Pores Pores Pores Pores

Pores Pores Pores Pores

We're at the height of a national obsession with eliminating pores and I cannot tell you how many patients come into the office looking for the real-life magic eraser that will make their skin flawless. I hate to be the one to break it to you, but there is none. To compare your skin, a functioning organ with a very important job, to images that have been Photoshopped and filtered is a fool's errand.

These tiny holes you see on the surface of your skin, the ones that are source of so much angst, are the openings of your pilosebaceous unit.  This structure includes tiny hair follicles and the sebaceous gland, the source of the oil that can potentially clog your pores. The size and appearance of your pores can be affected by the following factors: compacted skin cells and debris (a.k.a black heads and white heads), photodamage, excessive trauma (pickers, I'm looking at you), genetics, hormones and skin diseases i.e. rosacea.  

While you will never be able to get rid of your pores completely, there are a few things that can may improve their appearance.  As a caveat, most of these treatments have only been studied in small groups of patients and are lacking in evidence backed by vigorous, standardized studies. 

  • Topical retinoids and weekly glycolic acid peels (i.e. tretinoin, adapalene, etc.) help reduce the amount of dead skin cells clogging up your pores, making them more visible. Actual shrinkage of the pore openings is modest. 
  • Oral medications prescribed by your dermatologist can help reduce oil production in the skin and potentially reduce the appearance of pores.  Isotretinoin, known to many as Accutane, induces shrinkage of your sebaceous glands and in my experience while treating severe acne, does a pretty good job of minimizing those pores. 
  • Laser devices tend to be a bit more effective because it reaches the deeper layer of the skin and can tighten up the collagen/elastin support around the pilosebaceous unit. 
  • Note: Blackhead removal strips or masks are a short term solution which merely manually remove the dead skin cells clogging your pores.  I don't personally recommend them because they can strip your skin of its protective barrier and cause irritation resulting in a rash. 

Bottom line, pores are important, complex anatomic structures in your skin, so you can try minimize to them but will never ever be completely rid of them.  My advice is to get rid of that magnifying mirror and learn to love those little suckers. 

For a deeper dive into the causes and treatments: 

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

Lee SJ, Seok J, Jeong SY, Park KY, Li K, Seo SJ.Facial Pores: Definition, Causes, and Treatment Options. Dermatol Surg. 2016 Mar;42(3):277-85.

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