Admittedly, there is no one perfect treatment for enlarged pores, which is believed to be a inherited (family predisposition) trait. I have been disappointed with the results I have seen from a series of superficial chemical peels, microdermabrasion, fraxel lasers, and even after true dermabrasion. In fact, in some cases, by abrading the surface portion of the pore, the end result can be a more prominent-looking pore as the deeper, wider portion of the pore becomes exposed as a result of the treatment.
I have found medical microneedling to yield consistently gratifying results, especially when combined with individual deep peeling or deeper needling of any larger, more patulous pores.
The procedure is quick and simple. First, larger, more pit-scar-like pores are treated by either inserting a superfine 33 gauge needle down the shaft and irritating the lining walls down to the pores depth. Pore walls treated in the fashion will eventually close up, just as pierced ears close when the hole becomes irritated and inflamed.
If the exposed surface of the pore is very open and prominent, a tiny amount of 100% TCA may be inserted with a toothpick--a procedure known as the CROSS technique when performed for pit scars.
Finally, following topical or local anesthesia, the entire area of enlarged pores is treated with medical microneedling, in which either a manual roller (e.g. Dermaroller) or an electrically driven set of sterilized microneedles (Dermapen) is used over the entire area to blend the skin entirely and to ensure a more even complexion. Results of this combined approach have been quite gratifying.