Google searches for “How to Shrink Pores” peak every summer, which makes sense, considering sebum—the oil secreted by skin in conjunction with sweat—is one of the main causes of large pores. The thick fluid presses on the pore walls, making them expand. But let’s get one thing straight: Our pores may seem to grow or shrink temporarily, but their size never actually changes. Chicago dermatologist Omer Ibrahim, MD explains it this way: “Pore size is like shoe size; it’s genetically predetermined.”
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A pore-altering tool in many dermatologists’ kits, microneedling creates tiny wounds in the skin, stimulating the wound-healing response with collagen production and reducing the appearance of pores. “Newer microneedling radio-frequency (RF) technologies, like Vivace, have been the best option to smooth skin in my experience,” says Fort Lauderdale dermatologist Dr. Igor Chaplik. “The noninsulated tips of the device provide an amazing result in pore size reduction, oiliness, texture, and tone.” West Palm Beach, FL dermatologist Kenneth R. Beer, MD says that although microneedling has received flak in the past—if not performed correctly, it can damage skin—it is now getting the level of scrutiny it deserves, and is being used with active ingredients that can positively impact skin quality. “Keep an eye out for companies that are marketing their products the right way, with FDA approval,” he says.
Although no research has specifically connected retinoids to a measurable drop in sebum production, consistent use has proven to make pores look smaller, as well as smooth away the majority of other texture issues like wrinkles, dry patches and acne. According to New Orleans dermatologist Mary Lupo, MD, “Topical retinoids help by improving cell turnover, and oral retinoids shrink pores by decreasing the size of the sebaceous gland.” New York dermatologist Peter Chien, MD adds that pores are more noticeable if you have comedones: plugs of sebum and keratin that stretch them out. “If skin is not sun-dam- aged, reducing the comedones with a topical retinoid will help the pores shrink again,” he explains. “Very sun-damaged skin will have irreversible enlarged pores—like in Favre- Racouchot syndrome—as the damaged elastin will not allow the pores to snap back. In this case, a fractional laser may be able to tighten the pores by producing new elastin.”
More than a decade ago, doctors began experimenting with shallow intradermal injections of Botox Cosmetic to minimize sebum production, and patients experienced a reduction in pore size. The anticholinergic action of Botox—it prevents neutrotransmitter acetylcholine from binding to receptors in nerve cells—works to temporarily minimize pores in the same way it smooths forehead wrinkles. According to Covington, LA dermatologist Christel Malinski, MD, “Micro-Botox helps reduce the appearance of pores by working on the small muscle attached to the hair follicle called the arrector pili muscle.”
ALL THE SMALL THINGS
Some of the biggest speed bumps on the road to clear skin are actually pretty tiny: Milia look like tiny whiteheads, but are actually shallow, miniature cysts. They can be caused by heavy occlusive creams or by irritating an area by rubbing it, which is why milia are common around the eye area. “To treat milia, we open up the overlying skin with a tiny blade or needle, and express the cysts,” Dr. Ibrahim explains. “You can prevent or slow down their occurrence by using a retinoid.”