One of the most common beauty questions repeatedly asked in dermatology offices is how to prevent and treat blackheads, shrink pores, and decrease oily skin. Here are a few suggestions to help your facial skin looking clean, clear, and with time, smooth with smaller pores.

Blackheads, otherwise known as open comedonal acne, are the result of oil duct blockage with sebum (a fatty oil mixture) from the oil glands, and may be due in part to blockage from dead skin cells. The sebum stagnates in the oil duct and leads to a blockage of the opening. With continued exposure to air on the surface of the skin, the sebum contents become oxidized and turn black leading to the appearance of blackheads. Blackhead mostly occur in the oiliest areas of the face such as the nose, cheeks, and chin, but may also occur on the chest and back. Prevention of blackheads naturally centers around keeping the oil ducts clear. This may be accomplished by either decreasing sebum production or dissolving the sebum in the duct and allowing it to drain to the skin rather than causing a blockage.

Prevention of blackhead can be done by several methods: use of tretinoin products (e.g. Retin-A®), salicylic acid products (peels, lotions, creams), glycolic acid products, and microdermabrasion. Tretinoin products allow normal maturation on skin cells and prevents dead skin cells from contributing to pore blockage. Salicylic and glycolic acid products remove dead skin cells to prevent pore blockage, and salicylic acid works particularly well to dissolve the sebum for easy drainage and unblocking. Microdermabrasion also removes dead skin cells from the skin surface and may physically remove some smaller blackhead.

Treatment of blackheads include the prevention methods above and physical blackhead removal. This primarily includes doing a salicylic acid or glycolic acid peel, or microdermabrasion, followed by the use of force to physically push the occluded pore material out. Commercially available alternatives to physically remove blackheads are also available such as the Biore® Pore Perfect Nose Strips.

In regards to large pores, there are unfortunately no guaranteed method to reduce pore size. It is widely believed that consistent use of tretinoin products, microdermabrasion, and salicylic/glycolic acids all result in the appearance of smaller pores. For more dramatic results, deeper laser treatments and manual dermabrasion destroying the upper layers of the skin may result in smaller pores when full healing occurs.

Oily skin is a product of genetics and is individual to each person. While there is no single best topical treatment to decrease oil production, there are a variety of treatments to minimize the appearance of oily skin. These are mainly benzoyl peroxide, glycolic acid, and salicylic wipes that essentially decrease the skin. Some of these products are only made to be used once a day, while washes are made to be used 2-3 times per day. Decreasing oil production is difficult and really is performed through adjunctive use of isotretinoin therapy for recalcitrant acne. Repeated use of a retinoid product may in theory decrease oil production to some degree.

In summary, the first step to magnificent smooth skin with small pores is to remove the blackheads, either physically or by peels. Then, the use of a salicylic acid, glycolic acid, or benzoyl peroxide wash along with a retinoid is needed to prevent blackhead formations. Regular use of salicylic acid products and retinoids should lead to smaller pore appearance, and regular microdermabrasions may be additively helpful in achieving this goal. Finally, for oily skin, carry some salicylic acid, glycolic acid, or benzoyl peroxide wipes to enjoy clear, dry, and healthy skin.

© Physician's Skincare Group, LLC. 2006. All Rights Reserved. This material may not be reproduced, published, or distributed in any form without express written consent of DermBlue.com. DermBlue.com does not assume any financial, legal, or medical liability for any content on this site. Please review any condition or treatment plan with your physician.