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What is the problem with enlarged pores and acne pits?

Dec 15,2021 | HISEEK PRETTY

Why do I have large pores and acne pits? Did it happen when I squeezed the pimples? The following is a personal understanding.

In fact, the principle of acne pits is the same thing as large skin pores, both are caused by the degradation of the dermal extracellular matrix by various enzymes.


The figure above shows activated fibrinolytic enzymes and matrix metalloproteinases destroying the extracellular matrix in the dermis - structural degradation such as collagen and elastin fibers.

The main dermal fillers currently available are several types of extracellular matrix ECM (extracellular matrices) - namely: collagen, glycoproteins, proteoglycans, glycosaminoglycans, and elastin fibers. Without these types of substances filling and supporting your skin, your pores or non-pore locations will appear to be visibly collapsed.


Normally, in the physiological state, ECM degradation and synthesis are in a dynamic balance, i.e., degraded and synthesized at the same time.

But in the pathological state, the situation is not harmonious

1, Increase: In some people, after trauma or surgery with P53 gene mutation, the wound location collagen fibers continue to proliferate and cause scarring.

2, decrease: persistent inflammation or persistent stress can cause excessive collagen degradation - at this point, you can see depressed scars.

The following substances are known to degrade ECM.

Co-peptidases, serine proteases, cysteine proteases, asparagine proteases, glycosidases, and matrix metalloproteases

Among them, the most important degraders of the extracellular matrix are - matrix metalloproteinases (MMPs).

In 1962, Gross and LaPierre discovered MMP-1 while studying the mechanism of frog tail self-absorption.

In the following decades, 16 MMPs were discovered, broadly classified into four categories: collagenases, gelatinases, stromal lysosomes, and membrane-type lysosomes.


MMPs are involved in many complex physiopathological activities, including tissue restructuring, cell migration, wound healing, and other tasks related to extracellular matrix reconstruction.

Of course, it is not only inflammation caused by a bacterial infection that activates MMP causing degradation of ECM.

There is another way: extrusion-type atrophy, which is a form of tissue atrophy

This condition can be miserable because so many people don't have inflammation and the pores on their face can become very large. Do you think you have squeezed every pore? Definitely not squeezed by your hands. And see my analysis.

Let's look at the impact of squeezing on skin tissue, first.

Very classic eye wrinkle tension diagram.

The formation of periorbital wrinkles in humans is related to the formation of periorbital dermal tension by the orbicularis oculi muscle, which has the highest tension at the base of the wrinkles. Fibroblasts in the ECM are induced to produce MMP-1 interstitial collagenase, on the one hand, to break down the components near the wrinkles, and on the other hand to synthesize new collagen fibers to wrap around the bottom area of the wrinkles in the direction of pressure to form a stiffer wrinkle structure, and over time, under constant squeezing pressure, this stiff wrinkle groove is fixed! -- notice my adjective word, stiff (the bottom of the wrinkle forms a U-shaped linear collagen fiber structure that wraps around the wrinkle) and eventually it remains on your face even if you don't make an expressive movement.

I'm sure you're impatient, you were talking about pores and pockmarks, now why are you talking about eye wrinkles?

The problem of pressure-induced dermal matrix atrophy-tissue degradation at the location of acne occurs simultaneously in two steps.

1, fibroblasts will occur around the acne with new degradation activity and collagen synthesis
2, the dermis is squeezed for a long time, which can activate dermal energetic fibrinolytic zymogens, further activating the MMPs in the dermis by degrading the extracellular matrix of the dermis.

Manifestations of giant blackheads and acne.

In fact, most people with oily skin acne form large pores as follows.

Of course, pimples cause enlarged pores by long-term squeezing, which is not the only cause of enlarged pores.

Inflammation, which is also the cause of enlarged pores, is also the main cause of acne pits, and there are two main types.

1, Inflammation caused by non-polar sebum in the early stages of acne.

The oil overflowing from the sebaceous glands in the pores contains triglycerides, cholesterol, squalene, and other substances, which are a class that can cause natural immunity of the skin, yo! The non-polar lipids (triglycerides, squalene, cholesterol) contained in the body of acne can be recognized by CD1a, which activates restrictive T cells and causes an immune-inflammatory response.

2, pustules in the middle and late stages of acne form inflammation.


Additional knowledge on acne pits.

During inflammation, various inflammatory cells, such as neutrophils, macrophages, and monocytes, accumulate in the diseased tissue of the human skin.

Neutrophils correspond to the production of

MMP-8 granulocyte collagenase and degrades collagen I, II, III, and proteoglycans.

Macrophages correspond to the production of

MMP-1 mesenchymal collagenase, which degrades collagen types I, II, III, VII, and X, gelatin, and proteoglycans

MMP-3 mesenchymal collagenase, which degrades gelatin, proteoglycans, collagen types III, IV, V, and IX, elastic fibers, and fibronectin

MMP-9 gelatinase, degrades collagen types IV, V, VII, IX, and elastic fibers

MMP-12 metalloelastase. Degrades elastin and fibronectin.

Monocyte counterparts produce

MMP-7 matrix lysin, which degrades elastin, gelatin, proteoglycan, and fibronectin

Where did the stuff in the pit go?

I looked for the contents of a broken pustule on my face and after Gram staining, many filamentous collagen fibers and other dermal matrix components were visible - if the pustule burst, these were lost from the face, if not, the skin would have absorbed and degraded them.

The disrupted dermal collagen fibers (long filaments) were accompanied by foliated nucleated neutrophils and rod-shaped nucleated neutrophils in the vicinity.

Summary of the causes of acne pits and enlarged pores.

Chronic squeezing and inflammation of the dermis over a long period of time has caused enlarged pores and acne pits to develop on the skin


Back to Acne Skin Care.