How to Improve Textured Skin, According to Doctors

Flawlessly smooth skin is a lofty goal and, honestly, a completely unrealistic ideal fabricated in the land of photo filters and editing. How soft or rough your skin looks and feels can change from day to day due to various factors.

“There are many reasons a person’s skin can feel and look “textured,” including lines or peeling from chronically dry skin, bumps or scars from acne breakouts, deep folds and pebbled appearance from severe sun damage, dilated pores, dullness, dead skin build-up, inflamed plaques and more,” says Dr. Jennifer Baron.

What Is Textured Skin?

While all skin has varying textures with fine hairs, varying pore sizes, lines and wrinkles, and blemishes, textured skin can be considered less smooth or soft and rougher, bumpy, or dry, often with patches of different textures on specific areas of the face and body. “Two broad categories of textured skin can be described by your skin’s immediate or long-term quality, like dryness, age, sun damage, scarring, and also your skin’s state of disease or inflammation, like acne, eczema, psoriasis, or others,” explains Dr. Baron.

Textured skin isn’t an aspect of any single skin type but can be present for everyone. Those with oilier skin may experience more blemishes and bumps, while those on the drier side can experience roughness and flakiness. Of course, combination skin can have the “best” of both worlds with slicker, oilier areas and dryness elsewhere.

Causes of Textured Skin

Linda N. Lee, M.D., a double-board certified facial plastic and reconstructive surgeon, breaks the causes of textured skin into four categories: genetic, environmental, hormonal, and age-related.

• Genetics: Genetic reasons for textured skin include enlarged pores, dry or oily skin, and conditions like eczema, which can cause irregular skin texture that we are born with.
• Environmental: Sun damage from UV rays, including natural sunlight and (worse!) tanning beds, is one of the most common causes of thickened and “leathery” skin. Smoking and air pollution can also contribute to poor skin texture.
• Hormonal: Teenagers, pregnant patients, and perimenopausal patients all have skin conditions that can be treated specifically in different life stages. Hormonal changes can result in acne-prone skin, oily or dry skin, melasma during pregnancy (“pregnancy skin”), and skin thinning, resulting in easier breakage.
• Age: Skin turns over less as you mature. Fine lines and dull skin tone can result from this. Everyone will have collagen breakdown over each decade, and eventually, skin that is saggier and more coarse with deeper wrinkles.

Other related factors that can cause textured skin include acne scars, skin conditions, and poor skincare habits. These factors can lead to a rough, uneven skin surface with fine lines, wrinkles, or scars, according to Kautilya Shaurya, MD, a board-certified dermatologist. “To address textured skin, it’s crucial to identify the underlying cause and seek appropriate treatments, skincare routines, or a dermatologist’s recommendation for improvement,” he says.

How to Treat Textured Skin at Home

Addressing textured skin can start at home with over-the-counter or prescription treatments. Here’s what works best, according to the experts.

Topical Retinoids  

“The single best at-home treatment option is a vitamin A derivative (topical retinol or retinoids) to help reduce collagen breakdown and treat fine lines,” says Dr. Lee. Retinoids are derivatives of vitamin A that are converted into retinoic acid for skincare, helping boost skin cell turnover and improving the look and feel of skin texture. 

There are several doses and types of topical retinol, including over-the-counter, medical grade, and prescription strength. Not everyone can tolerate retinol, but it is essential to start at a low dose and slowly work up to the best quantity you can handle without significant peeling, according to Dr. Lee. “I think of it like exercise: rather than running 3 hours once a month, it is better to exercise routinely for 30 minutes three times a week. You want to do the best dose you can tolerate regularly that is sustainable and does not cause too much dryness or redness,” she explains. 

The best dose for you will be unique to your skin’s needs and tolerance. “It is great to work with a board-certified skin care provider to find the best regimen for your skin type,” says Dr. Lee.

Chemical Exfoliating Acids

“Chemical exfoliants increase the rate of cell turnover by encouraging the skin to produce new, healthy cells,” says Connie Yang, MD, cosmetic dermatologist at PFRANKMD by Dr. Paul Jarrod Frank. 

This process helps to replace damaged or dull skin with a fresher, smoother skin over time. Look for products containing alpha hydroxy acids (i.e., glycolic acid, lactic acid), which help break down the bonds between dead skin cells to reveal smoother and more even skin, according to Dr. Yang.

Antioxidants and Hydrators

Antioxidants improve cell health and protect the skin against sun damage, while hydrators soothe and plump dry, damaged skin, making the duo a powerful defense against textured skin. Dullness and peeling, in particular, can be brightened and resolved with antioxidants, including vitamin C, and hydrators such as hyaluronic acid, according to Dr. Baron.

“Some inflammatory skin diseases can also improve with potent antioxidants such as green tea and hyaluronic acid, as well as some oils like coconut, macadamia, and kukui nut oils,” says Dr. Baron.

In-Office Treatments for Textured Skin

Treating textured skin with the help of in-office treatments can help you get smoother skin when at-home treatments aren’t enough or when you’re looking for a more dramatic change.

Chemical Peels

Depending on the underlying cause of poor skin texture, chemical peels can help accentuate your at-home regimen, according to Dr. Lee. These exfoliating treatments are a step up from the at-home versions, similarly exfoliating and improving the skin’s texture, using powerful acids to peel off the top layer of skin, revealing the fresh, smooth, bright skin beneath.

Microneedling

Microneedling, also called Dermapen and Rejuvapen, helps produce collagen and thicken the skin for a more youthful, plump, and even appearance. Essentially, needles are inserted into the skin to create tiny puncture wounds on the skin’s topmost layer, triggering the skin to produce collagen and elastin in response.

Another option is microneedling with platelet-rich plasma (PRP), which uses your own growth-protein-containing plasma to stimulate collagen production, wound healing, and cell renewal. “Microneedling with PRP is often very helpful when performed in three treatments for smoothing irregularities, brightening skin tone, and even softening old acne scars,” says Dr. Lee. 

Facelifts and Eyelid Surgery

“For the person with a lot of skin laxity related to age and irregularities in the skin, in-office facelifts and eyelid surgery can be performed to remove the excess skin and tighten the underlying facial musculature and overlying skin,” says Dr. Lee. 

Fillers and Injectibles 

Facial fillers (including Restylane and Juvederm) can help plump skin and restore volume to the aging face, according to Dr. Lee. Biostimulating injectable treatments such as Sculptra (often called a “liquid facelift”) can help stimulate facial collagen. These treatments stimulate collagen production for gradual texture improvement. 

Skin-Care Routines for Textured Skin

An effective skincare routine for textured skin aims to promote skin renewal, improve hydration, and minimize the appearance of unevenness. Dr. Shaurya recommends the following separate routines for morning and evening to care for textured skin.

Morning Routine for Textured Skin

1. Cleanser: Start with a gentle cleanser to remove any impurities and oils that may have accumulated overnight. 

2. Toner: Apply a hydrating, alcohol-free toner to balance your skin's pH and prepare it for subsequent products. 

3. Serum: Use a serum containing vitamin C, hyaluronic acid, or niacinamide to target specific texture concerns, promote collagen production, and brighten the skin. 

4. Moisturizer: Apply a lightweight, non-comedogenic moisturizer to promote hydration and maintain skin barrier function. 

5. Sunscreen: Finish with a broad-spectrum sunscreen with at least SPF 30 to protect your skin from UV damage, which can worsen texture issues. Reapply if you'll be exposed to the sun throughout the day. 

Evening Routine for Textured Skin 

1. Cleanser: Cleanse your skin to remove makeup, sunscreen, and daily grime. 

2. Exfoliation: Use an exfoliant, such as alpha hydroxy acids (AHAs) or beta hydroxy acids (BHAs), 2-3 times a week to help remove dead skin cells and improve texture. Start with a lower concentration and increase gradually to avoid irritation. 

3. Toner: Apply toner as in the morning routine to balance your skin. 

4. Serum: Use the same serum as in the morning or switch to a different one that targets nighttime repair and renewal, like a retinol serum for collagen production. 

5. Moisturizer: Apply a slightly thicker moisturizer or hydrating night cream to nourish your skin overnight. 

6. Optional Treatments: Consider incorporating treatments like facial oils or masks specific to your skin's needs 1-2 times a week.