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By Dr. Ying-Chun Wu

How to tighten enlarged pores and alleviate acne and pimples – A detailed description of causes and treatment tips

Although viewers can derive an inexplicable sense of comfort from watching other people squeeze acnes and acne, unwelcome acne outbreaks on one’s own face are vexing and annoying. A blackhead-speckled nose and enlarged pores give the skin an uneven appearance. It is extremely difficult to stop the growth of acnes and if they are left untreated, they can cause inflammation, erythema (redness), or even pustule outbreaks. Treatment is greatly complicated if pockmarks are present, which has a highly detrimental impact on skin quality. A clear understanding of the underlying causes is an essential prerequisite for effective and accurate treatment and identification of perfect solutions for irritating skin issues such as enlarged pores, acnes, and pimples. People afflicted with acne or pimples will no longer slavishly follow well-known but ineffective home remedies or routines once they are fully aware of the deeper causes of such issues. 

Lesson 1Understanding the structure of pores

A deeper insight into the structure of pores is vital for a clear understanding of the causes of acne formation and pore enlargement. Pores serve as the exit points for individual hairs. They resemble tapered bags that widen toward the bottom and contain the hair follicles through which the hair grows and the sebaceous gland on the side which is responsible for the secretion of sebum. This sebum forms a hydrolipidic film on the skin surface in the vicinity after exiting the pores. This film has hydrating and moisture-retaining functions. Under normal circumstances, pores have openings which allow them to discharge lipids just like an unobstructed water pipe.  

Lesson 2 Causes of acne formation and acne types

I mentioned above that normal pores have openings. However, abnormal keratin metabolism prevents the natural shedding of dead skin cells and causes them to become firmly attached to the stratum corneum. If old cells are not discarded and new cells keep accumulating, the pore openings will end up being blocked and sealed by abnormally and excessively keratinized cells.  This in turn results in lipids secreted by the sebaceous glands accumulating in the pores since they cannot be discharged. As these lipids keep piling up, they eventually lead to the formation of closed acnes, which appear as small white bumps on the skin’s surface, barely visible to the naked eye or noticeable by touch.

Sometimes pore openings are not blocked by these dead skin cells. However, due to the abnormally excessive secretion of sebum by the sebaceous glands, these lipids cannot be discharged fast enough, and they end up blocking the pores. To the naked eye, these accumulations appear as yellowing or whitish spots inside the pores. They are often referred to as whiteheads, which are in fact unoxidized acnes. Once open acnes inside pores turn black due to oxidization, they appear as small black spots (the so-called “blackheads”) on the skin. 

Lesson 3Causes of pimple formation and pimple types

Closed and open acnes (whiteheads and blackheads) represent the initial stage of pimple formation. If they are left untreated or treated improperly, they worsen and gradually turn into annoying pimples.

As mentioned above, excessive sebum secretion and abnormal keratinization on the skin surface, which leads to blocking of the pores, causes the formation of acnes and whiteheads. As acnes cannot be charged and plug the pores, they compress the surrounding tissue which leads to inflammation, redness, heat, and pain, which signals a pimple outbreak.

Our skin is a little universe with countless microorganisms. Cutibacterium acnes, which is an anaerobic bacterium inside the pores that subsists on fatty acids, is part of this flora. These bacteria thrive in clogged pores with excessive amounts of secreted sebum. Uncontrolled proliferation of these bacteria causes inflamed pimple to become purulent. This can result in cystic acne which is painful, difficult to treat, and tends to leave scars.   

Lesson 4 Reasons for enlarged pores

Despite the fact that both oily and dry skin types can be affected by enlarged pores, it can’t be denied that pores are particularly noticeable on oily skin. This can be attributed to the fact that the stratum corneum of oily skin types is thicker. As dead skin cells accumulate, they compress the neatly arranged keratinocytes. Uneven keratin surfaces don’t reflect light evenly, which makes the skin appear less translucent and the pores more visible. Skin characterized by profuse lipid secretion is more prone to acne formation. Needless to say, these acnes which stay in the pores over extended periods tend to enlarge the pores, which is why pores in the T-zone are more prominent than those on the cheeks. Squeezing of acnes for a prolonged period of time creates tiny wounds and can lead to pore enlargement. These enlarged pores tend to appear roundish.   

Loosening of the pore base represents another cause of pore enlargement. This is more common in dry and oily skin types. With advancing age, the amount of collagen in the skin gradually declines, which leads to sagginess. Excessive dryness, on the other hand, causes the connective tissue surrounding the pores to become loose. All these factors make the pores appear more prominent. The shape of this pore type resembles a Y or a waterdrop. Special attention must be given to sun protection since sunlight exposure is the main culprit of this type of pore enlargement.   

Lesson 5How can enlarged pores be minimized?

  1. Externally applied acidic products: Mandelic, glycolic, azelaic, and salicylic acid-based skin renewal products applied as part of a home skin care routine can accelerate keratin renewal and decrease sebum secretion. These products also help prevent abnormal keratinization, which in turn causes clogging. As the barriers that block the pore openings disappear, the acnes inside the pores can be dissolved and discharged, which tackles the issue of pore enlargement at the root. I highly recommend mandelic acid due to its macromolecular, lipophilic properties and the fact that it less irritating than other acidic products since it remains in the stratum corneum to produce its effect.
  2. Orally administered retinoic acid:These products inhibit abnormal lipid secretion, prevent abnormal follicular keratinization, and thereby control inflammatory reactions of the hair follicles. However, retinoic acid has its limitations due to its significant side effects and the fact that it is a prescription drug.
  3. Laser toning:The thermal energy generated by laser beams accelerates epidermal metabolism, stimulates collagen regeneration, reduces lipid secretion, and thereby tightens the pores.
  4. Intense pulsed light (IPL):IPL is a milder light therapy than lasers, resembling a gentle combined laser. It can stimulate collagen regeneration and inhibits sebaceous gland activity.
  5. Fraxel Laser: This laser is capable of vaporizing keratin and boosts collagen regeneration around the pores.
  6. Picosecond Laser: This laser repairs pores which have been damaged by the sebaceous glands.

Post-class Q&AAcne and pore issues

Q:Does popping acnes really enlarge the pores?

A: Acne popping is indeed one of the main causes of pore enlargement. It also tends to result in loss of collagen and elastin or generation of scar tissue, which is bound to enlarge the pores. As a matter of fact, acne formation (whitehead or blackhead) is a clear indicator of inflammation. If left untreated, the cytokines and enzymes secreted by inflamed cells damage the tissue surrounding the pores and enlarge the acnes over time.  

Blackheads and huge closed acnes that have grown over the years are particularly vexing. The former lead to evaporation of moisture over time since they are not fully sealed. This causes them to dry and harden and thereby compress the surrounding tissue and loosen the follicular tissue. If these two acne types are squeezed or dug out in a forceful way, the epidermis tends to suffer unnecessary damage. The best way to prevent pore enlargement is to block acne and pimple formation as much as possible. Existing acnes and pimple must be conditioned in a gentle manner with moisturizing products. 

Q: How should hidden acnes be treated?

A:These closed acnes, which are invisible on the surface of the skin but feel like little knots when touched, are caused by the sealing of pore openings by abnormally and excessively keratinized cells. Acidic components like mandelic, alpha hydroxy (fruit), retinoic, and azelaic acids are the most recommended ingredients for treatment of closed acnes. These components can accelerate keratin metabolism and thereby tackle the issue of abnormal keratinization at the root. Mandelic acid is the best choice for a safe and effective home skin care regimen.

It is not recommended to squeeze or use peel-off masks to extract closed acnes. This causes injuries to the skin since whiteheads are trapped inside closed pores. Users have to be prepared for a massive acne breakout if mandelic acid-based products are applied to alleviate closed acnes. This is a direct result of mandelic acid relentlessly pushing all hidden acnes and pimples to the skin surface. However, these symptoms will go away after around one month and the skin will become increasingly smooth and supple.

 

Q: How to select the ideal acid-based product for tackling acne?

A: Mandelic acid is a macromolecular, liposoluble alpha hydroxy (fruit) acid. Since the stratum corneum is capable of absorbing large amounts of liposoluble substances, mandelic acid is easily absorbable and remains in the surface layer where acne is located. Due to its macromolecular properties, it is less likely to penetrate deeply into the skin and less irritating than micromolecular glycolic acid. It has therefore turned into a mainstream ingredient for home skin renewal regimens. Marketing campaigns for mandelic acid products available on the market tend to focus on acid concentrations. However, the most crucial factor is the pH value. The minimum pH value of skin renewal acidic products for home use as prescribed in applicable laws is 3.5. It is evident that products with pH values only slightly above 4 have rather weak keratin renewal effects. When selecting skincare products for the treatment of acne, the pH value is of much greater importance than acid concentrations.

 

Q:Is facial cleanser or toner capable of contracting pores?

A:The main function of facial cleansers is to cleanse the skin and wash off part of the sebum. Toners, on the other hand, hydrate the skin. Astringent toners have temporary pore contraction effects due to the addition of refreshing alcohol or plant-based astringents such as witch hazel, aloe vera, rosemary, or St. John’s wort. These products do not provide long-lasting pore tightening effects.  

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