Skin Texture & Pores
For rough, uneven skin and pores that look bigger.
With Dr. Juliya Fisher and Dr. Shereene Idriss.
In Brief
Skin texture treatment smooths rough, uneven skin and makes enlarged pores look smaller by renewing the surface and rebuilding the collagen around it. We use fractional lasers (Fraxel Dual, Clear + Brilliant) and microneedling, with or without radiofrequency (SkinPen microneedling, SecretRF, Morpheus8). No treatment shrinks a pore for good. The aim is smoother, more even skin.
Diagnosis First
Pore size is largely genetic, written into your skin’s DNA. What changes is how visible pores are and how smooth the skin looks, and three things drive that:
- Inflammation. Redness and swelling stretch the skin around each pore so it looks dilated, and chronic inflammation makes the surface look more textured too.
- Oil and buildup. Excess oil, debris and dead skin cells collect in the pore and on the surface, so pores look darker and wider and skin feels rough.
- Collagen. Sun and time break down collagen and elastin, so the skin around each pore spreads out and pores look wider over the years. That is why daily sunscreen is part of every plan.
When redness is behind it, calming it comes first, with skincare and sometimes a pulsed dye laser such as Vbeam, which can make superficial pores look better quickly. Deep, indented acne scars are a different problem, with a plan of their own.
Whether pores look bigger from inflammation, oil or lost collagen decides the treatment, and so does whether your skin can take heat. Your dermatologist judges both before choosing.
“Pores look bigger when skin is inflamed or clogged, so I start by calming the skin and keeping pores clear. Any procedure does more for skin that is already calm.”
What We’d Skip
Pores attract more false promises than almost anything in skincare.
Don’t pay for a promise to shrink your pores
No cream, toner or device changes a pore’s structure. “Can you enhance its appearance? Absolutely, but you will never change its structure,” says Dr. Idriss.
Don’t squeeze, strip or vacuum them
Pore strips take off only the surface, and pores soon fill again. Home pore vacuums can make pores look worse in the long run. Extraction belongs in a professional’s hands.
Don’t scrub your way to smooth
Exfoliating acids clear what sits inside a pore but cannot shrink it, and too much leaves skin inflamed and rougher. “Overexfoliating is like overplucking your eyebrows,” says Dr. Idriss.
Don’t laser texture while acne is active
Resurfacing waits until breakouts are under control, or new spots keep undoing the work. Your doctor treats the acne first.
Don’t microneedle at home
Home rollers reach only 0.2 to 0.5 mm, short of the depth studies show working, and they can leave dark marks and worse scarring, especially in darker skin.
How Are Texture and Large Pores Treated?
The choice turns on how deep the roughness goes, what is making pores look bigger and how your skin handles heat. “No skin care is ever going to replace what a laser can do for your texture,” says Dr. Idriss, and no laser works without skincare that matches it.
- Rough texture with sun damage or fine lines. Fraxel Dual Laser is a non-ablative fractional laser. Its 1550 nm setting treats texture and fine lines, and its 1927 nm setting treats discoloration in the same plan.
- Dullness, early texture and pores that look bigger, with little downtime. Clear + Brilliant is the gentler laser in the Fraxel family, used in a series to keep skin smooth and bright.
- Texture in skin that does not tolerate heat. SkinPen Microneedling builds collagen with needles alone, often with PRP. In Dr. Idriss’s experience, microneedling about once a quarter makes a big difference to texture, especially over 40.
- Pores and texture in thin or crepey skin. SecretRF passes gentle radiofrequency heat between fine needles. Its maker lists large pores and texture among what it treats.
- Texture with loosening skin on the lower face. Morpheus8 reaches deeper with radiofrequency, firming loosening skin while it refines texture.
If you have melasma, your doctor chooses differently, because heat can make it worse. The table below shows which treatments suit it.
The Treatments
For texture and pores, there are five treatments to choose from.
Fraxel Dual LaserA non-ablative fractional laser for texture, sun damage and fine lines
Clear + BrilliantThe gentler fractional laser, for dullness, early texture and pores
SkinPen MicroneedlingMicroneedling with no heat, often with PRP
SecretRFGentle radiofrequency microneedling for pores, texture and crepey skin- Morpheus8Deeper radiofrequency microneedling to firm and smooth
Side by Side
Fraxel Dual and Clear + Brilliant resurface with laser heat at two strengths. SkinPen, SecretRF and Morpheus8 use fine needles, with or without radiofrequency heat. The last column shows which suit skin with melasma.
| Treatment | How it works | Suited to | Downtime | Sessions | Results | With melasma |
|---|---|---|---|---|---|---|
| Fraxel Dual LaserNon-ablative fractional laser, 1550 nm and 1927 nm | A non-ablative fractional laser treats microscopic columns of skin and leaves the surface intact; 1550 nm for texture, 1927 nm for discoloration | Rough texture, sun damage, brown spots and fine lines | Shorter than ablative lasers; a few days of redness and peeling | 1 to 5, set after your skin’s first response | After the first session, improving over time | Used with caution: heat can make melasma worse, so skincare comes first |
| Clear + BrilliantThe gentler laser in the Fraxel family | A gentler fractional laser that treats the upper layers of the skin | Dullness, uneven tone, early texture and enlarged looking pores | Little to none; redness usually settles in 12 to 24 hours | A series; improvement reported after 4 to 6 | Softer, brighter skin in 1 to 2 weeks | Usually not: its maker lists melasma among reasons someone may be a poor candidate |
| SkinPen MicroneedlingMicroneedling, often with PRP | Fine needles make controlled micro injuries that heal with new collagen, with no heat; often paired with PRP | Rough texture and fine lines, and skin that reacts to heat | 1 to 3 days of redness | More than one, 4 to 6 weeks apart | Texture from 4 to 8 weeks; builds for 6 months | Can be part of a careful plan, as it uses no heat |
| SecretRFGentler RF microneedling | Needles up to 3.5 mm deep, with radiofrequency energy passing sideways between them | Pores and texture in thin or crepey skin, fine lines | A few days of pink, slightly bumpy skin | Often a short series | Over months; full effect at about 6 months | Usually not: radiofrequency heat can make it flare |
| Morpheus8RF microneedling | Needles release radiofrequency heat beneath the surface, up to 4 mm deep on the face | Uneven texture with loosening skin on the jawline and lower face | 4 to 5 days of pink, slightly bumpy skin | One or a short series | Over months; full effect at about 6 months | Usually not: radiofrequency heat can make it flare |
In Their Words
“
I highly recommend Dr. Fisher. I followed her from her previous practice and I continue to be happy with my results. I’ve gotten fillers and laser. Whenever I’ve wanted to do more, she was always honest with me. If I didn’t need it, I could count on her to tell me
Lillian J.
“
Dr. Idriss takes her time to listen to your concerns. She works with you to develop a treatment plan you are comfortable with, without ever being pushy. Her work is subtle and her expertise is evident. …
Sydney S.
“
I’ve always had a great experience here. Dr. Fisher is great, I’ve seen her many times for a variety of different conditions. I never feel rushed and her advice on treatments, products, and care have always been highly effective. The results are great. …
August R.
“
I would recommend Dr Idriss a thousand times over and over. She is extremely knowledgeable, knows what will work and what won’t and will always give you an honest recommendations. You will never feel pushed into moving forward with any injections or procedures.
Hiva F.
Bryant Park, New York
Your Dermatologists
Founder
Dr. Shereene Idriss
Candid advice, subtle results.
Board-certified, Practicing since 2013
Dermatologic Surgeon
Dr. Juliya Fisher
Trained to work in millimeters.
Double Board-certified, Columbia Mohs fellowship
Both doctors share one philosophy, so either is a good place to start. Book online with Dr. Fisher, or call (212) 612-1520 for Dr. Idriss.