RF Microneedling for Acne Scarring

Radiofrequency microneedling energy device

What is Radiofrequency Microneedling?

Radiofrequency microneedling energy devices, such as the Sylfirm X, uniquely combine and improve upon the traditional benefits of both radiofrequency therapy and microneedling into one treatment.

RF devices operate via the use of radiofrequency energy to heat the skin at specific depths. The heat allows for immediate collagen contraction to produce a tightening effect whilst simultaneously engaging the skin’s natural repair process to ensure more collagen production is stimulated. The radiofrequency energy is usually unfocused in these devices and this means that a large bulk of the skin is heated each time in a process known as “bulk heating”.

Instead of using heat, microneedling relies on the mechanical act of micro-injuries to the skin (via the use of tiny needles injected into the skin) to break down existing scar tissue and to engage the skin’s natural repair process.

Illustration of how radiofrequency microneedling works on the skin

As a combination treatment – RF microneedling consists of the release of radiofrequency energy via tiny needles delivered into the skin. This improves on the existing standalone radiofrequency and microneedling technologies by:
1. Enabling radiofrequency energy to be delivered in a localised manner instead of a widespread area and
2. Allowing controlled injuries to the skin via the mechanical act of microneedles to stimulate rejuvenation via the skin’s natural healing process

This results in a safe and effective treatment modality that can treat a variety of conditions from acne scarring and large pores, to the tightening and lifting of skin for rejuvenation, and even pigmentation.

Benefits of RF Microneedling

  • Group 176
    Facial and Body Rejuvenation
    • Reducing the size of pores
    • Reducing the appearance of fine lines/wrinkles
    • Tightening skin laxity over the face/neck/chin/décolletage regions
    • Reduction of stretch marks
  • Group 176
    Reduction of Acne Scars
  • Group 176
    Treatment of Active Acne
  • Group 176
    Pigmentation disorders
    • Post-inflammatory hyperpigmentation
    • Melasma
  • Group 176
    Vascular disorders
    • Rosacea
    • Telangiectasia

Understanding Acne Scarring

How is acne scarring formed?

In order to understand why RF microneedling would be effective in treating acne scars, we need to understand how acne scars are formed.

Acne scars are formed due to 3 main reasons:

Fibrotic scarring, volume loss, and uneven skin texture

Fibrotic Scarring 
Inflammation and infection under the skin causes fibrous-like bands to form under the skin. These bands are called fibrotic scars which tether and pull the skin inwards, resulting in scarring and an uneven skin texture.

Volume Loss
Inflammation under the skin also causes tissue and collagen destruction, resulting in volume loss within the skin structure. This creates a ‘hole’ under the skin and causes the skin to sink inwards.

Illustration of Fibrotic Scarring vs Volume Loss

Uneven Skin Texture 
Infection from acne also causes the surface of the skin to become uneven due to the damage to the superficial skin layer. This damage creates superficial potholes on the skin, and at the same time causes pores to become bigger.

Traditionally, these reasons for acne scarring are treated individually by different treatments. RF microneedling can effectively treat all 3 reasons with just a single session, thus reducing the number of treatments needed with increased effects.

How does RF microneedling treat acne scarring?


Fibrotic Scarring
Fibrotic scarring is usually treated with subcision. Subcision is a process where a specialised needle is used to physically breakdown the scar tissue by ‘cutting’ these fibrous bands to release the tethered skin.
Illustration of traditional Subcision vs Sylfirm Subcision

RF microneedling achieves subcision with microneedles that can be calibrated to specific depths where different scars are situated. Microneedles (25 needles in each handpiece) are slowly ‘injected’ into the skin, reaching up to 4mm depth (deeper than any laser can reach).

These microneedles are able to break down the fibrous bands more effectively and quickly as they cover a larger surface area than just 1 needle used during subcision, and ensure that no areas are being missed out because of the close arrangement of the microneedles. Due to the very small diameter of the microneedles, it also is much more tolerable and less painful than traditional subcision.


Volume Loss

Volume loss resulting from tissue destruction under the skin is usually treated by injectables such as hyaluronic acid fillers or Rejuran S. These injectables can mostly be replaced by RF microneedling which delivers controlled and adjustable radiofrequency energy into the skin layers through the microneedles.

This radiofrequency remodels the skin to produce collagen and increases volume from within, thus ‘pushing’ the scars upwards without the need for injectables. Best of all, this volume stimulated by RF microneedling is permanent and does not disappear like fillers after a period of time.


Uneven Skin Texture
The uneven texture on the skin due to acne scarring is usually treated by fractional lasers such as the fractional CO2 laser, fractional pico laser, etc. These fractional lasers damage the surface of the skin, promoting repair and resurface the skin to make it smoother.

RF microneedling, because of the adjustable depths of the microneedles, can be adjusted to different depths on the surface to target more precisely all the superficial layers of the skin. The treatment is adjusted to different depths to cause damage and resurfacing while at the same time delivering radiofrequency energy to repair the skin and minimise pores.

Why choose RF microneedling for acne scarring treatment?

Faster and Effective Results
RF microneedling can treat all causes of acne scarring with 1 procedure, thus resulting in faster and more effective results.

Less Pain
Because of the smaller microneedles, RF microneedling is much less painful than traditional subcision. It is also less painful than most fractional lasers such as the fractional pico laser as it does not cause as much ‘explosive’ damage to the skin as the radiofrequency energy can be adjustable and controlled to match different depths of the skin and different scar types.

Cost Effectiveness
Due to the effectiveness and reduced number of treatments, RF microneedling can be more cost effective at treating scars compared to traditional treatments.

Reduced Downtime 
Surprisingly, one of the BIGGEST advantages of RF microneedling is the reduced downtime. Traditional procedures such as subcision and fractional CO2 lasers require about 1-2 weeks of downtime such as redness and scabbing. RF microneedling, because of its controlled energy and very small needles, has a much reduced downtime of 1-3 days.

Other Benefits
RF microneedling not only treats acne scarring, but at the same time minimises pores, reduces fine lines, and leaves the skin glowy and softer.

What happens during the procedure?

First, your skin will be gently cleansed before you are taken for a skin analysis. A thorough consultation with a registered medical professional will be done prior to any treatment.

Once your treatment has been discussed and agreed upon, a topical anaesthetic will be applied to reduce discomfort during the procedure. The numbing cream may be reapplied depending on treatment and pain tolerance. The topical anaesthetic is then removed after an adequate time has passed before the procedure is carried out.

Our doctor will then ensure that your skin is clean before carrying out the treatment. The RF microneedling tip will be firmly rested upon your skin firmly before every shot. Each shot sends radiofrequency energy via the microneedles that will be pushed into your skin. Treatments typically last for 20 – 30 minutes depending on the size and complexity of the area treated.

After the treatment is over, a cold gel and light therapy may be introduced to help reduce redness and aid healing.
RF Microneedling procedure for treatment of acne scars

How many sessions will I need?

As each person’s skin type and scarring is different, the number of sessions needed and the improvements seen in each session do depend on how your skin reacts to RF microneedling.

The depth, power settings and the frequency between treatments would generally determine how quick or visible the improvements are.

On average, the number of treatments are 2 or 3 times lesser than what other traditional procedures will require.

Side effects & aftercare

In general, side effects are minimal and are usually limited to:
  • Group 176
    Erythema (Redness)
  • Group 176
    Very mild swelling at higher energy settings
  • Group 176
    Post-inflammatory hyperpigmentation (uncommon)
Medical Doctor Performing RF Microneedling for Refining Pores and Glowy Skin on Woman's Face
Most patients typically experience 1 – 3 days of downtime. One may experience mild erythema or swelling. Longer downtime can be observed for those treating acne scarring, which typically requires treatment at deeper depths.
Improvements to the scars tend to be observed around a month after the treatment as time is needed for new collagen formation and remodelling to occur.
It is also the best time to apply skincare with healing benefits such as stem cell serums, or hydrating sheet masks!

A topical cream is usually prescribed to patients to reduce the chance of hyperpigmentation and infection. This should be applied diligently for the first few days. Adequate sun protection and moisturisation are also key for faster recovery and to reduce the chances of side effects.

Can RF microneedling be combined with other treatments?

Most definitely! However, not all treatments can be done together on the same day.

RF microneedling can be combined with other energy based devices or injectables for better or enhanced results, such as:

Medical Doctor Performing RF Microneedling for Acne Scarring on Woman's Face Skin
Cursor Image