Microneedling with Radiofrequency

Compare To Other Treatments

Compared to many other scar revision treatments, microneedling with radiofrequency poses a low risk of side effects. The charts below show the chances of developing various side effects from microneedling with radiofrequency treatment.1-8

For some side effects, we currently do not have enough data to provide a percentage.

Certain/Likely Side Effects (% = Incidence)

SHORT TERM Pain*up to 100%
SHORT TERM Transient redness (erythema)**up to 100%
SHORT TERM Swelling immediately after procedure (edema)†up to 100%
SHORT TERM Burning sensationup to 100%
SHORT TERM Crustingup to 46%
SHORT TERM Bleeding from wound‡up to 20%
SHORT TERM Skin drynessup to 17%
SHORT TERM Scaling (peeling)up to 16%

*Pain: Microneedling causes temporary pain or a burning sensation.

**Erythema: Mild skin redness after skin needling is normal and usually disappears after 2-3 days.3,4

†Edema: Swelling after skin needling is normal and should disappear after 2-3 days at most.3,4

‡Bleeding/oozing from wound: Bleeding or oozing from the wound is normal after skin needling and stops when a crust forms on the skin.

Possible/Rare Side Effects

SHORT TERM Skin marks*up to 8%
SHORT TERM Skin darkening (post-inflammatory hyperpigmentation)**up to 4%

*Skin marks: This percentage is based on a single study in which 3 out of 40 patients developed what are called “mesh marks.” These mesh marks are a pattern of marks that are left where the small needles enter the skin. These changes disappeared after one week of enhanced moisturizer use.7 Other studies do not report this side effect. 

**Post-inflammatory hyperpigmentation (skin darkening): This percentage is based on one study.2

Studies:

Seven studies have looked at the side effects of microneedling with radiofrequency.

  • Study 1:

    • Authors: Kim et al.1
    • Total # of patients: 25
    • # of female patients: 8
    • # of male patients: 17
    • Age of patients: 16-29
    • Duration of treatment and follow-up: 3 treatments, follow-up at 3 months
    • Side effects:
      • Redness (erythema ): 32%
      • Swelling (edema): 32%
      • Crusting: 24%
      • Bleeding: 20%
      • Peeling (scaling): 16%
  • Study 2:

    • Authors: Vejjabhinanta et al.2
    • Total # of patients: 30
    • # of female patients: 15
    • # of male patients: 15
    • Age of patients: 22-45
    • Duration of treatment and follow-up: 3 sessions, follow-up at 1 month, 3 months and 6 months
    • Side effects:
      • Pain: 100%
      • Immediate redness (erythema): 100%
      • Swelling (edema): 100%
      • Burning sensation: 92.31%
      • Crusting: 46.15%
      • Post-inflammatory skin darkening (hyperpigmentation): 3.85%
  • Study 3:

    • Authors: Chae et al.3
    • Total # of patients: 20
    • # of female patients: 4
    • # of male patients: 16
    • Age of patients: 20-39
    • Duration of treatment and follow-up: 3 sessions, follow-up at 2 months
    • Side effects:
      • Redness (erythema): 15%
      • Dryness: 10%
      • Swelling (edema): 5%
  • Study 4:

    • Authors: Baskan et al.4
    • Total # of patients: 9
    • # of female patients: 2
    • # of male patients: 7
    • Age of patients: 17-50
    • Duration of treatment and follow-up: 1-5 sessions, follow-up at 4 weeks
    • Side effects:
      • Pain: 100%
      • Redness (erythema): 100%
      • Swelling (edema): 100%
      • Crusting: 11.1%
  • Study 5:

    • Authors: Lan et al.5
    • Total # of patients: 60
    • # of female patients: 39
    • # of male patients: 21
    • Age of patients: 17-30
    • Duration of treatment and follow-up: 3 sessions, follow-up at 1 month, 3 months, and 6 months
    • Side effects:
      • Pain: 100%
      • Redness (erythema): 100%
      • Swelling (edema): 100%
      • Burning sensation: 100%
      • Dryness: 16.67%
      • Crusting: (incidence not reported)
  • Study 6:

    • Authors: Emam et al.6
    • Total # of patients: 21
    • # of female patients: 12
    • # of male patients: 9
    • Age of patients: 20-41
    • Duration of treatment and follow-up: 4 sessions, follow-up at 3 months
    • Side effects:
      • Mild burning sensation: 57.2%
      • Peeling (scaling): 9.5%
  • Study 7:

    • Authors: Huang et al.7
    • Total # of patients: 40
    • # of female patients: 34
    • # of male patients: 6
    • Age of patients: 19-45
    • Duration of treatment and follow-up: 3 sessions, follow-up at 3 months
    • Side effects:
      • Pain: 100%
      • Skin marks (temporarily): 7.5%
      • Post-inflammatory skin darkening (hyperpigmentation): 2.5%*

*Skin darkening occurred in 1 patient who got infected by herpes virus after the first treatment.

Study 1: In a study published in 2014 in The Journal of Dermatology, Kim and colleagues performed microneedling with radiofrequency on 25 patients. The patients received 3 sessions at 1-month intervals and were followed up 3 months after treatment. The researchers observed erythema (redness) and swelling immediately after the treatment which lasted up to 7 days. Patients reported that they were able to continue normal daily activities after treatment. The researchers did not find post-inflammatory hyperpigmentation (skin darkening) or hypopigmentation (skin lightening) in any of the patients.1

Study 2: In a study published in 2014 in the Journal of the European Academy of Dermatology and Venerology, Vejjabhinanta and colleagues treated 30 patients with atrophic acne scars with microneedling with radiofrequency. The patients received 3 sessions of treatment at 1-month intervals and were followed up 1 month, 3 months, and 6 months after the final treatment. The researchers found transient pain, erythema (redness), and edema (swelling) in all patients. Additionally, some patients experienced while burning sensation and crusting, while post-inflammatory hyperpigmentation was seen in only one patient.2

Study 3: In a study published in 2015 in the Journal of Cosmetic Dermatology, Chae and colleagues treated 20 patients with facial atrophic acne scars with either 1550 nm Er:Glass fractional laser or fractional radiofrequency microneedle device. The patients received 3 treatment sessions at 4-week intervals and were followed up after 2 months. The researchers routinely observed mild transient erythema (redness), dryness, and edema (swelling) in several patients treated with fractional radiofrequency microneedle device, but did not consider these to be side effects.3

Study 4: In a study published in 2018 in the Journal of Cosmetic Dermatology, Baskan and colleagues treated 9 patients with atrophic acne scars with a microneedle radiofrequency device. Patients received 1 to 5 sessions of treatment at 4-week intervals. All patients experienced transient pain, erythema (redness) and edema (swelling) after treatment that lasted for several days. Crusts formed in 11.1% of patients.4

Study 5: In a study published in 2020 in Lasers in Surgery and Medicine, Lan and colleagues treated 60 patients with atrophic scars with microneedle radiofrequency on one side of the face and fractional micro‐plasma radiofrequency on the other side of the face. Both treatments were performed 3 times at 1-month intervals. The researchers followed up with the patients 1 month,  3 months, and 6 months after the last treatment session. All patients experienced pain during the procedure, erythema (redness), swelling, and burning sensations, while only 16.67% of them reported skin dryness. However, authors noted that microneedling with radiofrequency induced less severe side effects than fractional micro‐plasma radiofrequency.5

Study 6: In a study published in 2022 in the Journal of Cosmetic Dermatology, Emam and colleagues treated 21 patients with atrophic scars with a fractional Er:Glass laser or a microneedling with a radiofrequency device. All patients received 4 sessions of treatment at 1-month intervals. The researchers followed up with the patients 3 months after the last treatment session. Fractional radiofrequency microneedling treatment induced a lower number of side effects and they were less severe. Authors reported a mild burning sensation in 57.2% of patients and scaling (peeling) in 9.5% of patients.6

Study 7: In a study published in 2023 in the Journal of Cosmetic Dermatology, Huang and colleagues treated 40 patients with atrophic scars with a microneedling with radiofrequency device. Patients received 3 sessions of treatment at 1-month intervals. The researchers followed up with the patients 3 months after the last treatment session. Only pain during the procedure was reported by all patients while hyperpigmentation occurred in 1 patient as a consequence of the herpes virus developing after the first treatment. The hyperpigmentation mark disappeared after a month.7

Systematic reviews: Two systematic reviews published in 2020 and 2021 found that microneedling with radiofrequency is a well-tolerated and safe acne scar treatment with only transitory side effects such as pain, redness, swelling, and burning sensations. No long-term side effects were reported so far.8,9

References
  1. Kim ST, Lee KH, Sim HJ, Suh KS, Jang MS. Treatment of acne vulgaris with fractional radiofrequency microneedling. J Dermatol. 41(7), 586-91 (2014).
  2. Vejjabhinanta V, Wanitphakdeedecha R, Limtanyakul P, Manuskiatti W. The efficacy in treatment of facial atrophic acne scars in Asians with a fractional radiofrequency microneedle system. J Eur Acad Dermatol Venereol. 28(9), 1219-25 (2014).
  3. Chae WS, Seong JY, Jung HN, Kong SH, Kim MH, Suh HS, Choi YS. Comparative study on efficacy and safety of 1550 nm Er:Glass fractional laser and fractional radiofrequency microneedle device for facial atrophic acne scar. J Cosmet Dermatol. 14(2), 100-6 (2015).
  4. Bulbul Baskan E, Akin Belli A. Evaluation of the efficacy of microneedle fractional radiofrequency in Turkish patients with atrophic facial acne scars. J Cosmet Dermatol. 18(5), 1317-21 (2019).
  5. Lan T, Tang L, Xia A, Hamblin MR, Jian D, Yin R. Comparison of Fractional Micro-Plasma Radiofrequency and Fractional Microneedle Radiofrequency for the Treatment of Atrophic Acne Scars: A Pilot Randomized Split-Face Clinical Study in China. Lasers Surg Med. 53(7), 906-13 (2021).
  6. Emam AAM, Nada HA, Atwa MA, Tawfik NZ. Split-face comparative study of fractional Er:YAG laser versus microneedling radiofrequency in treatment of atrophic acne scars, using optical coherence tomography for assessment. J Cosmet Dermatol. 21(1), 227-36 (2022).
  7. Huang L, Liu Y, Fang W, Liu L, Sun Q, Lin X, Xu H, Yang Y. Efficiency and safety of microneedling fractional radiofrequency in the treatment of Chinese atrophic acne scars: A retrospective study of 3 consecutive treatments with 1-month intervals. J Cosmet Dermatol. 22(2), 497-504 (2023).
  8. Alessa D, Bloom JD. Microneedling Options for Skin Rejuvenation, Including Non-temperature-controlled Fractional Microneedle Radiofrequency Treatments. Facial Plast Surg Clin North Am. 28(1), 1-7 (2020).
  9. Gowda A, Healey B, Ezaldein H, Merati M. A Systematic Review Examining the Potential Adverse Effects of Microneedling. J Clin Aesthet Dermatol. 14(1), 45-54 (2021).

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