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I have been using Profhilo routinely with gratifying results for well over a dozen years in my Israel satellite practice where it was regulatory agency approved long, long before the FDA came lumbering around to only just recently approve it here in the U.S. as Skinvive. Better late than never. I have used it alone or in combination with professionally performed manual microneedling (no need for the added expense or risks of RF microneedling). So, the short answer is that long experience shows that it may be used in separate sessions or even during the same treatment session when it can enhance the benefits of the microneedling. Hope this helps. Best of luck.