Pore size is the thing every woman I've talked to seems to have been sold something to fix, and almost nothing has worked. Here's what's actually happening.
Visible pore size is determined by two things, and only two things.
1. How much sebum you produce. Sebum production is driven by androgens and insulin. When either is elevated, more oil flows through the follicle, stretches the opening, and — when it oxidizes — turns dark and reads as a bigger visible pore. This is why insulin resistance, PCOS, and adult hormonal acne all show up with visibly larger pores.
2. How much collagen is supporting the tissue around each follicle. Every pore sits in dermal tissue held together by collagen. When collagen weakens — from age, glycation, chronic inflammation, or estradiol decline — the tissue can't hold the pore opening as tightly. It looks larger, especially on the cheeks and around the nose.
What actually changes visible pore size:
- Lowering sebum output — address elevated insulin, elevated androgens, and stress-driven cortisol. This is the biological handle.
- Preserving collagen — sun protection, HbA1c management, estradiol adequacy, retinoids over time.
What doesn't work: pore-shrinking toners, cold water splashes, egg-white masks, or anything topical that claims to "close" pores permanently. Pores don't open and close like doors.
Measuring fasting insulin, hs-CRP, HbA1c, and estradiol gives you the biological picture.