The 4 Types of Enlarged Pores: Why Your Pore Treatments Fail

This is an English adaptation of a clinical article Dr. SangYoul Yun — board-certified dermatologist and Medical Director of Delight Dermatology in Gangnam, Seoul — originally published in Korean. Read the Korean original on Naver. It has been restructured and translated for international readers; all references are the author's own.

"I keep getting pico toning and skin boosters elsewhere, but my pores just don't improve." I hear this constantly in clinic. My first question is always the same: "Has anyone accurately diagnosed your pore type?"

Enlarged pores are not one diagnosis. By cause they fall into four types, and the effective treatment is completely different for each. Collagen-stimulating procedures mean little for sebaceous pores; sebum-control agents don't help sagging pores; surface toning alone isn't enough for post-acne pores; and comedonal pores should be managed with regular care, not squeezing. If you don't know the type and just repeat a "pore care package," you often spend time and money without a satisfying result.

1. Four types — cause and location give the answer

Clinical research groups the main causes of enlarged pores into ① sebum overproduction, ② reduced elasticity from collagen loss, ③ keratin buildup, and ④ a thick hair shaft.¹ Add post-acne change and you get four clinical types. They share the name "pores," but the affected layer and location are completely different.³

Same "pore," different layer and location of the cause

Type	Age / area	Features and cause
① Sebaceous	20s–30s, T-zone	Round pores, excess oil. Active dermal sebaceous glands keep pushing oil out, so pores "look open"
② Comedonal / blackhead	All ages, central nose	Pores filled with keratin and oxidized sebum, appearing dark. Needs regular care, not extraction by squeezing
③ Sagging	Late 30s+, cheeks	Dermal collagen loss lets peri-pore tissue stretch vertically. Teardrop shape is characteristic
④ Post-acne	Acne history, cheeks/temples	Dermal fibrosis after acne widens pores markedly, often clustered with other scar pores

2. Self-assessment — find your pore type

Three tests you can do at home.⁶

• Area / oil test — check with blotting paper 3 hours after cleansing. Heavy oil in the T-zone = sebaceous; prominent on cheeks with little oil = sagging or post-acne.
• Stretch / shape test — pull cheek skin up and outward. If pores shrink, it's sagging (loss of elasticity); if unchanged, it's sebaceous or post-acne.
• Acne-history check — large pores over old acne marks = post-acne; black granules felt on nose/forehead = comedonal / blackhead.

If several apply, you have a mixed type. Precise diagnosis comes from an in-clinic 3D skin analyzer that measures pore size, shape, and distribution.

3. Treatment matrix by type

The recommended treatment differs completely with the layer and location of the cause.⁵

① Sebaceous — retinoid plus sebum control

First line: a topical retinoid (tretinoin, adapalene) plus salicylic-acid peeling, with skin Botox (intradermal botulinum toxin) increasingly popular.² A 2025 RCT showed intradermal botulinum toxin significantly reduced sebum and pore size.⁷ Note: strong peels can cause irritation and redness, so a gradual approach is best.

② Comedonal / blackhead — chemical peel plus care procedures

First line: salicylic/glycolic peeling + hydrafacial + BHA home care. Regular exfoliation is the key. Note: never squeeze with your fingernails — squeezing permanently widens pores and risks progression to scar pores.

③ Sagging — MTS RF and pico fractional

First line: microneedle RF stimulates collagen to rebuild the peri-pore dermis; combining pico fractional is also effective. Note: sebum-control agents alone don't work on sagging pores — it's a structural problem, so the structure must be rebuilt.

④ Post-acne — MTS RF plus pico fractional

First line: post-acne pores overlap with acne-scar treatment. A combination of high-energy microneedle RF + pico fractional + subcision is standard, and newer approaches such as microcoring are also being studied.⁴ Note: surface toning alone isn't enough — you need a procedure that works at dermal depth.

4. Myths vs facts

• "Squeezing shrinks pores." → Squeezing with fingernails damages the surrounding dermis, permanently widening pores and risking scar pores.
• "Cold water or ice closes pores." → Only a brief, temporary tightening with no lasting effect. Structural problems need a procedure.
• "One pore session fixes everything." → Collagen regeneration and sebum control happen gradually. Three to six sessions at monthly intervals is standard.
• "A pore-minimizing cosmetic is enough." → Most cosmetics only give a temporary tightened feeling. Real effect starts around Grade-A ingredients such as retinoids.⁸

5. How we approach pores at Delight Dermatology

We first assess pore size, shape, and distribution with a 3D skin analyzer, then account for age and sebum status (sebum control first in the 20s–30s, collagen regeneration first from the late 30s). Because most patients have a mixed type with two or more patterns, we plan a multi-session protocol of three to six treatments at monthly intervals, and pair it with retinoid and sun-protection home care to maintain the result.

Bottom line: pores are not one thing — if you don't know the type, the procedure misses. Sebaceous, comedonal, sagging, post-acne all need different treatments. Rather than relying on a "pore care package," accurate diagnosis plus type-matched procedures plus a multi-session protocol is the fastest, most satisfying path.

References

1. Roh M, Han M, Kim D, Chung K. Sebum output as a factor contributing to the size of facial pores. Br J Dermatol.
2. Vachiramon V, et al. A Study of Combined Onabotulinumtoxin A and Hyaluronic Acid Filler for the Treatment of Enlarged Facial Pores. Toxins. 2025;17(1):38.
3. De Tollenaere, et al. Facial pore refining by targeting dermal and epidermal functions: Assessment across age and gender. J Cosmet Dermatol. 2024.
4. Yi Y, et al. A novel microcoring technology: A completely new concept of enlarged pore treatment. J Cosmet Dermatol. 2023.
5. Parvar N, et al. The efficacy and adverse effects of treatment options for facial pores: A review article. J Cosmet Dermatol. 2023.
6. Lee S, Cherel M, et al. Identifying patterns behind the changes in skin pores using 3-dimensional measurements and K-means clustering. Skin Res Technol. 2022;28(1):3-9.
7. Comparison of Intradermal Versus Microneedling-Assisted Botulinum A Toxin Injection for Enlarged Facial Pores: A Randomized Clinical Trial. 2025.
8. Enlarged Facial Pores: An Update on Treatments. Cutis / MDedge.

Medical disclaimer. This article is general information and does not replace individual consultation. Pore-type diagnosis and procedure selection should be decided after an in-person consultation with a dermatologist. Pores are treated toward improvement, not complete disappearance, and squeezing by hand can cause permanent skin damage and should be avoided.