Will Tretinoin Reduce the Size of My Pores?

What causes large facial pores?

Unfortunately, there is no one single thing that contributes to pore size. It is a mix of multiple and often inter-related factors (fore example, age, sun exposures, and loss of elasticity), many of which are difficult or impossible to modify and control, including:

• High Sebum Excretion: Excessive oil production is strongly correlated with increased pore size.

• Decreased Elasticity Around Pores: Loss of skin elasticity leads to structural weakness around pores, making them appear larger.

• Increased Hair Follicle Volume: Thick hair shafts and larger follicle openings contribute to visible pores.

• Hormonal fluctuations: Sebum production and pore size appear increased during ovulation

• Genetics and Aging: the elasticity and structural integrity of our pores is determined by our genetic make up and can be influenced by aging and accelerated aging as seen from excessive sun exposure.

• Acne and inflammation: can cause follicular plugs which make pores look more prominent, and lead to scarring and deepening of scarred pores.

  
  

Most enlarged pores occur in one of two locations, the nose or the medial cheeks (forward facing part of your cheeks). These also happen to be areas where there is the highest density of sebaceous glands on the

face.

Does tretinoin help?

Yes! It does appear that the use of tretinoin and possibly other retinols can improve pore size, or at least the appearance of pores size.

Multiple clinical studies support the efficacy of tretinoin and other retinoids in reducing pore size.

Retinoids, including tretinoin, have been shown to effectively reduce pore size in clinical studies. Comparing tretinoin 0.025% cream to a proprietary retinol/LR2412 formulation found both similarly effective. (Bouloc et al., 2015) Another clinical study similarly showed effectiveness of tretinoin 0.025% at reducing pore size, but did not show improvement from treatment with 1% retinol. (McDaniel et al, 2017) Finally, tazarotene 0.1% cream has documented efficacy in significantly reducing apparent pore size. Kang et al. (2005) These findings support the notion that retinoids including tretinoin, tazarotene, and even some proprietary products containing retinol may improve pore size and appearance.

Potential if not likely mechanisms by which they do this are: 1) accelerating epidermal renewal and preventing pore clogging which reduces follicular distension, and 2) promoting dermal thickening and improved skin elasticity, which may help pores appear smaller and less stretched over time. Sebum regulation has also been proposed, (Bouloc et al, 2015) but as we have discussed in prior posts, it appears tretinoin has a minimal impact on sebum production and sebaceous gland growth.

This amounts to a 22-25% reduction of pore area size (Kang et al., 2005; McDaniel et al., 2017), but before you get too excited, take a look at what that looks like graphically:

Because of, um, math, a 25% reduction in pore area (A) corresponds to only a 13% decrease in the diameter (d) of the pore.

What else can I do?

There are 4 main factors contributing to pore size that are potentially modifiable:

1. Active comedonal acne - follicular plugging can distend pores and make them more prominent

2. Sebum (oil) secretion - oily skin and excess sebum production is associated with enlarged pores (causality unclear).

3. Pore elasticity - loss of dermal support around pores due to aging, UV damage, and decreased collagen/elastin leads to distension.

4. Hair follicle caliber - large hair follicles contribute to pore size, especially in individuals with thick facial hair.

   
   

Lee et al. (2016) provides a an excellent summary of different treatment options for enlarged pores and the mechanisms they purport to target. Beware, their effectiveness is supported by varying degrees of research. I recommend speaking with a licensed professional with experience in diagnosis and treating skin conditions before engaging in these treatments:

Reducing Sebum Secretion

• Oral Medications:

  • Isotretinoin (13-cis-retinoic acid): most potent sebum suppressant; reduces sebaceous gland size.

  • Hormonal therapy (e.g., oral contraceptives, spironolactone, cyproterone acetate): reduce androgens, leading to lower sebum output.

• Topical Ingredients:

  • 2% Niacinamide: purportedly shown to reduce sebum production.

  • L-carnitine: may reduce lipid production in sebocytes.

  • Orthosiphon stamineus extract: a botanical ingredient with possible sebum-reducing properties.

  • Salicylic acid peels: potentially useful in treating oily skin and preventing clogged pores.

• Laser & Light Treatments:

  • 1,450-nm diode laser: targets sebaceous glands, reducing their activity.

  • Fractional RF microneedle devices: demonstrated a 30–80% reduction in sebum production.

  • Photodynamic therapy (ALA-PDT): targets and destroys sebaceous glands.

  • 800-nm diode laser with gold nanoparticles: induces thermal injury to sebaceous glands.

• Dietary Modifications:

  • Low-glycemic diet: may help reduce sebum production.

  • Reduction in dairy intake: dairy products (except cheese) have insulinotropic effects that may increase sebum output.

• Botulinum Toxin (Botox):

  • Intradermal injections have been found to potentially reduce sebum secretion and decrease pore size.

Improving/Maintaining Skin Elasticity

• Topical Retinoids:

  • Tretinoin & Tazarotene: may increase collagen synthesis and skin elasticity

• Laser & Energy-Based Treatments:

  • 2,790-nm Er:YSGG laser: may improve wrinkles, scars, skin tone, and pores.

  • 1,410-nm erbium fiber laser: clinically purported to treat dilated pores in Fitzpatrick skin types III–IV.

  • 1,440-nm fractional diode laser: demonstrated a 17% reduction in pore size.

  • Fractional bipolar RF: may improve pore size, smoothness, and collagen density.

  • Intense pulsed light (IPL) & ELOS (electro-optical synergy): may enhance collagen remodeling and reduce pore size.

• Sun Protection: prevents photoaging-related pore enlargement.

Decreasing Hair Follicle Volume

• Laser Hair Removal: reduces follicle size and, consequently, pore volume.

  • Effective wavelengths: 694-nm (ruby), 755-nm (alexandrite), 800-810-nm (diode), 1,064-nm (Nd:YAG), and IPL.

Conclusion

So, if you are looking for modest improvement in the size and appearance of your pores, there is solid data supporting the use of tretinoin or other retinoids like tazarotene leading to an approximately 22-25% decrease in pore area. However, many factors are involved in pore size and appearance they may not be modifiable by topical creams like tretinoin.

Dr. Ryan M. Trowbridge, MD, MS, MA

Harvard-Trained, Board-Certified Dermatologist and DermMythBuster

P.S. Have you come across any new or conflicting research on this topic? Please share—I’d love to explore it further with you!

Would you like to try tretinoin, isotretinoin, or tazarotene or discuss other recommendations for reduction in pore size? You can obtain an online consultation from Dr. Trowbridge at Bridge Dermatology if you currently reside in California, Connecticut, Illinois, or Nebraska.

Citations

1. Bouloc A, Vergnanini AL, Issa MC. A double-blind randomized study comparing the association of retinol and LR2412 with tretinoin 0.025% in photoaged skin. J Cosmet Dermatol. 2015;14(1):40-46. doi:10.1111/jocd.12131.

2. Kang S, Krueger GG, Tanghetti EA, Lew-Kaya D, Sefton J, Walker PS, Gibson JR; Tazarotene Cream in Photodamage Study Group. A multicenter, randomized, double-blind trial of tazarotene 0.1% cream in the treatment of photodamage. J Am Acad Dermatol. 2005;52(2):268-274. doi:10.1016/j.jaad.2004.06.021

3. Lee SJ, Seok J, Jeong SY, Park KY, Li K, Seo SJ. Facial Pores: Definition, Causes, and Treatment Options. Dermatol Surg. 2016;42(3):277-285. doi:10.1097/DSS.0000000000000657

4. McDaniel DH, Mazur C, Wortzman MS, Nelson DB. Efficacy and tolerability of a double-conjugated retinoid cream vs 1.0% retinol cream or 0.025% tretinoin cream in subjects with mild to severe photoaging. J Cosmet Dermatol. 2017;16(4):542-548. doi:10.1111/jocd.12381.

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