More microneedling for my enlarged pores, or something else? (Photo)

A combination approach will give the most improvement. I recommend lasers, microneedling/PRP, Peels like Cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, I suggest getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

I have been performing professional microneedling for well over twenty years and have found it to be an excellent "polishing" step for the skin to improve very superficial, surface irregularities in skin texture and color. Despite claims to the contrary, it is not particularly effective for deeper issues like scars and very dilated pores. On the other hand, TCA CROSS, which I have been using for over two decades works well for narrowing dilated pores (as well as ice pick acne scars). Just make sure to consult a board certified cosmetic dermatologist and not just any venue hawking the supposedly "next big thing," relatively expensive fraxel laser or RD device whose hard science to support its use lags woefully behind the heavy marketing to promote it. Hope this helps, and best of luck.

Hi and thanks for your question!
I can't see the rest of your face, so I don't know how the microneedling did for skin texture elsewhere.But from what I can see on the nose, I would recommend either a series of chemical peels OR a Halo laser treatment to address this pore size.
For the peel, I would recommend the ZO 3 Step Peel monthly, alternating with Hydrafacial treatments every 2 weeks, concentrating on extracting sebum from the pores.
For the Halo laser, I would recommend settings that focus on pore size, and again follow up with a Hydrafacial treatment in a month to further reduce sebum in the pores.
To maintain the results, staying on a good medical grade skin care regimen and continuing with routine Hydrafacials will help.
Hope this was helpful!