Objective To observe the effect of microneedle combined with human-like collagen on the skin condition of patients with enlarged facial pores. Methods A total of 86 patients with enlarged facial pores admitted to Suzhou Industrial Park Yinxiang Mulan Qingyan Medical Beauty Clinic from February 2023 to October 2024 were selected as the research subjects, and they were divided into the control group and the study group by the random number table method, with 43 patients in each group. The control group was treated with human-like collagen, and the study group was treated with microneedle combined with human-like collagen. The clinical efficacy, skin barrier indexes, skin test condition, treatment satisfaction and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the study group was 97.67%, which was higher than 81.40% in the control group (P <0.05). After treatment, the transepidermal water loss, skin water content and skin surface lipids in the study group were all better than those in the control group (P <0.05). After treatment, the scores of pores, texture and red area in the study group were all better than those in the control group (P <0.05). The treatment satisfaction in the study group was higher than that in the control group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion Microneedle combined with human-like collagen treatment for patients with enlarged facial pores can effectively improve skin conditions, without damaging the skin barrier. It has high safety and patient satisfaction, which is worthy of clinical application.