Open pores: can they really be reduced?

Key takeaways

• A pore is the opening of a hair follicle with its oil gland. Everyone has them, and they are more visible on the nose, cheeks and forehead.
• Pores look larger with more oil, blackheads, ageing and sun damage, and with genetics. Men and people with oily skin often have more visible pores.
• Topical retinoids are a reasonable first step, with evidence that they help appearance, although few studies measure pores directly.
• Peels, fractional lasers, radio frequency and microneedling can help some people, but evidence is limited and changes are modest.
• Steam, ice cubes, "pore-closing" toners and strips change the look for an hour at most. Squeezing can leave marks on Indian skin.

What actually is an open pore?

Patients say "my pores are open" as if they are doors. They are not. A pore is simply where the hair follicle and its oil gland open onto the skin. It cannot be closed, and you would not want it closed. What happens is that some pores look wider and darker than others.

A review in the journal Cutis looked at what drives large pores. The main factors were: - Oil (sebum). More oil output goes with larger-looking pores, and this link is strongest in men. - Ageing and sun damage. As skin loses elasticity, the walls around each pore sag and the opening looks wider. - Hair follicle size and genetics. Some people simply have larger pores from their teens. - Blackheads and acne. A pore plugged with oil and dead skin stretches and looks dark. - Hormones. Pore size and oil can rise around ovulation in women.

So, normally, open pores are a mix of oil, plugs and slack support around them. Treat those, and the pore looks smaller.

Why do pores look worse in Mumbai?

Heat and humidity make the skin shinier, and shine makes pores easier to see. Sweat and oil mixing with pollution and makeup also fill the pores, so they look darker by evening. Many people in Mumbai over-wash because the face feels greasy, which can irritate the skin. Irritated skin sometimes produces more oil. I have written a full routine in oily skin in Mumbai humidity.

What can I do at home that genuinely helps?

• Wash twice a day with a gentle cleanser, and after heavy sweating. The American Academy of Dermatology suggests a gentle foaming wash for oily skin, and avoiding scrubbing.
• Use oil-free, non-comedogenic products. That includes moisturiser, sunscreen and makeup.
• Start a retinoid at night. Adapalene, tretinoin or a good retinol help clear plugged pores and support collagen. Start two or three nights a week. More in retinoids explained.
• Add salicylic acid if you get blackheads. It dissolves into oil and helps clear plugs.
• Use sunscreen every day. Sun damage weakens the support around pores over years.
• Blot, do not scrub. Blotting paper during the day reduces shine without irritating the skin.

How much difference does a retinoid make? The Cutis review mentions a 24-week trial of 568 people using tazarotene 0.1 percent, where 42 percent improved on a pore score compared with 20 percent on a placebo cream. The authors also note that it is hard to separate the pore benefit from the acne benefit. So it helps, and it is not dramatic. That is very important to understand before spending a lot on serums.

What do clinic treatments add?

The same Cutis review lists peels, oral anti-androgens, lasers, radio frequency and ultrasound devices as options, and calls the device-based ones promising. It also says, honestly, that few studies use pore size as their main outcome, and pore size is measured inconsistently. So I present these as tools that can help some people a moderate amount, not as a fix.

On Indian skin I use gentler settings and space sessions out. A dark patch after an aggressive laser will bother you far more than the pore did. For the differences between laser types, see lasers for skin explained, and for peels, chemical peels explained.

What does not work?

• Ice cubes and cold water. They tighten the skin for a few minutes. That is all.
• Steam at home. It does not open pores in any useful way, and on sensitive skin it can cause redness.
• Pore strips. They pull out the top of a blackhead, which refills within days. On some skin they irritate.
• Squeezing and pinching. On brown skin, this commonly leaves dark marks and sometimes small scars.
• Harsh scrubs and alcohol toners. They make skin irritated and sometimes oilier.
• Expecting pores to vanish. Even photographs of "poreless" skin are usually edited or made up.

When are large pores something else?

Sometimes what looks like open pores is actually something different: - Acne scars, especially small rolling or boxcar scars, on the cheeks. These need scar treatment, not pore care. See acne marks vs acne scars. - Many small blackheads and whiteheads, which are comedonal acne and respond to acne treatment. - Enlarged pores with redness and flushing, which may be rosacea.

Basically, the right diagnosis changes the plan. Pores, scars and acne look similar in a mirror and very different under a magnifying lamp.

How we approach this at Dr Tvacha

At a Rs 499 skin consultation I look at your skin closely to separate pores from scars and acne, and we talk about your routine and climate. Most people start with home care for a couple of months. If a peel, laser or medical facial would add something, you get the plan and fee in writing before you pay. The full approach is on the Second Layer Skin Plan page, and you can see us at any of our four centres.

Written by

Dr Amit KarkhanisAesthetic Physician · MBBS, Dip. Dermatology (UK) · Reg. No. 2001/02/1124

Founder of Dr Tvacha, practising in Thane since 2005. Leads the weight loss and hair programmes.