RF microneedling.

A grid of fine needles enters the skin to a depth we set for the area being treated, then delivers bipolar radiofrequency between them. That produces small, controlled zones of thermal coagulation in the dermis — the layer where collagen and elastin live.

We use both insulated and non-insulated needles. Insulated needles are sheathed along the shaft and release energy only at the tip, so the heat lands at one depth we choose. Non-insulated needles are active along the whole shaft, so a single pass heats a column of tissue from just under the surface down to the tip. Neither type is better than the other — they do different jobs, and which we reach for depends on the area and what we are treating. We won’t tell you that one type is inherently safer than the other, because that comparison has not been established in patients.

The healing response to those zones is the treatment. New collagen is laid down over the following weeks and months, which is why the result builds rather than appears. It is a different mechanism from Dermapen 4 microneedling, which creates mechanical channels without a thermal component, and different again from Er:YAG resurfacing, which works by removing the surface.

Reasonable indications

• Early to moderate skin laxity — jawline, lower face, neck
• Atrophic acne scarring, often over a longer series
• Fine lines and crepey texture
• Enlarged pores and general skin quality
• Some surgical and traumatic scars, as part of a layered scar protocol

Where it fits is between needling and resurfacing: more effect on laxity than microneedling alone, less downtime and less pigment risk than ablative laser. For pigment and vascular concerns it is the wrong tool — IPL and the pigment laser do that work better.

Topical anesthetic first, then roughly twenty to forty minutes of treatment depending on the area. Expect redness and mild swelling for one to three days, sometimes with pinpoint crusting or a faint grid pattern that settles within a week. Most patients are presentable the next day.

Plan on three sessions four to six weeks apart; scarring usually needs more. The fuller result shows around three to six months after the last session, as remodeling completes. Aftercare products for the healing window are included in the procedure price — consistent with why we don’t sell retail skincare.

Radiofrequency heats tissue by its resistance to the current passing through it, rather than being absorbed by melanin the way laser light is. The mechanism does not depend on how much pigment your skin carries. Across the published work in Fitzpatrick III–VI skin, reported rates of post-inflammatory hyperpigmentation are low and mostly transient, and in the two split-body trials that compared them head to head, RF microneedling disturbed pigment less than ablative carbon-dioxide resurfacing. Low is not zero, and the studies behind those numbers are small. We take a full history, and a melasma or PIH history may mean we pre-treat.

Worth being precise about what this is not. We do not offer radiofrequency-only devices for fat reduction, where the independent evidence is thin. RF microneedling for collagen remodeling is a separate indication with a separate and stronger evidence base — which is the reason one is on our menu and the other is on the list of things we don’t sell.