How a Top Dermatologist Treats Pores
How a Top Dermatologist Treats Pores
Nearly everyone who comes to see New York dermatologist Robert Anolik has a question about pores (he blames Instagram filters and magnifying mirrors). Fortunately, Anolik, a clinical assistant professor of dermatology at the NYU School of Medicine, has plenty of solutions for enlarged pores—both at home and in the office.
A Q&A with Robert Anolik, MD
Nearly every patient asks about visible or enlarged pores, even if it’s not their primary concern. Most people coming for Botox or filler ask me about pores, and so does everyone coming in for laser treatments. People of every age and skin type are concerned about pores. But what everyone needs to know is: Pores are not a flaw in your skin! We’re human beings, so we have pores—it’s normal. Part of the problem lately is we’re all looking at Instagram-filtered images that hide pores. If you’re looking at one of those close-up selfies and the person has no pores, that’s just not real. That said, pores do get enlarged, and we do have lots to treat them with.
Magnifying mirrors: Throw them away! No one sees you that way—they would (obviously) need a magnifying glass to do that. A magnifying mirror is kind of the opposite of an Instagram filter; it makes a person look worse. And using a really occlusive moisturizer—like petroleum jelly or a heavy ointment—can promote clogging.
Really though, the biggest mistake is not using sunscreen, as sun damage leads to the degradation of your collagen, which will make pores look bigger.
They do. They can get stretched out when they’re clogged with dirt, oil, dead skin cells, or other debris, or when the skin has lost some of its structural support—collagen—because of sun damage or even just because of normal aging, especially after menopause. If you have oily skin, your pores might bother you when you’re younger, but oily skin generally ages a bit more slowly, so your pores might bother you less when you’re older.
I think of a pore as a column exiting at the skin’s surface. It can look bigger if there’s something within the column enlarging it, like a dead skin cells, oil, or even acne, and it can also look bigger because of the skin surrounding it—because of a weakening of the surrounding collagen. Healthy collagen sort of cinches a pore tight.
Pores are where the hair follicle exits the skin and where the oil gland exits the skin and releases our body’s natural moisture. When dead skin cells get clogged deep inside a pore, it creates a dark shadow, and that’s why a blackhead looks black—it’s actually the shadow of the sides of the pore. If the clog is more toward the surface, that’s a whitehead. Inflamed pores become acne, and the oil gland swelling around the clogged pore leads to a cyst.
If the problem is clogged pores, you’ve got to unclog them. I use alpha or beta hydroxy acids (salicylic acid is great if the skin is breakout-prone; glycolic can be great even if skin is dry), prescription Retin-A, over-the-counter retinols to help exfoliate, prevent the clogging of the pores, and help build up a little collagen in the process.
To keep the column clear for patients with really clogged pores or even breakouts, it’s great to combine mild chemical peels with Isolaze, an intense pulsed light laser that’s mixed with suction action and known as photopneumatic therapy. The laser helps kill the bacteria that drives acne and helps normalize the skin tone, getting rid of some of the discoloration from acne; the suction helps clear pores; and then doing a gentle chemical peel over it really improves pores and problem skin. People used to do deeper-depth peels until the 2000s, but since then, lasers have surpassed peels in terms of safety. I definitely don’t recommend anything deeper than a superficial chemical peel.
To help build the collagen back up, most dermatologists use laser resurfacing therapies. It’s a broad category with many brands, all aimed at stimulating collagen, from very noninvasive technologies, like PicoSure or Clear + Brilliant, to more-intense treatments, like Fraxel, that can help remodel collagen and cause collagen production. How often you do laser resurfacing is individual—there’s a tug of war between the treatments and the effects of natural aging and sun exposure, and you just have to find the right balance.
Yes. If you’ve lost collagen in your skin, it doesn’t matter whether your skin is dry or oily—the pores will be less tight.
Yes. A facial makes your skin glow for several days afterward because it exfoliates the skin’s surface, unclogging thousands of pores on your face. If patients enjoy them, I always encourage them.
Robert Anolik, MD, is a board-certified dermatologist who specializes in cosmetic dermatology and laser skin treatments. He received his undergraduate degree from Princeton University and earned his medical degree from Thomas Jefferson University, where he graduated magna cum laude. He completed his residency training in dermatology at NYU School of Medicine, where he is now a clinical assistant professor of dermatology. He practices at the Laser & Skin Surgery Center of New York.
This article is for informational purposes only, even if and to the extent that it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The views expressed in this article are the views of the expert and do not necessarily represent the views of goop.