Damage from RF microneedling - what treatments will help orange peel skin? (Photos)

Question

I had RF microneedling in January 2025 and have since been told that I now have rosaeca. I have orange peel texture on both cheeks and specifically one cheek is much worse with still a patten of what appears to be a track mark. Will this eventually get better or is there anything I can do further halt the damage it’s caused?

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

RF microneedling can sometimes lead to textural changes like orange peel skin, especially if there is underlying rosacea. Here are a few treatment options that might help improve your skin texture and manage rosacea:

Topical Treatments: Consider using products containing niacinamide, hyaluronic acid, or peptides to help improve skin texture and hydration. Prescription treatments like azelaic acid or metronidazole may help manage rosacea symptoms.

Laser Therapy: Pulsed dye laser or intense pulsed light (IPL) therapy can be effective in reducing redness and improving skin texture associated with rosacea.

Chemical Peels: Superficial chemical peels may help in smoothing the skin texture. However, they should be used cautiously and under professional guidance to avoid aggravating rosacea.

Gentle Skincare Routine: Use a gentle, fragrance-free cleanser and moisturizer to maintain skin barrier function and avoid further irritation.

Lifestyle Modifications: Identify and avoid triggers that may worsen rosacea, such as spicy foods, alcohol, and extreme temperatures.

Consultation with a Dermatologist: A thorough evaluation by a dermatologist can help tailor a treatment plan specific to your needs and monitor your progress closely.

While some improvement can be expected over time, a combination of treatments and lifestyle adjustments is often necessary to achieve optimal results.

Damage from RF microneedling - what treatments will help orange peel skin? (Photos)

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Damage from RF microneedling - what treatments will help orange peel skin? (Photos)

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Everything you need to know about Microneedling

Our mission is to create a world where every investment in modern beauty is Worth It.