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Suzanne Harrison

Photographs of flawless-skinned models may make us think otherwise, but beneath their impeccable makeup, even models can have visible pores.
'People's pores enlarge as they get older,' says dermatologist Adrian Fung Yee-ho. 'Just look at a child and you can see their skin is like silk. But when you're a teenager, pores start to appear. Then when you're 30, they're even more visible.'
Pore size also varies from person to person, depending on genetic makeup, and if  you're prone to blackheads and whiteheads from excessive sebum production,  the pores appear more prominent.
Fung  says blocked pores - especially in the T-zone area of the nose, chin and middle forehead - are caused by oil produced by the sebaceous glands which are responsible for regulating oil production.
There are two types of acne - inflammatory and non-inflammatory, says SkinCentral dermatologist Kingsley Chan. Blackheads and whiteheads  are non-inflammatory.  A blackhead is simply an open  comedone and a whitehead is a closed one, he says.  A comedone is a plugged pore of sebaceous and dead skin at the hair follicle opening.
'It's black, not because your face is dirty, but because the oil inside the pore [is exposed] and after it has oxidised through contact with the air, it turns black,' says Chan
For everyday blocked pores and blackheads, experts agree that paying a fortune for a cleanser is not the solution. 'You need a gentle cleanser,' says Chan. 'You just need to remove the cause - the excess oil - and the dead cells.'
This means  exfoliation will  help remove blackheads temporarily, and cleansing 'once or twice a day is enough', says Chan.  Don't over-exfoliate  because this can dry out skin; twice a week is enough, and avoid products with alcohol for their drying properties as well, he says.
Fung agrees that inexpensive cleansers are ideal to remove blocked pores, but go easy on these.  'I also tell people not to over-wash, as this can dry out your skin,' says Fung. 'Cleanse with something like  Cetaphil or  Physiogel - a mild cleanser  which is available over the counter and cheap as well.'
Sometimes cleansing isn't enough for those with very oily skin.  'If people have continuing problems with oily skin and blocked pores, they can use products with ingredients such as salicylic acid, or do peels with a professional which can reduce the appearance of pores with such things as vitamin A (retinol),' says Fung.
Retinol is  commonly used to treat acne, but it's also been shown to reduce the appearance of fine lines.  You need to start off slowly  using just small amounts  every other day or so because irritation and dryness can occur. 'You have to improvise,' says Fung. 'Some areas of your skin may be dry and others may be oily. So what you put on the T-zone may be different from the rest of your face. And as you age, your skin changes again and you need to improvise then, too.'
Henry Chan Hin-lee, former head of dermatology at the University of Hong Kong and Chinese University who's now in private practice,  says oily skin and blocked pores are due to the sebum and dead skin cells blocking the hair follicle.
'The cause of this is genetic,' he says.  'The second factor is hormones - we know that testosterone can stimulate the sebaceous gland and make it hyperactive, so for women, just before the get their period, they can get acne.
'But purely for blackheads, one can use a cleanser that contains  keratolytic agents. Basically, our skin cells contain keratin,  and this ingredient unblocks the blockage.'
There are many types of common keratolytic agents, says Henry Chan,  such as 'simple over-the-counter preparations that contain benzoyl peroxide, or salicylic acid.  Retin-A,  is effective, but you need a prescription  [for an effective  product].  Alpha hydroxyl acid is another common ingredient that can  be used.'
However, Henry Chan disagrees with the popular belief that a lot of cleansing means your skin will  produce more sebum, saying it's a common misunderstanding that if you unblock these pores, you have a greater risk of sebum production.
'Sebum production is a combination of genes and hormones, and people say 'don't wash your face too often'. But it's got nothing to do with that.'
Potent ingredients such as retin-A and alpha and beta hydroxyl acids, as well as  salicylic acid can have the side effect of dryness and irritation, so use them every other night, he suggests. 'If that's not causing problems, then use it more often.  Patients learn that if their skin is getting too dry, then they can stop for a few days and then go back to it. For patients with more oily skin, they should use lotions or gels rather than creams.'
They should also choose a moisturiser that  won't block their pores, advises Henry Chan.
If you have oily skin in the T-zone and dry skin on other parts of the face  - a combination skin type - use the  keratolytic-based product at night (for example, something like retin-A).  But take care out in the sun as retin-A   makes the skin more sensitive to sunburn and damage,  so wear a high-factor sunscreen even if you've only used it at night.
Other minor procedures, such as microdermabrasion, now a home device, 'can work to some degree', says Henry Chan.  'They're also good for treating acne, blackheads and pore sizes.'
For excessively greasy skin, Kingsley Chan  suggests a medical treatment such as a chemical peel done regularly. For home use, he advises choosing medical or dermatological brands with cleansers that don't leave your skin feeling tight afterwards.
For enlarged pore problems,  laser treatments such as Intense Pulsed Light  can work on reducing their size. But  to clear everyday blocked pores,  Kingsley Chan recommends a routine of regular cleansing and occasional exfoliation. Under no circumstances squeeze them. This can cause scarring and even larger pores over time.



Pores and flaws