Concern with enlarged pores is not isolated to women; men also cite concerns about the condition. In response, skin care manufacturers have introduced countless products intended to minimize pore appearance. Claims range in their boldness, with most products promising to refine, minimize or deep clean pores, and a few promising to actually shrink them. Those individuals seeking a more aggressive approach to pore minimization have flocked to skin care professionals for focused aesthetic treatments.
Of course, for each product or treatment that does make a difference in pore appearance, there are scores that do absolutely nothing. Given the prevalence with which consumers are now seeking professional intervention for the issue, client satisfaction is heavily determined by improving the problem. Therefore, what follows is an overview of top recommendations for the treatment of enlarged pores. But first, let us overview the factors that cause the condition. The term pore refers to the opening of a sebaceous gland (oil gland) or sudoriparous gland (sweat gland) on the surface of the skin. Below, an oil gland features a hair follicle, which provides a pathway for a shaft of hair and a tunnel through which sebum and dead skin cells may reach the skin’s surface. Typically, it is the oil glands that may appear enlarged on the face.

There are four main reasons why:

• The number one cause is genetics. Those with oily skin tend to have larger, more visible pores to compensate for heightened oil production, while those whose skin is drier have less noticeable pores. Since facial oil is more prevalent in the T-zone, this is where most individuals experience enlarged pores, as a bigger passageway is needed for the secretion of greater amounts of oil.
• You have seen, no doubt, that pore size increases with age. The production of collagen and elastin (essential proteins that give the skin structure and elasticity) slows as we get older. This causes pores to become increasingly visible, as they are no longer held tautly in position. By our 40s, increased pore size is no longer limited to the T-zone. Because of this skin slackening, enlarged pores may show throughout the face, mainly on the cheeks and jawline.
• A reason that we have a bit more control over this is blocked pores. This may happen in individuals with follicular hyperkeratinization, where dead skin cells are abnormally sticky and, therefore, clog the hair follicle. It can also be caused by improper skin care or the degradation of skin structure as we age. As collagen and elastin production slows and the skin becomes looser, dirt, sebum and dead skin cells can become trapped in the hair follicle. This can also lead to acne, which further exacerbates pore size.
• Extrinsic factors can significantly impact pore size as well. Smoking, excess UV exposure, pollution and more can cause the production of free radicals, which quickly break down collagen, elastin and other proteins in the skin. Meanwhile, the manner in which acne lesions are treated can also have an effect. Individuals who tend to pick at acne spots often find that, once the sore heals, an enlarged pore is left behind.

Regardless of the cause of enlarged pore size, there is one commonality – you cannot shrink them. While certain products and treatments can, indeed, make them appear smaller, a permanent solution does not currently exist.

Professional Treatment Options
As stated earlier, enlarged pores tend to frustrate consumers. However, they can also be frustrating to the skin care professional charged with improving their appearance. This is partially because clients often have unrealistic expectations, but also due to the broad array of treatment and product options available to address the condition. A first step in the treatment of enlarged pores is to ensure the client understands the improvements that are realistic. Once expectations are aligned and they understand that their pores cannot be shrunk, clients are better positioned to appreciate the small gains that can be achieved via proper professional treatment and ongoing maintenance with well-formulated products.
Skin care professionals have two routes in which the appearance of pore size can be improved. The first is management of sebum levels and pore blockages. Only when these issues are under control should the focus turn to the second route: skin rejuvenation. (In some cases, treatments can address both goals simultaneously.)

Initial Treatment Approach
If, via skin analysis, it is determined that the client has a thickened keratin layer and/or pore blockages, light exfoliation and a deep pore cleansing should be implemented. This is a suggested first step, as a thickened keratin can enhance the appearance of pores, while blockages can cause pores to dilate and cause unregulated sebum levels.

The following treatments are recommended:

• Pore-Cleansing Facials – A facial that includes cleansing, steam, extractions and a facial mask or enzyme peel is effective at eliminating clogged pores. However, regular treatments are key in order to maintain the improvements. Some clients will notice that their pores look instantly smaller following a facial, while others will require the addition of other procedures.
• Microdermabrasion – By removing the outermost layer of dead skin cells, microdermabrasion is an effective way to jumpstart the benefits associated with exfoliation.
• Superficial Peels – To thin the keratin layer, superficial or medium-depth peels using AHAs (i.e., glycolic or lactic acid) or BHAs (i.e., salicylic acid) may be implemented. While a deep peel can improve the appearance of pores, they do so at a greater risk. Hair follicles are funnel-shaped, making them wider below the surface. If the peel is too deep, pores could look much bigger. Keep in mind that peels may be implemented in conjunction with LED (light-emitting diode) therapy for optimal results.

Light-Based Therapies
Those clients who practice regular exfoliation and are still concerned with pore size may be good candidates for skin rejuvenation via light-based therapies.

• Non-Ablative Fractional Laser – While ablative lasers can dramatically improve skin condition, the threat of taking away too many layers of skin applies. Pore size may be worsened following such an aggressive treatment. This is why non-ablative fractional lasers are highly recommended in the pursuit of minimized pores. Laser treatment stimulates the production of collagen deep within the skin’s layers, helping to restore skin firmness and giving the skin a tightened appearance. In fact, a recent study illustrated a 17 percent reduction in the appearance of facial pores after six treatments with a non-ablative fractional laser.1 (Note that lasers are an example of a treatment that exfoliates and encourages skin rejuvenation simultaneously.)
• Intense Pulsed Light (IPL) – While IPL has been shown to generate an improvement in characteristics associated with photoaging, including pore size, the results can be inconsistent among individuals. That is why some experts highly recommend it, while others attempt to dissuade its use in the treatment of enlarged pores. Regardless, IPL does help to stimulate the production of collagen and may be used as a last resort when all other treatments have failed or in conjunction with other treatments.

In some cases, pore size is unresponsive to any of the above treatments. In these situations, it is important to reevaluate the skin to ensure that what appears to be an enlarged pore is not a subtle ice-pick scar. If it is determined that is the case, fillers may be injected into the depression.

Client Maintenance Practices
During and after the implementation of professional treatments to minimize the appearance of pore size, the onus is on the client to maintain the benefits achieved. Besides understanding the importance of regular maintenance procedures with their skin care professional, it is vital that clients are educated about the proper skin care regimen and steps they can take to ensure even skin texture at home.
To meet the skin’s basic and essential needs, an individual should follow a four-step skin care routine. Skin should be cleansed, exfoliated, moisturized and protected each morning, with just the protect step taken away in the evening.

Cleanse – A gentle, non-drying cleanser should be used to eliminate makeup, dirt and sebum that accumulate on the skin each day. This step is essential to helping pores stay clear.

Exfoliate – While some argue that twice-daily exfoliation is too much, when a properly formulated exfoliant is used, this frequency is beneficial to ensuring proper skin rejuvenation and controlling sebum levels. The ideal at-home exfoliant is chemical versus mechanical. That is, AHAs or BHAs are used to thin the keratin layer. Products that use abrasives or granules to mechanically thin the dead skin layer should be avoided, as they can enhance the appearance of pores and create microscopic tears in the skin. Among clients who seek treatment for enlarged pores, exfoliation is often missing from their skin care routine or implemented improperly. Therefore, its importance should not be overlooked.

Moisturize – While larger pores are associated with oily skin, dry skin can suffer from enlarged pores as well. This is because dry skin can lead to clogged pores, which cause them to look larger. By regularly using a moisturizer formulated with humectants and emollients, dry skin can be avoided.

Protect – Given the impact that UV exposure has on the degradation of collagen, sunscreen is a definite must – especially for those using an exfoliant, as new skin cells are particularly sensitive to sun exposure. Rather than simply applying it once in the morning, sunscreen should be reapplied every few hours.

Pore Minimizing Products
While some pore-minimizers are capable of performing as they are marketed, the result can be an illusion. These products are often formulated with silicon crosspolymers or silicon-based surfactants, which leave a soft, matte-like texture when applied to the skin. Essentially, they act like a makeup primer to fill in depressions in the skin and eliminate shine. Other products intended to minimize pore size are formulated with AHAs or BHAs to offer light exfoliation or peptides to encourage collagen production. Newer formulations have begun using growth factors that are intended to encourage cell generation.
The results that can be achieved through use of at-home pore minimizers will never compare to those from a professional treatment. However, there is no harm in adding them to a client’s skin care repertoire, as long as harsh ingredients are not used. Retinoids can be highly beneficial in maintaining reduced pore size. In addition to encouraging the production of collagen and elastin, retinoids offer added exfoliation. Over-the-counter products can be effective but, for optimal results, prescription-strength formulations should be used. And finally, for those prone to clogged pores, non-comedogenic makeup is a necessity.
Professional treatments and proper at-home maintenance are key elements to minimizing the appearance of pores. However, there’s an additional practice that might just take priority. That practice is proper nutrition.
“We are what we eat,” is an adage that perfectly applies to the skin. Eating an antioxidant-rich diet helps to control free radical damage, which is often implicated in the development of enlarged pores. Additionally, clients should be advised to consider the use of a daily vitamin and/or supplement. Hydration should also be a priority, with water serving as their beverage of choice.
While pores cannot be physically reduced in size, the collection of therapies and practices outlined here most certainly can have an impact. And for most clients, that is a result they can live with.

References:
1. Saedi N, Petrell K, Arndt K. Journal of the American Academy of Dermatology. 2013 Jan: 68(1):113-8.

Ahmed Abdullah, M.D., F.A.C.S., F.I.C.S. is author of the book, Simple Skincare, Beautiful Skin: A Back-to-Basics Approach; CEO and founder of Lexli International, Inc.; and formulator of the company’s Lexli® line of professional skincare products. A board-certified plastic/reconstructive surgeon and a leading aloe researcher, Abdullah is a recognized expert on the restorative and medicinal effects of aloe vera. In fact, he is a pioneer in the use of pharmaceutical-grade aloe in surgical applications to expedite healing, a practice that is growing in popularity. Through his work with patients and the Lexli line, Abdullah has proven that many common skin concerns can be avoided by optimizing skin health. His research has shown that the use of pharmaceutical-grade aloe vera is a beneficial tool in that effort. Thus, Abdullah travels the world educating licensed skin care professionals and consumers alike about the proper ways to utilize aloe in skin care applications, the essential steps to ensuring the skin’s basic needs are met, and setting the record straight on prevalent skin care myths. He regularly sees patients at his practices in Fargo, North Dakota and Dubai, United Arab Emirates.