
Microneedling
Builds collagen around the pore so it holds a tighter shape.

Pore size cannot be permanently altered, but pores do stretch when they stay congested. Treatments that clear them and thicken the surrounding skin make them read smaller.
Pores are small openings in the skin that let oil and sweat reach the surface, and their size cannot be permanently altered by any product or treatment. What they do is stretch. A pore that stays packed with oil and dead cells is held wider by its own contents, and over time the collagen ringing the pore wall thins and stops springing it back into shape. That is why the same pore reads larger at forty than it did at twenty.
Rough texture has two separate sources, and they call for different treatments. The surface layer is dead cells and congestion, which scatter light and feel gritty under a fingertip. That layer is easy to fix. The structural layer is the skin underneath it: thinned collagen, the shallow indentations left behind by old acne, and the crepey quality that arrives with age. That takes actual remodelling, and remodelling takes months.
Some of pore size is simply inherited. Oily skin makes larger pores, always has, and that part is not going anywhere. The realistic aim is to keep the pores clear, thicken the skin around them so it holds a tighter shape, and smooth the surface so light bounces off evenly instead of catching in every dip.

The fastest visible change comes from clearing congestion. HydraFacial MD uses a vacuum tip to lift out what is sitting inside the pore, and the cleansing, the gentle glycolic and salicylic peel, the extraction, and the hydrating serum all happen in one visit, so the difference is there when you walk out. Microdermabrasion does something similar mechanically, polishing off the dead surface layer with abrasion and suction. Both nudge collagen production through exfoliation, but neither one remodels the skin the way a needling or energy device does. They remove what is in the way, which is exactly right when the problem is roughness and congestion, and not nearly enough when the problem is structural.
Microneedling addresses the pore wall itself. Fine needles create thousands of tiny channels in the skin, and the repair response lays new collagen around each pore, tightening the ring that has been holding it open. It is one of the most effective treatments for tightening enlarged pores, and it is widely used to improve the appearance of acne scars. It is done as a series, and each session leaves you looking sunburned for a few days.
Venus Viva pushes the same idea further. It delivers radiofrequency through a nano-fractional tip rather than through needles that penetrate the skin, creating controlled micro-injuries while heating the dermis directly, and that heat is what remodels genuinely uneven texture and deeper scarring. It is the more aggressive option in this group and it asks for more recovery in return. ThermiSmooth sits at the opposite end: gentle radiofrequency applied with a handpiece across the skin, no needles and no downtime, warming the tissue gradually over a series of visits. It suits crepey texture and delicate areas such as the skin around the eyes, which it is gentle enough to treat without needles at all.
Clear + Brilliant falls between the facials and the resurfacing devices. It is a fractional laser run at a light setting, creating microscopic zones of treated tissue that the skin replaces with new tissue over the following days, refining texture and evening tone across a series with little to no downtime. It is what to reach for when a facial has stopped being enough and Venus Viva is more than you want to take on.

Start by running a finger over your skin and deciding whether the problem sits on top of it or inside it. If the skin feels rough and looks congested but the surface underneath is smooth, Microdermabrasion or HydraFacial MD every four to six weeks will handle it and there is no reason to spend more than that. If you can see the texture in raking light, dips and shadows that are still there after the skin is clean, that is structure, and no facial is going to change it.
For structural texture, the choice is mostly about how much downtime you can absorb. Microneedling is the middle of the road: several sessions, a few days of redness each time, improvement that builds over the following weeks as new collagen forms. Venus Viva does more per session and asks more of your calendar. Clear + Brilliant is the gentlest of the three and correspondingly the most gradual. ThermiSmooth is for people who want no downtime whatsoever and accept a more modest result in exchange, or who would rather have a treatment with no needles at all.
A common mistake is over-exfoliating. People with large pores tend to scrub and strip the skin, and over-stripping irritates it and can make things worse, with the pores looking no better for any of it. Another mistake is expecting a lasting result from a treatment that clears the pore. Congestion returns, because your oil glands keep working, so a facial is maintenance rather than a cure. Anyone promising you a permanent reduction in pore size is overstating what is possible.
It is also worth saying that if the texture bothering you is really acne scarring, or acne that is still active, that is a medical conversation and a different plan. A consultation sorts that out quickly, gets an honest read on how oily your skin actually is, and sets the order of operations, because resurfacing skin that is still congested wastes a session.

Listed in the order we most often recommend them, with a line on when each is the right pick.
Your consultation decides which actually fits your anatomy, your goals, and the downtime you can spare.
Worth reading
Clear + Brilliant is a gentle laser treatment that targets fine lines and early wrinkles. Learn how this preventive anti-aging solution works.
Read the answerWorth reading
Clear + Brilliant laser for melanated skin in Cincinnati, OH. Safe, gentle laser treatment for dark spots, uneven tone, and glowing skin.
Read the answerRelated concern
Motion lines and creases that stay put
Start from the concernTell us what you would like to change and we will come back with the treatments that fit, honest expectations, and a time to talk it through.
Your details go straight to our Montgomery Road front desk and are never shared. A team member replies during office hours, usually the same day.

Book a consultation at our Montgomery Road office, or call and we will help you decide where to start.
Medically reviewed by Shalini Gupta, MD, Harvard-trained dermatologist and founder of The Dermatology, Laser & Vein Center. Last reviewed September 2026. This page is for education and is not a substitute for a personalized medical consultation.