of different reasons for it.

However, having textured skin from things like acne scars or skin conditions can make you feel extremely insecure and directly impact your mood. So, it’s only natural that you may want to ease texture when possible. To help you out, we asked derms for their best tips and tricks. Plus, a bit more about why your skin might be textured in the first place.

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• Ice pick: Ice pick scars are a form of atrophic scar, which means it’s indented rather than raised. (Research shows that 80 to 90% of people1 with acne scars have indented.) These look like small, narrow pinholes in the skin, with steep fall-offs. They are called “’ice pick” scars because they look like an ice pick was used on the skin. 
• Boxcar scars: Another form of atrophic scarring, boxcars look like small oval, circular, rectangular, or square pits. They often have steep drop-offs into a U-shaped scar. These are unlike ice pick scars in that they are wider and don’t usually go deep into the dermis.
• Rolling scars: These scars are characterized by wavelike, undulating skin. These are the result of long-term, chronic acne—as the repeated inflammation and trauma to the skin creates uneven scar tissue. In many cases, the appearance is shallow and perhaps not very noticeable. 
• Hyperpigmentation: These are surface-level stains where the pigment of the skin is altered due to inflammation2—essentially when skin is inflamed, it can trigger or halt pigment production. Hyperpigmentation on pale skin tones often appears red or pink, while darker skin tones usually appear brown or black. Hyperpigmentation isn’t technically a scar but it can cause localized uneven texture. 

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While redness is the most common symptom of rosacea, it’s not the only one. According to the American Academy of Dermatology, rosacea symptoms can also include roughness, small bumps, and even thickening skin that can lead to more uneven texture (though the latter is rare). 

Eczema (also known as atopic dermatitis) can also cause uneven skin texture. This can look like scaly, dry patches or thicker skin (similar to that of rosacea). 

Plus, both skin conditions can cause excessive dryness on the skin, which is another form of texture. When treating texture from rosacea or eczema, you should consult your dermatologist. Many of the over-the-counter methods that are marketed for smoothing texture might irritate these highly-sensitive skin types. 

Orange peel skin is one form of texture that is, in part, related to collagen loss. Image a citrus peel—the texture isn’t necessarily smooth, but it’s not dramatically uneven either. To the naked eye, the skin looks dimply and has enlarged pores. 

“It’s a sign of sun damage and aging. Basically as collagen and elastin are compromised, the pores are not held closed, leaving them larger and more visible,” Morgan Rabach, M.D., board-certified dermatologist and co-founder of LM Medical NYC previously said about orange peel skin.

Everyone experiences a dip in collagen production as you age—at a rate of 1% each year3 after you hit your mid-20s. Given the decline, you may experience more skin texture with age. There’s an easy remedy for this one—more on that to come.

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“AHAs work to improve skin by removing the top layers of the skin through weakening the lipids that bond them together, thus removing dull and dead skin cells and revealing healthy skin cells,” says board-certified dermatologist Dendy Engelman, M.D.

​​The most popular of the AHA family are glycolic acid and lactic acid. “Glycolic acid, derived from sugar cane, is the smallest acid in size, meaning the molecule can get deep into the skin,” says Engelman.

This makes it a go-to for breaking down and removing dead skin cells and particles. It also boosts collagen and elastin production. As for lactic acid, Engelman says it’s a good option for those with sensitive skin. It’s derived from sour milk and works to improve discoloration and age spots. 

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“Retinoids are particularly helpful as they help to improve cell turnover, stimulate collagen, and regulate sebaceous glands,” board-certified dermatologist Rebecca Marcus, M.D., FAAD explains. 

However, retinol won’t work instantaneously. You’ll have to commit to using the product every few days for a good month or two before seeing peak smoothing results. “With continued usage of this ingredient and over time, you can see an improvement in fine lines, wrinkles, tone, and texture, as it is strengthening the skin barrier,” Engleman says. 

Now there’s more than one kind of retinol to consider—so read up on the differences between over-the-counter forms and prescription-grade products here. 

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4.

Anti-inflammatory topicals. 

As mentioned above, skin texture can be caused by inflammation. What triggers your inflammation is important to note (dehydration, rosacea, acne, etc.), but how you tame it is just as essential. 

To mitigate inflammation on the skin, look to soothing topicals. A few of the best ingredients to keep an eye out for include: 

• Turmeric
• Botanical oils
• Centella asiatica
• Hemp seed oil 
• CBD
• Biotic ingredients like pre and postbiotics

5.

In-office treatments.

 If you’re struggling to ease skin texture at home, you’re not alone. Especially deeper scars (like ice-pick acne scars) are nearly impossible to treat DIY-style. While this might make you feel discouraged at first, you should find peace knowing that assistance is available (plus, some much-needed reassurance that you’re probably doing all the right things). 

There are a few different methods to treating textured skin in the office—here’s a quick breakdown of some of the best. 

• Fractional lasers: Clear and Brilliant, a specific type of fractional laser, “Works by creating millions of microscopic treatment zones in the upper layers of the dermis, replacing damaged skin with healthy tissue to yield refreshed, more even toned skin. This treatment requires little to no downtime,” medical esthetician and founder of JTAV Clinical Skin Care Joie Taverise tells mbg. 
• Chemical peels: “These use safe and gentle acids to remove excess dead skin cells that make skin look dull tired and pigmented. The most common are glycolic, lactic, and salicylic acid-based peels. Removing the top layer of dead skin cells speeds up cell turnover and stimulates skin regeneration to give skin a healthy glow,” Tavernise says.
• Vivace RF Microneedling: “This treatment combines targeted microneedling with radiofrequency (RF) to stimulate collagen and tighten skin. Tightened skin means that wrinkle texture and enlarged pores will appear smoother when skin elasticity is improved. Vivace is incredibly effective because microneedling allows the radio frequency to penetrate deeper into the skin to stimulate natural collagen production for real results,” she explains.

6.

Internal collagen support

7.

Plumping and hydrating ingredients. 

If your texture is caused by dry skin, or the texture of your skin creates sagging, then hyaluronic acid is a must-have in your lineup. Hyaluronic acid (HA) is a natural humectant, which means it retains moisture. 

For HA, that’s 1,000 times its weight in water. So, it’s really hydrating. “It helps smooth the skin surface due to increasing the amount of water in the dead cell layer, which delivers moisture to dry, rough skin surface,” Loretta Ciraldo, M.D., FAAD tells mbg.

Consider this hydrating acid like a tall glass of water for your skin. You can choose to use it in the form of a serum (like one of these mbg-approved picks) or look for hyaluronic acid in your moisturizers and face creams. 

Getting regular facials has a very long list of benefits, including maintaining a smooth complexion. Depending on what other skin concerns you have (dryness, acne, skin aging, etc.) what type of facial you get will differ. 

See when you visit a skin expert like an esthetician, they can help clear your dead skin cells via gentle exfoliation to reveal a fresh new canvas. Plus, the high-tech tools and professional-grade topicals might help you clear your texture even quicker. 

If you want to learn more about the different types of facials and which ones might be the best for your skin, check out this guide. 

“Enzymes work by ungluing stored-up dead cells at the skin surface and in the pores,” Ciraldo says. “This could include bromelain from pineapple, pumpkin, or pomegranate.” You can find enzymes in at-home products like masks and cleansers, or opt for a professional enzyme facial. 

These are particularly beneficial for those with eczema and rosacea, as classic exfoliants like AHAs and BHAs might be irritating for highly sensitive skin. 

Best products for textured skin

Prevention is always going to be easier than treatment. This doesn’t just mean preventing texture from the start, but also ensuring what texture you do have doesn’t get even worse. 

Especially if you’re putting time and effort into clearing your skin, you’ll want to do basic maintenance as well. Here are a few tips to keep in mind: 

• Wear sunscreen daily: Sun exposure is one of the leading causes of uneven skin texture. Here’s why: When your skin is exposed to the sun without protection, the body’s natural collagen production is compromised, and this can lead to a variety of texture issues with the skin. This can show up as tiny bumps, rough patches, oversized pores, and even dark spots that have a rough texture on the surface, aka hyperpigmentation. One study, focusing on Caucasian skin, found that UV exposure was responsible for 80% of visible facial aging signs101 including wrinkles, skin texture, pigmentation, and sagging of tissues.
• Tend to acne: Preventing acne from turning into scars is one of the best ways to mitigate texture. This starts with basic acne care. You’ll want to determine what kind of breakouts you have and then consult a dermatologist for the best treatment options. Most importantly, don’t ever pop your pimples. This will increase the likelihood of scaring and thus uneven texture. Not sure where to start? Here’s our acne breakdown to help you out. 
• Hydrate + calm inflammation: For your general skin care routine (disregarding retinol and exfoliants) focus on hydration and easing inflammation. See if you have too many harsh ingredients in one routine, your skin will become irritated and inflamed, leading to more uneven texture. Do your best to place those powerful ingredients within a soothing routine and don’t mix harsh actives. You may consider the popular skin cycling method to make it easier—here’s everything you need to know. 

As you can tell, there are plenty of at-home options for easing skin texture. That being said, not everything is DIY-friendly. It can make you feel even worse if you’re trying at-home remedies again and again with no success, so it’s important to know when to ask for help if you have access to it. 

Visiting a dermatologist can be immensely helpful for stubborn texture, like that of acne scars or even severe cases of rosacea that need to be treated with pro-grade treatments. Of course, trying at-home remedies first is a good idea, but visiting the experts might be just what your skin needs. 

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