Q: What are the pros and cons of RF microneedling?

Pros You’ll reap the collagen production-boosting benefits of both microneedling and radiofrequency energy, all in one treatment. This anti-aging treatment is suitable for all skin types and tones, with little risk of side effects when it’s performed properly. It comes with minimal downtime, so you should be able to resume your normal activities the next day. The treatment can be performed on almost any body area. Beyond the benefits of skin tightening and smoothing, the procedure can help fade scars and stretch marks that result from damage to the deeper layer of skin known as the dermis. Cons Most RF microneedling devices require multiple treatment sessions, four to six weeks apart, to create a visible change. Because results rely on new collagen growth, it can take up to six months to see your final outcome. Even with a topical numbing cream, you may experience some discomfort. RF microneedling carries some risk of hyperpigmentation for people with medium to dark skin tones, if the procedure is performed too aggressively. In inexperienced hands, microneedling with radiofrequency can create more of exactly the type of damage it’s meant to correct—grids with uneven skin texture, as well as dark spots of hyperpigmentation, if not burns and scars.

Q: Who's a good candidate for RF microneedling?

According to Dr. Emil Tanghetti , a dermatologist in Sacramento, California, RF microneedling works best for people with some degree of skin laxity and sun damage—specifically solar elastosis, the crinkling that develops due to depleted skin elasticity. It can also benefit people with stubborn acne scars . While RF microneedling can be suitable for all skin types and tones, Dr. Tanghetti cautions that “There is less experience treating Fitzpatrick skin types V and VI for sun damage, because these skin tones are protected by melanin, so they typically aren't seeking treatment for sun-damaged skin. But these patients may have other issues, such as skin laxity and acne scars, which RF microneedling can address.” If you have medium to dark brown skin, finding a provider who has experience treating skin tones like yours can help decrease your risk of problems like post-inflammatory hyperpigmentation (PIH). Related: 7 Questions to Ask Your Doctor Before Getting RF Microneedling

Question 1

What is RF microneedling?

Accepted Answer

Radiofrequency microneedling (commonly called RF microneedling) is a noninvasive skin rejuvenation treatment that enhances the collagen-boosting benefits of microneedling with the heat of radiofrequency energy.

In experienced hands, this potent combination can effectively treat a range of concerns, including:

uneven skin texture
large pores
fine lines and wrinkles
skin laxity
acne scars
stretch marks

The most common treatment areas include the face, neck, and decolletage, but the RF microneedling handpiece can also be used on the abdomen, knees, thighs, and almost any other body area.

RF microneedling works by creating controlled microdamage from both the ultra-fine needles and heat. This stimulates the body’s natural wound-healing response, kick-starting the biological processes that create new collagen and elastin.

Aging and environmental damage (particularly sun damage) break down these essential structural proteins, and the rate of replacement slows over time. Procedures like RF microneedling can slow and even temporarily reverse this process, helping skin look and even act younger.

However, this isn’t a risk-free procedure. Read on to learn more about how it works and why it’s so important to have it done by an experienced provider.

Related: Does RF Microneedling Live Up to the Social Media Hype? Top Derms and Plastic Surgeons Weigh In.

Question 2

What are the pros and cons of RF microneedling?

Accepted Answer

Pros

You’ll reap the collagen production-boosting benefits of both microneedling and radiofrequency energy, all in one treatment.
This anti-aging treatment is suitable for all skin types and tones, with little risk of side effects when it’s performed properly.
It comes with minimal downtime, so you should be able to resume your normal activities the next day.
The treatment can be performed on almost any body area.
Beyond the benefits of skin tightening and smoothing, the procedure can help fade scars and stretch marks that result from damage to the deeper layer of skin known as the dermis.

Cons

Most RF microneedling devices require multiple treatment sessions, four to six weeks apart, to create a visible change.
Because results rely on new collagen growth, it can take up to six months to see your final outcome.
Even with a topical numbing cream, you may experience some discomfort.
RF microneedling carries some risk of hyperpigmentation for people with medium to dark skin tones, if the procedure is performed too aggressively.
In inexperienced hands, microneedling with radiofrequency can create more of exactly the type of damage it’s meant to correct—grids with uneven skin texture, as well as dark spots of hyperpigmentation, if not burns and scars.

Question 3

How much does RF microneedling cost?

Accepted Answer

The price you pay will depend on the type of device your provider uses, their credentials, their location, and a few other key factors.

You can finance your treatment with CareCredit.

See our complete guide to RF microneedling costs

Question 4

Microneedling RF before and after pictures

Accepted Answer

The microneedling RF photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 5

Who's a good candidate for RF microneedling?

Accepted Answer

According to Dr. Emil Tanghetti, a dermatologist in Sacramento, California, RF microneedling works best for people with some degree of skin laxity and sun damage—specifically solar elastosis, the crinkling that develops due to depleted skin elasticity. It can also benefit people with stubborn acne scars.

While RF microneedling can be suitable for all skin types and tones, Dr. Tanghetti cautions that “There is less experience treating Fitzpatrick skin types V and VI for sun damage, because these skin tones are protected by melanin, so they typically aren't seeking treatment for sun-damaged skin. But these patients may have other issues, such as skin laxity and acne scars, which RF microneedling can address.”

If you have medium to dark brown skin, finding a provider who has experience treating skin tones like yours can help decrease your risk of problems like post-inflammatory hyperpigmentation (PIH).

Related: 7 Questions to Ask Your Doctor Before Getting RF Microneedling

Question 6

Is RF microneedling better than microneedling?

Accepted Answer

Yes, RF microneedling produces more dramatic results than traditional microneedling or radiofrequency treatments alone.

Traditional microneedling can be a more cost-effective approach to collagen-induction therapy, and radiofrequency energy treatments like Thermage, can also treat skin laxity. But the combination of the two makes each modality much more potent.

Microneedles allow precise delivery of radiofrequency energy into the dermal layer of skin, where collagen-producing cells reside, while the heat from the radiofrequency energy increases the level of controlled damage the microneedles inflict.

Question 7

Which RF microneedling device is best?

Accepted Answer

You’ll find a variety of FDA-cleared RF microneedling treatments offered by providers, including Profound RF, Vivace, Morpheus8, Potenza, Infini RF, Fractora RF, Genuis RF, and Secret RF.

All of these RF microneedling treatments work in essentially the same way, though their needles may vary in number or size. For example, Morpheus8 penetrates into the tissue deeper than any other RF microneedling device, going as deep as 8mm.

Many devices also use needles that are gold-plated and tapered, to allow for smooth penetration into the skin and to minimize trauma and the risk of pigmentation changes.

Some treatments are also more powerful than others. Profound RF delivers longer RF energy pulses and more intense heat to the dermis, which can create optimal results with a single treatment session.

While some devices have advantages over others (and Worth It Ratings vary), your provider’s level of experience will be the biggest factor in determining the quality of your results. Choose a provider who can show you their own before and after photos, and make sure they have a track record of positive patient reviews for the specific procedure you’re considering.

Question 8

What happens during an RF microneedling treatment?

Accepted Answer

Most RF microneedling treatment sessions take 30–45 minutes. Here’s what to expect:

Your provider will cleanse your skin and apply a topical numbing cream, to help mitigate pain.
Once you’re sufficiently numb, they’ll begin pressing the handheld device into your skin, methodically stamping it across the entire treatment area.
As the microneedles puncture your skin and penetrate the dermis, they will emit RF energy as heat. You may feel a warm, prickling sensation that can be uncomfortable, but it shouldn’t be painful because your skin will be numb.
After the treatment is complete, your provider may apply a calming mask, serum, or balm to your skin before sending you on your way.

RealSelf Tip: “RF microneedling can be combined with other primarily superficial treatments,” says Dr. Tanghetti. He frequently pairs it with low-downtime CO2 laser treatments such as CoolPeel, or picosecond lasers, like PicoSure. “Not only do you get some collagen remodeling in the dermis, but you make the surface look better—there’s a nice glow to your skin.”

Question 9

How long does RF microneedling recovery take?

Accepted Answer

Most patients have little to no downtime, but you might have some pinpoint bleeding, flushing, and mild swelling immediately afterward. These side effects are an expected inflammatory response to the micro-injuries inflicted on your skin, and they should resolve in 24–48 hours.

As you recover, you can encourage healthy healing with gentle skincare. “You want to take care of your skin with mild cleansing, good moisturization, and a mineral-based sunblock,” says Dr. Tanghetti.

A physical sunscreen (featuring titanium dioxide or zinc oxide) with 30+ SPF will help protect your skin, with less potential for irritation than a chemical sunscreen that may enter the microchannels left by the needles.

You can wear makeup the day after treatment, but keep those little puncture marks in mind. Your skin will be more sensitive, and anything you put on it will penetrate more deeply than usual.

Talk with your provider about whether you'll need to lay off skin-care products with potent active ingredients (like retinoids, vitamin C serums, exfoliating acids) for a few days, or if there may be some advantage to using certain ingredients while they can be more easily absorbed.

Question 10

How long does it take for RF microneedling to work?

Accepted Answer

You may notice your complexion looking brighter and smoother within the first two weeks of treatment. Your results will continue to improve with each treatment session.

It takes time for your body to produce the new collagen and elastin, but within about six months you should see optimal results, including structural benefits like firmer skin.

See RF microneedling before and after photos

Question 11

Is RF microneedling permanent?

Accepted Answer

Like other nonsurgical skin rejuvenation treatments, RF microneedling is not permanent. Results last one to two years, depending on the device used, the intensity of your treatment, how your body responds, and your skin care routine.

Some patients do see improvements that last longer than two years, depending on the concern they’re treating, says Dr. Tanghetti. “For example, if you are treating acne scars, you could expect the improvements to last a number of years. For photodamage and skin aging, the duration of improvement may be less, unless these patients are concurrently using products like topical retinoids and sunscreen,” he says.

You can expect to need maintenance treatments to continue reaping the benefits.

To prolong your results, use medical-grade skin care and be diligent about wearing sunscreen with an SPF of 30 or higher every day, to prevent new sun damage.

Question 12

Is RF microneedling safe?

Accepted Answer

When it’s done right, RF microneedling is considered to be safe, with mild, temporary side effects. The treatment should cause only controlled microdamage—not real, lasting damage—to your skin.

Side effects like bleeding, scabbing, swelling, or flushing usually subside within a few days, if they occur at all. Possible pinprick marks from the needles should fade on their own within two weeks.

However, some RealSelf members who say it’s “Not Worth It” report long-term textural problems, visible pinpricks, or grid marks following their treatment.

An experienced provider should know precisely how much of an injury to create, without inducing those adverse effects.

Related: Everything You Need to Know About Microneedling Side Effects

Question 13

Can you have RF microneedling after fillers or Botox?

Accepted Answer

According to Dr. Tanghetti, "there is not consensus on this topic. Some providers feel that it is better to perform the RF microneedling series first, to determine the response of this modality, before proceeding with dermal fillers."

At his practice, they often recommend that patients finish with dermal filler, to correct any concerns that were not addressed by the RF microneedling series. "There is a question as to whether the RF microneedling might damage, alter, or remove the fillers," he notes. "This depends upon RF microneedle placement in the skin, and the placement of dermal fillers in and under the skin."

Not everyone is so cautious. “You are absolutely able to have RF microneedling after Botox and Juvedérm injections,” says Dr. Michele Green, a dermatologist in New York City. “I generally tell patients to wait two weeks after having injections to have these other procedures performed.” This timeline allows you to see the final results from your injectables.

An experienced provider will develop a treatment plan that best suits you.

Question 14

What are some alternatives to RF microneedling?

Accepted Answer

Your provider may recommend one of these skin rejuvenation treatments, either as an alternative or to improve your results.

Chemical peels exfoliate away surface layers of the epidermis with strong acids in order to improve cell turnover. This helps reduce dull or uneven skin tones, and minimizes the appearance of fine lines and wrinkles.
Laser resurfacing similarly creates micro injuries with targeted heat, to stimulate collagen and elastin production while removing damaged surface skin.
Vampire Facials pair microneedling with platelet-rich plasma (aka PRP), which contains growth factors that boost the skin’s healing response.

Related: The Treatments and Ingredients Actually Proven to Reduce Wrinkles

Question 15

Sources & studies

Accepted Answer

Chandrashekar, Byalekereshivanna, et al. “Evaluation of Microneedling Fractional Radiofrequency Device for Treatment of Acne Scars.” Journal of Cutaneous and Aesthetic Surgery, vol. 7, no. 2, Apr. 2014.

Dayan, Erez, et al. “Adjustable Depth Fractional Radiofrequency Combined With Bipolar Radiofrequency: A Minimally Invasive Combination Treatment for Skin Laxity.” Aesthetic Surgery Journal, vol. 39, May 2019.

Iriarte, Christopher, et al. “Review of Applications of Microneedling in Dermatology.” Clinical, Cosmetic and Investigational Dermatology, vol. 10, Aug. 2017.

MICRONEEDLING RF

Emil A. Tanghetti, MD

Kali Swenson

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	Potenza nonsurgical	Vivace nonsurgical	Secret RF nonsurgical	Genius RF Microneedling nonsurgical	Morpheus8 nonsurgical	Fractora RF nonsurgical	Profound RF nonsurgical
Worth It Rating	91%	86%	80%	65%	65%	83%	62%
Average Cost	$2300	$1115	$1295	$1993	$1834	$1138	$3952
Downtime	Little to no downtime	Little to no downtime	Minimal downtime	1 day of downtime	Little to no downtime	2 days of downtime	1 day of downtime
Anesthesia	Topical numbing cream	Topical anesthesia	Topical anesthesia	Topical anesthesia	Numbing cream or local anesthesia	Numbing cream and local anesthesia	Local anesthesia

	Chemical Peel nonsurgical	Laser Resurfacing nonsurgical	Vampire Facial nonsurgical
Worth It Rating	84%	89%	89%
Average Cost	$429	$2733	$1595
Downtime	Up to 2 weeks of downtime	1–12 days of downtime (depending on intensity)	Little to no downtime
Anesthesia	No anesthesia	Topical anesthesia	Topical anesthesia

Emil A. Tanghetti, MD

Kali Swenson

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