Enlarged facial pores are a frequent complaint from patients. But the mechanism behind why some patients develop larger pores than others remains unclear.
The face is home to some of the thinnest areas of skin on the body, excluding the skin of the eyelid. It has both large terminal hair follicles, as well as thin vellus hairs. The hairs are a transition point between the skin and the follicular ostia (or openings) that lead to the base of the follicle.
This follicular opening is connected to the underlying sebaceous glands, the “pore.” The texture of the face is in part the result of mounds around follicular ostia and valleys in the interfollicular space. The larger the pores, the coarser the skin, and the smaller the pores, the more even and smooth the skin surface.
Pores can become packed and dilated with sebum, makeup, dirt, and bacteria. Pore size is dependent not only on the contents of the pore, but also on genetic factors.
Ethnic differences in the appearance of pores can contribute to different aesthetic concerns, as well as to treatment options for patients.
A recent study was conducted to elucidate ethnicity-dependent differences in facial pore size and in epidermal architecture (J. Dermatol. Sci. 2009;53:135-9). Surface replicas of 80 patients – healthy white, Hispanic, Asian, and African American women (aged 30-39 years) – were created to compare pore sizes in cheek skin.
Horizontal cross-sectioned images from cheek skin were obtained noninvasively from the same subjects using in vivo confocal laser scanning microscopy to determine the severity of impairment of epidermal architecture around facial pores. Finally, the interfollicular epidermal architecture of the cheek skin of the different ethnic types was evaluated with horizontal cross-sectioned images and counts of dermal papillae.
The study showed that all ethnic groups had similar morphologic features. Asians had the smallest pore areas, compared with other ethnic groups, while African Americans showed substantially more severe impairment of architecture around facial pores.
Although this study did not account for amount of sebum production or bacteria in epidermal pore dilation, it did highlight an intrinsic difference in pore size among various types of skin of color.
Other factors that can extrinsically affect pore size include smoking, sun exposure, and age. Ultraviolet radiation and free radicals can degrade collagen and elastin, thereby altering the dermal structure of the skin,which influences its texture and integrity.
Some methods to decrease pore size include:
Retinoids: By increasing cell turnover and decreasing sebum and bacteria content, retinoids can prevent dilation of pores.
Exfoliants: Alpha and beta hydroxy acids can remove sebum, dirt, bacteria, and keratin from pores, creating a smoother-looking texture to the skin. Keeping pores clean and free of debris can make pores appear smaller though the actual size may not differ.
Ablative and nonablative fractional laser: These treatments help exfoliate the skin, increase cell turnover, and increase collagen and elastin production, thereby helping tighten the skin and reduce pore size.
Sunscreen: Photodamage can delay cell turnover, degrade collagen and elastin, and thicken the top layer of skin, causing pores to look larger. Aggressive photoprotection will ensure healthier skin and overall improved skin texture.
Alcohol based toners and heating may temporarily give the illusion of tightened skin but do not actually alter pore size.
Many women and men seek the advice of their dermatologist to help decrease the appearance of enlarged pores. We now understand that there are both extrinsic and intrinsic differences in pore size and skin texture, and vast differences among our patients of color. This understanding can help direct treatment modalities and help educate our patients in the skin care regimens they choose.