What it is
The device combines two things: fine needles that enter the skin to a pre-set depth, and radiofrequency energy released from their tips. The needling alone prompts healing; the energy adds controlled heating in the target layer that stimulates collagen remodelling.
Setting the depth is the substance of it: the forehead is not the cheek, and the neck is not the lower face. The wrong depth either does nothing or causes harm.
What it does not do: it does not replace lost volume and does not treat marked laxity. The improvement is in texture and quality, with limited tightening.
Where it is used
- The face generally: texture and enlarged pores
- The lower face and jawline
- The neck
- Acne scarring — this has its own page, linked below
- Areas of the body in selected cases
When it shows, and how long it lasts
The effect is gradual. Redness and the fine grid marking settle over days, then improvement in texture begins to show over weeks and continues for months as remodelling occurs.
Most cases need more than one session, spaced according to examination and response.
Who it suits
- Those more bothered by skin texture or pore size than by lines
- Those with mild laxity who accept limited improvement rather than surgical tightening
- Those who can tolerate some days of redness and needling marks
- Those able to commit to sun protection before and after
When we advise delaying or not treating
- Pregnancy and breastfeeding
- Active infection or severe inflamed acne in the area
- Recent isotretinoin use — timing is discussed
- A known tendency to keloid scarring
- An implanted medical device affected by radiofrequency — always asked about
- Recent heavy sun exposure or an active tan — we postpone, because pigmentation risk rises
- An expectation of a surgical lift result
- Anyone unable to commit to sun protection; here that commitment is part of the treatment, not passing advice
How the session goes
- Examination, mapping of areas and depths, and a review of medical history and medicines.
- Numbing cream applied well before the session.
- Passing the handpiece over the area at one or more depths as planned.
- Sensation varies; the neck and forehead are usually more sensitive.
- Cooling and soothing afterwards, with written aftercare instructions.
Afterwards
- Redness and warmth on the first day, which may extend beyond it
- Fine grid marking that remains for some days
- Dryness and light flaking are possible
- Avoid make-up for the first hours, as instructed
- Strict sun protection — this is not optional
Possible effects
- Redness, swelling and grid marking — expected and temporary
- Bruising, particularly in thinner areas
- Post-inflammatory pigmentation: the principal concern in deeper skin tones. Reduced by conservative settings, by not treating after recent sun exposure, and by strict protection afterwards
- Infection — uncommon, and managed early
- Burns or scarring — rare, associated with inappropriate depth or energy
- Reactivation of cold sores in those with a history — mentioned beforehand so precautions can be taken
A note on darker skin
Radiofrequency microneedling depends less on skin pigment than lasers that target melanin, which is why it is offered for Fitzpatrick types IV to VI more readily than many alternatives. That does not mean the risk is absent: post-inflammatory pigmentation remains the most likely problem. What reduces it in practice is conservative settings to begin with, postponing when there is a recent tan, and committing to sun protection before and after.
See also
Morpheus8 for acne scarring, Ultherapy
Common questions
How many days before I can go back to work?
Redness and grid marking usually settle within days, varying between people and with the intensity of the session. We plan the timing around your commitments.
Does it hurt?
Numbing cream is used. Sensation is noticeable, particularly on the forehead and neck, and varies between people.
How many sessions will I need?
The examination and your response between sessions decide. Most cases need more than one.
Does it suit darker skin?
It is offered more readily than many lasers because it depends less on pigment, with extra precautions for pigmentation.
Does it treat sagging?
It does not treat marked laxity. The improvement is in texture and quality, with limited tightening.
What if I am taking isotretinoin?
Tell the doctor. Appropriate timing is discussed rather than risked.
Can it be combined with botulinum toxin?
Usually yes, with the order and timing decided by examination.
Can it be done in summer?
It can, but sun protection becomes harder and more important. Sometimes we postpone.