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Acne Scars and Large Pores: Causes, Treatment, and Prevention

a person with acne scars and large pores

Acne scars and large pores often coexist, forming a complex dermatological issue. Acne scars result from inflamed pores filled with excess oil, dead skin cells, and bacteria. When the pore wall ruptures, it forms a wound, and the skin responds by creating new collagen fibres, leading to a scar. 

Large pores are genetic but can be influenced by age and environmental factors. Sebum, dirt, and bacteria can accumulate in these pores, enlarging them over time. 

Both conditions can exist simultaneously, causing uneven skin texture and tone. Let’s explore their causes and how to manage them.

What are acne scars?

Acne scars can be broadly categorized into Atrophic (depressed) scars and Hypertrophic (raised) scars. Atrophic scars result from severe acne that destroys collagen in the skin, leading to a depression or dent. They are further classified as Ice pick scars (deep and narrow), Boxcar scars (wide and rectangular), and Rolling scars (broad depressions with sloping edges). Hypertrophic scars are raised lumps of scar tissue at the acne wound site. Unlike Atrophic scars, they remain within the boundaries of the initial wound. 

Some people may also experience Post-Inflammatory Hyperpigmentation (PIH), which is flat, discoloured spots left behind after an acne lesion heals. It’s important to note that PIH is not a true acne scar but rather a form of skin discolouration that usually fades with time.

What are large pores?

a woman trying to have a good skincare regimen

Large pores are enlarged openings on the skin’s surface, serving as exit routes for natural oils and sweat. While not a direct sign of skin problems, their appearance can be aesthetically undesirable. Pore size depends on skin type, age, genetics, and environmental exposure. Oily skin tends to have larger pores due to increased oil production. Ageing causes pores to dilate as the skin loses elasticity. Large pores affect the skin’s texture, making it appear rough and prone to acne and blackheads. Managing large pores is crucial for maintaining clear, smooth skin.

How are Acne Scars and Large Pores related?

The interplay between acne scars and large pores is complex. Clogged pores, caused by excess sebum production, can lead to acne. If these acne lesions rupture, wounds form and heal with new collagen, potentially resulting in acne scarring. Large pores can trigger a cycle that leads to acne scars.

Additionally, these two skin lesions together worsen skin texture irregularities. Large pores contribute to a rough, uneven surface, while acne scars, especially atrophic ones, add indentations. This combination affects self-confidence.

Treating one condition can positively impact the other. For example, treatments reducing sebum production and unclogging pores can diminish pore size and decrease acne incidence, reducing future scarring. Some acne scar treatments might tighten skin, indirectly reducing pore size. 

Understanding the relationship between enlarged pores and acne scars is crucial for effective skin treatment strategies.

How acne scars can accentuate the appearance of large pores

Large pores indirectly contribute to acne scars by providing access to oil, dirt, and bacteria. When these pores are filled with excess sebum, they can become clogged, forming acne. Over time, the build-up of these materials can cause the pore walls to rupture, triggering inflammation and subsequent scarring. Additionally, large pores can worsen ongoing acne conditions, as acne-prone skin with high sebum production and enlarged pores is more prone to breakouts. Managing large pores is crucial for acne and scar prevention.

What Causes Acne Scars and Large Pores?

Various factors can cause large pores and acne scars. One significant cause is severe or untreated acne, which can lead to both atrophic and hypertrophic scars by damaging the skin’s collagen. Inflammatory acne lesions like cysts and nodules can cause extensive damage, penetrating deeper into the skin and affecting collagen layers. Genetics also play a role in pore size and scarring propensity; if your parents have these traits, you might, too. Ageing also contributes as collagen production decreases, making pores appear larger, and healing takes longer, leading to more noticeable scarring.

Signs and Symptoms

Acne scars can be depressed or raised. Depressed acne scars appear as small indentations caused by insufficient collagen production during healing. They are categorized as ‘boxcar’, ‘ice pick’, or ‘rolling’ scars. Raised scars result from over-production of collagen and are bumpy, often found on the chest and back.

Large pores are enlarged openings on the skin’s surface, more visible in the ‘T-zone’ (forehead, nose, and chin). They can be filled with sebum or dead skin cells, making them appear larger.

Uneven skin texture is another symptom associated with large pores and acne scars. The skin may feel rough, bumpy, or coarse due to varying depths of scars and enlarged pores. The skin may also appear dull due to reduced light reflection from the irregular surface. Identifying these symptoms is the first step in addressing skin issues related to acne scars and large pores.

Diagnosis and Evaluation

Diagnosing and evaluating large pores and acne scars usually involves a thorough clinical examination and patient history. Dermatologists visually inspect the skin for scarring and pore enlargement, using a dermoscopy to examine the depth and severity of scars. Scar type (atrophic or hypertrophic) is determined based on visual characteristics and texture. 

For large pores, the focus is on size, quantity, and overall skin texture. Patient history includes onset and duration of symptoms, acne history, skincare regimen, lifestyle factors, and previous treatments. Genetic predisposition is also considered. Through clinical examination and patient history, dermatologists accurately diagnose and assess the condition’s severity, forming the basis for an effective treatment plan.

Treatment Options

a woman seeking for optimal results

1. Topical Treatments

Topical treatments are crucial for improving acne scars and shrinking large pores. Retinoids and vitamin A derivatives encourage cell turnover and collagen production, helping reduce scar visibility and pore size, though they may cause initial irritation. Alpha Hydroxy Acids (AHAs), particularly glycolic acid, exfoliate dead skin cells, smoothen skin texture, and lessen scars and pores. Vitamin C, essential for both collagen growth and synthesis, can fade scars and enhance skin radiance. While these treatments are effective, results take time and vary per individual, so a dermatologist’s guidance is recommended for a personalised skincare routine.

2. Clinical Treatments

When topical treatments don’t provide satisfactory results, clinical procedures can significantly improve the appearance of large pores and acne scars.

  • Microneedling is a minimally invasive treatment procedure using fine needles to puncture the skin, prompting a healing response that increases collagen and elastin, improving acne scars and pores. Temporary redness and sensitivity are common post-treatment. 

  • Chemical peels use acids like glycolic or salicylic to remove dead skin cells, encourage new cell growth, and clear pores, with varying recovery times based on peel intensity. 

  • Laser resurfacing employs focused light to remove skin layers and stimulate collagen, smoothing skin and reducing scars and pores. Treatment types range from ablative, which removes skin, to non-ablative, which targets underlying tissues tailored to the patient’s condition.

3. Dermal Fillers

Dermal fillers are a popular treatment for atrophic acne scars, which are depressions or pits in the skin. They work by injecting a substance, usually hyaluronic acid, into the scarred area. The filler material elevates the depression, improving the skin’s texture and reducing the appearance of scars. Some fillers also stimulate natural collagen production over time, enhancing skin firmness. However, dermal fillers are temporary solutions. The body gradually absorbs the filler, so periodic treatments are necessary to maintain results. 

4. Surgical Interventions

For more severe acne scars, surgical interventions like subcision and punch excision can be considered. In subcision, a special needle breaks fibrotic strands beneath the scar, releasing tension and allowing the scar to level with the surrounding skin, promoting collagen production. It may lead to temporary bruising and swelling. 

Punch excision, suitable for deeper scars, entails removing scarred skin with a circular blade and suturing the area, leading to a less conspicuous scar after healing, with potential risks including infection and discolouration. Both procedures require skilled practitioners for safe and effective results.

How to prevent acne scars and minimize pores?

scars caused by improper skincare routine

Preventing acne scars and minimising pores is a process that necessitates a multifaceted approach. Here are a few strategies to consider:

  • Skincare Routine: Cleanse with a non-comedogenic product twice a day and exfoliate weekly to remove dead skin and oil. Use moisturizers and products with retinoids, niacinamide, or salicylic acid to keep pores clear and small.

  • Sun Protection: Apply broad-spectrum SPF 30 sunscreen daily, cover up with clothing, and stay in the shade during peak sunlight to prevent worsening of scars and pore enlargement.

  • Lifestyle Modifications: Eat a balanced diet, exercise regularly, drink plenty of water, and practice stress reduction to improve skin health and reduce acne.

Living with Acne Scars and Large Pores

Living with large pores and acne scars can sometimes pose emotional and psychological challenges. It’s important to remember that you are not alone, and there are ways to manage these feelings.

  • Acknowledge Your Feelings: Recognize and accept your emotions as a normal response to changes in skin appearance.

  • Seek Support: Connect with friends, family, or online groups for shared experiences and encouragement.

  • Professional Help: If distress from skin issues significantly affects your life, seek a mental health professional for coping strategies.

  • Mindfulness and Self-Compassion: Practice being present without judgment and treat yourself with kindness.

Complications and Follow-Up

Acne treatments can improve skin appearance, but they have potential complications. These may include skin discolouration, infection, texture changes, or worsened acne scars. Allergic reactions and adverse effects are possible. Invasive procedures carry risks of bleeding, bruising, and scarring. 

To mitigate risks, follow your dermatologist’s advice. Stick to the skincare routine, take medications as directed, and avoid acne triggers. 

Regular visits to your dermatologist allow for treatment adjustments and early detection of complications. They monitor progress, address concerns, and offer cosmetic suggestions if needed.

How to tell the difference between acne scars and large pores?

Acne scars and large pores are distinct skin concerns. Acne scars result from inflamed lesions like papules, pustules, or cysts that cause skin rupture. During healing, collagen production repairs the damage, but an imbalance can lead to scars. Scars range from deep pits (ice pick scars) to wavy, rolling undulations. 

In contrast, large pores are small openings where sebum and sweat reach the skin surface. Age, genetics, excessive sebum production, decreased pore elasticity, and increased hair follicle volume contribute to enlarged pores. They often appear tiny holes, especially in the T-zone (forehead, nose, and chin).

Are large pores considered acne?

Large pores are not acne but can become more visible when clogged or due to skin ageing and sun damage. While having large pores doesn’t guarantee acne, maintaining clean and well-cared-for skin can help reduce their appearance and the likelihood of breakouts.

How do you hide pores and acne scars?

Follow an effective skincare routine to minimize the appearance of large pores and acne scars. Cleanse your face twice a day, use a toner, and incorporate exfoliation. Topical treatments with retinoids or vitamin C can help fade acne scars over time. Use non-comedogenic makeup products like primer, concealer, and foundation for immediate results. Remember to remove makeup before bed for healthy skin.

Do acne scars and large pores affect certain skin types more?

Acne scars and large pores can be more common in certain skin types. Severe, inflammatory or cystic acne can lead to scars, while oily skin or combination skin types may have more noticeable large pores. Darker skin tones are often associated with larger pores due to higher melanin and sebaceous gland activity.


Acne scars and large pores can impact an individual’s self-confidence, but effective treatments are available. From over-the-counter options to professional procedures, it’s important to consult a dermatologist for personalized recommendations. 

By maintaining a skincare routine, practising sun protection, and seeking support, individuals can manage these skin concerns’ physical and emotional effects. 

Remember to prioritize self-care and self-compassion, as having large pores and acne scars does not define one’s beauty or worth. So, embrace your uniqueness and take care of your skin.


Medical Director

After graduating from the National University of Singapore, Dr Boey’s journey in aesthetics brought him to esteemed institutions such as Harvard Medical School, American Academy of Aesthetic Medicine and Queen Mary University of London in diverse cities like Seoul, London, Boston and New York.