How to Shrink Enlarged Pores for Good: Top Docs Share Their Tips
There are many markers to hit on the way to lovely skin. Brightness: that indescribable glow. Evenness: the absence of dark spots and redness. Clarity: no pimples and scars. All are elusive but none more so than a smooth, pore-less finish. If you have them, you know visible pores are persistent. They seem impossible to get rid of with lotions and potions.
What makes them so hard to shrink? You can blame your parents for that. Pore size is largely determined by genes and, as with anything inherited from mom and dad, it’s pretty difficult to change. But there is hope.
What are pores anyway?
Simply put, they’re the skin surface openings of hair follicles. Imagine a tiny tube going through the first few layers of the skin. This tube is the hair follicle, a hair-making factory inside the skin. The opening of that tube at the surface of the skin is the pore. Think of it like a volcano rim — a particularly apt metaphor for acne sufferers.
We all have pores, but sebaceous glands, found on either side of the follicle, determine how large they are. The more oil they produce, the larger the pores are. Sebaceous glands produce sebum, a waxy substance that protects our skin from the outside world.
Note: Sebaceous glands are not to be confused with sweat glands, which are separate and not responsible for the pores we see.
We often think of sebum as the main culprit in acne. It is. But keep in mind, oil is not all negative. As we age, our oil production slows, leading to dry skin and wrinkles. Those with very active sebaceous glands (read: bigger pores) will experience less dryness and likely fewer fine lines later. Lucky people. Even with that pretty cool positive for those of us who have bigger pores, we all still want to know how best to shrink them. As is typical with the skin, the most effective treatments are provided by doctors. But that doesn’t mean there aren’t a few things you can do at home as well.
Accutane and at-home solutions
Dr. Debra Jaliman, a dermatologist who practices in New York City, explains how birth control pills are one option to effectively shrink pores. “Birth control pills rebalance hormones, including male hormones that cause excess oil production,” says Jaliman. “They can also include spironolactone (a diuretic typically employed to treat high blood pressure), which blocks androgens, or excess male hormones, which aids in preventing large pores.” She adds that Accutane, a very strong oral medication used to treat acne, can also be used to treat large pores, but cautions that it’s “an extreme option.”
Accutane is essentially a large dose of Vitamin A which over time shrinks sebaceous glands, therefore shrinking pores. It has some serious side effects so doctors generally only prescribe it to patients with severe, persistent acne. Smaller pores are simply an added bonus of the treatment.
Skincare solutions like creams and scrubs don’t actually shrink pores but can help their appearance by smoothing out the skin surrounding them. “It’s really hard to reduce pores topically,” says Dr. Michelle Henry, a board-certified dermatologist and dermatologic surgeon at the Laser & Skin Surgery Center of New York. “But when the pores are clogged, they look much larger. Getting out all the gunk, like dead skin cells, helps. Salicylic acid and glycolic acid both also unclog pores by dissolving dead skin cells. And retinoids, like Tretinoin, Tazorac and Differin (which recently became available without a prescription) increase cell turnover so they help keep follicles clear and stimulate collagen production. Adding a Clarisonic or even an old-school buff puff will clean out those follicles,” offers Henry.
Laser Pore Tightening Treatments
According to Dr. Henry, treatments to actually reduce the size of pores need to be a little more invasive than topical treatments. Lasers like Fraxel and Halo work well for this purpose. They’re not ‘invasive’ per se, but are more aggressive than topical treatments. They create little microchannels of damage in the skin, and that damage stimulates a healing response which, in turn, creates more collagen. Collagen is a protein in the skin that gives it structure and that boost causes pores to close up.
“It’s sort of like a drawstring bag. If you have a big pore with loose tissue around it, that tissue just sort of hangs out,” explains Dr. Henry. “But if you can create more collagen, it chokes the bag and makes the opening smaller.” Lasers that are ablative — that is, they cause the epidermis to shed — will smooth the skin around the pore, leading it to look smoother and less noticeable.
Laser treatments vary in price but start around $1000 for a full-face treatment.
Dr. Norman Rowe, a New York City-based, board-certified plastic surgeon, uses a time-tested procedure, microneedling, in a creative way to help treat pore size. Microneedling has long been used to rejuvenate skin and treat scarring. During the procedure, a pen-like device with 25 to 30 tiny needles on its head is carried across the skin. Each needle is extremely fine, so it does not harm the skin. Instead, the micro-punctures trigger the skin’s wound-healing response, stimulating collagen production. Over a roughly six week period following the procedure, the skin starts looking smoother and more radiant.
Microneedling has long been an effective tool in the dermatologist’s anti-aging kit, but with one small tweak, Dr. Rowe is making the procedure even more appealing for patients. In short, he’s using hollow needles so he can inject “skincare cocktails” into the skin while microneedling.
The device has what looks like a nail polish bottle on top. Dr. Rowe can put any number of treatments in the bottle, which he says function like skincare boosters. For example, injected antioxidants protect the skin, fruit acids encourage cell turnover, while diluted hyaluronic acid moisturizes and plumps.
But perhaps most importantly for our purposes, a diluted form of Botox can shrink pores. Here’s how it works. As we know, everybody’s favorite anti-aging friend, Botox, is a neurotoxin that inhibits the function of muscles. According to Dr. Rowe, when injected at the superficial skin level of microneedling (during a regular Botox injection, the toxin is injected deep into the larger facial muscle) this diluted Botox decreases the production of sebum and also paralyzes the tiny muscles surrounding the skin’s pores.
End result: smaller pores, and — bonus — less acne because of the decreased sebum production.
It’s worth noting that this use of Botox has not yet been studied extensively by the medical community. Nevertheless, Dr. Rowe swears by its results for his patients, “It can be used effectively on any skin color, unlike lasers, which can be damaging to darker skin.”
A patient typically only needs one or two treatments, which last about 20 minutes. Even better, because the needles are so fine, the procedure is almost painless. At approximately $500 per session, it’s much more affordable than your average laser treatment. And because the area metabolizes the Botox slower than a larger muscle would, the results last longer, roughly six to nine months.
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