What it is
What is causing it decides the treatment, because sebum output, sun damage, age and family tendency each produce a different-looking pore, and heavy occlusive products worn in the heat make congestion worse. The plan is normally a course rather than a session — prescribed topicals and sebum control at home, with peels, needling, fractional or radiofrequency devices added where they genuinely add something.
What this page covers
- Skin quality assessment and a staged plan across topicals, in-clinic treatment and photoprotection
- Enlarged pore treatment protocol, matched to the cause
- Oily skin and seborrhea management, including low-dose oral isotretinoin in selected patients
- Topical retinoids, niacinamide and salicylic-based home care
- Medical facial with deep cleansing and gentle extraction
- Microdermabrasion and superficial peels
- Retinol (yellow) peel
- Microneedling for texture
- Fractional picosecond resurfacing
- Non-ablative fractional laser for texture and skin quality
- Fractional radiofrequency microneedling
- Carbon laser peel
- Intradermal microtoxin (mesobotox) for pores and oiliness
- Hyaluronic acid skin boosters, polynucleotides and platelet-rich plasma for skin quality
- Keratosis pilaris and follicular roughness on the arms
- Barrier repair for skin irritated by too many products
Who it suits
- Someone whose complaint is the surface rather than the color: a shine that is back a few hours after washing, roughness felt with the hand before it is seen, and congestion around the nose and chin
- Someone who accepts a staged plan in which most of the work happens at home: a routine built up slowly, with in-clinic sessions added where they genuinely add something rather than because they are available
- Someone who arrives with many products on one face at once — scrubs, home peels, acids layered over acids — and skin that now stings. Here treatment begins by subtracting rather than adding, and we say so at the first visit so you do not leave thinking you were given nothing
- Someone whose congestion follows what sits on the skin: a face covering or a mask worn in the heat, or heavy occlusive products. What goes on the face, how long it stays and how it is washed off are reviewed before any device is proposed, otherwise the congestion simply returns after every cleanse
- And not you if what bothers you in the mirror is the color rather than the surface: dark marks left by a spot or by inflammation, melasma, or sun damage. That is a different route and a different plan — post-inflammatory pigmentation and melasma — and smoothing the surface does not move the color
When we advise delaying or not treating
- Pregnancy, planning a pregnancy, or breastfeeding. Isotretinoin is out in pregnancy at any dose, and the low dose prescribed for oiliness is not an exception; it is not started until pregnancy has been excluded and the contraception plan is agreed and already in place before the first capsule. Topical retinoids are not used in pregnancy or while you are trying to conceive, and salicylic acid peels are avoided in pregnancy. While you are breastfeeding, isotretinoin is not started, and every other medicine here is decided one at a time with your own doctor rather than assumed to be safe. Tell us before the prescription, not after it
- Starting isotretinoin resequences the whole plan rather than one line of it: waxing and threading, dermabrasion, ablative laser and elective skin surgery are deferred during the course and for a period afterwards set by the doctor prescribing it; peels are deferred; and the timing of needling and device sessions is decided case by case by that same prescriber, not at the clinic door on the day. That is why we ask about it before anything is booked
- Skin thinned by a mixture with no name on the jar, or by a topical steroid used for a long stretch: peels, needling and laser are deferred, and it is not extracted at all, until the skin barrier recovers. Stopping the steroid all at once sets off a rebound flare, so it is withdrawn by degrees and on a plan. Bring the jar with you
- Threading, waxing or sugaring of the area in the preceding days: anything laid over it — a peel, needling — waits. The skin has lost its surface layer, so more is taken than intended, and in the most visible place there is: the upper lip and the brow. It is asked before every session, not only at the first visit
- Active inflamed acne, infection in the area, a cold sore, a known tendency to keloid, or uncontrolled diabetes: the skin-breaking steps are deferred. And if what is showing is actually acne, it is treated as acne first — acne treatment — not with a facial program
- Recent heavy sun exposure or an active tan: device sessions are postponed, because the risk of pigmentation rises
- A request for pores that disappear: we decline it, and we say so before you book rather than after a course. The size of the opening is largely inherited, and no plan on this page changes it. What a plan does move is the oil, the congestion and the roughness around it, so the opening catches less light and reads as smaller. If that is not the offer you want, say so, and we will not sell you a course on a promise we do not hold
- A request for a harsh scrub, pore strips, a home peel, or a stronger acid because the last one "did nothing": we decline. These leave the skin around the pore worse than they found it, and on this skin irritation turns into color. Peels bought online with no known source are among the causes of the worst injuries we see
- A request for mesobotox as the answer to pores: we put it in its place. The effect is modest and short-lived, the evidence is smaller than the advertising suggests, and many injection points mean pinpoint bruising and transient marks that can leave pigment on deeper skin. It is not given in pregnancy or breastfeeding, and we ask by name about myasthenia gravis and Lambert-Eaton syndrome, and about aminoglycoside antibiotics, because they strengthen the toxin's effect. It is also not low-dose intramuscular toxin; that is a different procedure with a similar-sounding name
Possible effects
Stated in full, because the decision is not sound without them. Every step on this page has something it gives and something it takes, and no plan is built before both have been said.
- Isotretinoin — at any dose — causes severe birth defects. The low dose prescribed for oily skin is not a different medicine and does not carry a lighter warning. It is not started until pregnancy has been excluded, and the contraception plan is agreed and already in place before the first capsule rather than begun on the day the medicine is dispensed. Pregnancy is then avoided throughout the course and for a period after stopping that your prescriber sets, with repeated pregnancy testing. A capsule is never taken from someone else's box and never given to anyone. Blood donation is not permitted during treatment or for a period afterwards
- Isotretinoin — what is expected, and what is reported at the time: dry lips, eyes and nose, minor nosebleeds in air conditioning, and marked sun sensitivity here in every season. Blood tests before and during are not optional, and the course is not continued on repeat prescription without review. But a change in night vision, a change in mood, withdrawal or hopelessness, severe headache, muscle pain or bowel symptoms are reported immediately and not held over until the next appointment
- Isotretinoin — what it does to the rest of the plan: the whole sequence changes once it starts, not one item in it, and what is deferred is listed above. Absorption depends on the fat in the meal, so the capsule is taken with a proper meal, and in Ramadan with the main meal at iftar rather than at suhoor or on an empty stomach, arranged with the doctor before the month begins rather than in its first days. A tetracycline antibiotic — doxycycline among them — is not taken alongside it, because the combination is linked to raised pressure inside the head
- Medical facial, extraction, microdermabrasion and superficial peels: redness, flaking and stinging in the first days. Forceful extraction leaves a mark that outlasts the comedone it removed, and inflamed lesions are not extracted at all. Excess suction or repeated passes in microdermabrasion leave friction pigmentation on deeper skin. A medium-depth peel on Fitzpatrick III to VI carries a risk of both darkening and loss of color, which is why the depth is kept conservative
- Microneedling and radiofrequency microneedling: redness, swelling, grid marking and bruising for some days. Depth is reduced on Fitzpatrick IV to VI, because aggressive settings produce post-inflammatory pigmentation and visible needle-track marks. Infection is uncommon and managed early, and cold sores can reactivate in anyone with a history, which is why it is mentioned beforehand so precautions can be taken
- Fractional laser, fractional picosecond and the carbon peel: post-inflammatory pigmentation remains the main concern on this skin; density and energy are reduced, sessions are spaced further apart, and the skin is sometimes primed beforehand with a pigment-controlling agent. Stacking passes or bringing sessions too close together is what provokes it. The carbon peel is the lightest of this group: surface-level, gradual, not a treatment for deep pigment or for a scar, and its advertising photographs are frequently over-processed
- Intradermal microtoxin (mesobotox): pinpoint bruising and transient marks at the injection points, which can leave pigment on deeper skin. Placement deeper than intended weakens a muscle and changes the smile. The effect is temporary and is repeated. What needs emergency care immediately is in the box at the top of this page
- Skin boosters, polynucleotides and platelet-rich plasma: bruising and small lumps that settle, and a dense injection grid raises the chance of pigmentation at the puncture points on Fitzpatrick III to VI. Platelet-rich plasma is prepared from your own blood in the same session, with single-use disposables that are never shared between patients, and hepatitis B, hepatitis C and HIV status is asked about before the blood is drawn, because it changes how the sample, the equipment and the waste are handled — not whether you can be treated
- Topical retinoids and the acids in the home routine: dryness, redness and flaking at the start, and a flare of small spots in the first weeks that is expected and does not mean failure. Too much product irritates, and on this skin irritation turns into color. Retinoids raise sun sensitivity, so they are used at night with sunscreen every day, and they are paused on an area due to be threaded or waxed, because they let skin lift with the hair. Salicylic acid is avoided in pregnancy, and only a limited area is treated with it in one session because it is absorbed
A note on darker skin
Most of the skin treated here is Fitzpatrick III to VI, and that is the fact the settings are built on rather than a footnote added to them. What suits deeper skin better: letting most of the work happen in the home routine — a retinoid built up slowly, niacinamide, salicylic acid — because what is changed slowly leaves no color behind it; then radiofrequency microneedling, because it depends less on skin pigment than a laser that targets melanin; and the micro-pulsed 1064 nm laser, one of the gentler things offered on this skin because it does not rely on targeting pigment, though its change is subtle and cumulative and needs a course. Conservative superficial peels also suit, and the salicylic-mandelic combination is often chosen where spots and pigmentation sit together. What needs more caution: needling depth is reduced on Fitzpatrick IV to VI, because aggressive settings produce post-inflammatory pigmentation and leave the marks of the needle tracks visible for a while; fractional picosecond is marketed as suitable for every skin tone, which is not an argument for raising the energy — deeper skin still needs lower energy, wider spacing and photoprotection between sessions; the 1927 nm wavelength is a recognized trigger for pigmentation on darker skin; a medium-depth peel carries a risk of both darkening and loss of color; and excess suction in microdermabrasion leaves friction pigmentation. Irritation is itself a pigment trigger, which is why scrubs and pore strips are refused and the routine is built up by degrees. And on the arms, in keratosis pilaris, the roughness settles before the color does, picking and scrubbing are what leave the darkest marks, and aiming a laser at the brown marks on darker skin can deepen them. Skin type is judged for each individual at the examination, and never inferred from nationality.
Afterwards
- Sunscreen every day, in a texture you will tolerate under makeup and in the heat. Here it is not decoration laid over the treatment: light is what fixes any color the skin passes through after a session
- The routine as it is written, in the amount you were shown. Dryness, flaking and a flare of small spots in the first weeks are part of the road; more product does not make anything faster, and irritation turns into color
- Stop the scrubs, the pore strips, the home peels and the cleanser that leaves the skin tight. If the plan at this stage is to subtract rather than to add, then the emptiness is the treatment
- After any in-clinic session: let the crusts and the grid marking come away on their own, with no rubbing and no exfoliants, and no threading, waxing, sugaring or hair-removal cream over the area until it has recovered
- Report any darker patch as soon as you notice it, not at your next appointment. It is treatable, and it is more straightforward the earlier it is seen
- Report small white bumps that appear in a crop after a session or under a heavy cream — they mean the routine is reviewed, not only that they are removed — and report stinging or burning that does not settle, and skin that has started reacting to everything put on it
- Tell us before the next session about anything that changed: a new medicine, isotretinoin started or stopped, pregnancy or planning one, threading, waxing or sugaring of the area, a cold sore, or a change in your diabetes control. The screening is repeated before every session and is not taken once at the first visit
- Come to the review with everything you are using, in its packaging, including the mixture if there is one. And if you are on isotretinoin: take the capsule with a proper meal as you were instructed, and settle the Ramadan plan with the doctor before the month starts
Honestly
Pore size has a structural and inherited component, so the honest framing is a smoother, less shiny surface rather than pores that disappear; scrubs and pore strips leave the surrounding skin worse, the intradermal microtoxin sold for pores is modest and short-lived, and isotretinoin at any dose changes the whole sequence of the plan and is not compatible with pregnancy.
Common questions
Will the pores go away?
No, and we will not tell you otherwise. Part of the size of an opening is simply what you inherited, and nothing here changes that. What does change is what surrounds it — less oil, less congestion, a smoother surface — so the opening catches less light and reads as smaller in daylight and under makeup. As for the mesobotox offered for shrinking pores, it works on oil and shine more than on the opening itself, it wears off and is repeated, and the evidence behind it is smaller than the advertising suggests. Anyone selling you a disappearance is selling something they do not have.
I use pore strips and a scrub every week and my skin feels smooth afterwards — should I stop?
Stop them. The smoothness you feel lasts hours; what they leave lasts longer. The skin around the pore is irritated, and on our skin irritation turns into color, so the pores show up more against a darker background. And a strip pulls off the surface of the skin; it does not shrink an opening. Replace them with a routine built up by degrees — and honestly, in the first weeks it will feel as though we took things away and gave nothing back. That is expected.
I heard there are capsules for oiliness at a small dose — does that mean the warnings are lighter?
No. Isotretinoin at any dose is out in pregnancy, and the low dose is not a different medicine: the same exclusion of pregnancy, the same contraception plan already in place before the first capsule, the same blood tests and reviews, the same dryness and sun sensitivity. What genuinely changes is the order of your plan: waxing and threading, ablative laser, peels and elective skin surgery are deferred during the course and for a period afterwards set by the doctor prescribing it. And no capsule is ever taken from someone else's box.
I am fasting and taking the capsules — when do I take them?
With the main meal at iftar, not at suhoor and not on an empty stomach. Absorption depends on the fat in the meal, so taken fasting, what reaches you is not what is written, and the dose drifts through the whole month. Arrange this with the doctor prescribing it before Ramadan begins rather than in its first days, and arrange the review appointments and blood tests around the month as well. And watch the dryness: lips and eyes are harder in a month when you drink less during the day.
My skin is brown — do laser and needling suit it? I have heard the skin darkens afterwards.
They do suit it, but with different settings, not the same ones. Radiofrequency microneedling depends less on skin pigment, and the micro-pulsed laser is among the gentler options offered on our skin. Even so, post-inflammatory pigmentation remains the main concern: depth and energy are reduced, sessions are spaced further apart, a session is postponed after a recent tan, and sun protection in between is part of the treatment. The advertising line that a device suits every skin tone is not an argument for raising the energy. And if a darker patch appears, tell us early; it is treatable.
I tried a lot of peels and now my skin burns with anything I put on it.
That is a damaged skin barrier, and treating it means stopping rather than adding: a very short routine, no acids and no scrubs, until it settles. We ask about two things by name, because they are the ones most often missed: a mixture or a cream with no name on the jar — the steroid in it is withdrawn by degrees, not all at once — and allergy to gel and acrylic nail products, which travels from the fingertips to the eyelids, cheeks and neck, and which no moisturizer will fix while the nails stay as they are.