The Microneedling Craze Is Here to Stay—But Do We Need It?

There's no doubt about it: Consumers are into microneedling. So much that a trend report published by Transparency Market Research in 2023 predicted the industry at large would be valued at $1.1 billion by 2031—with radiofrequency (RF) microneedling creating a lot of buzz on its own. Known as a step-up from traditional microneedling (which involves the insertion of tiny needles into the skin to trigger collagen production), RF microneedling combines radiofrequency energy to reach the deepest layers of your skin for better smoothing and tightening results. Basically, it’s no wonder why so many people are turning to microneedling, both RF and traditional, in 2024.

Still, if the thought of pressing multiple teeny needles in your face in the name of firmer skin gives you pause, we get it. To help break down whether it’s worth making an appointment with an expert for RF microneedling, we spoke to board-certified dermatologist Mariana Vergara, MD, and board-certified internal medicine physician Glenicia Nosworthy, MD, to discuss everything you need to know about RF microneedling before making your first appointment.

Experts in this article:

• Mariana Vergara, MD, a board-certified dermatologist and founder of Beauty Villa Vergara in Beverly Hills
• Glenicia Nosworthy, MD, an internal medicine physician specializing in aesthetic medicine at Glo by Glen in New York City

What is radiofrequency microneedling? 

Radiofrequency microneedling is a minimally-invasive cosmetic treatment that helps trigger fresh collagen and elastin production through a combo of deep-tissue energy and itty-bitty needles. The use of microneedles and radiofrequency creates micro “injuries” beneath the skin, which sends signals to your body to produce more collagen to repair it, resulting in firmer, plumper skin over time. 

Radiofrequency (RF), for the unfamiliar, is a type of electromagnetic energy that’s delivered into the deeper layers of the skin through microneedles. “The RF energy heats the skin tissue, stimulating collagen production and tightening skin," says Dr. Nosworthy. However, it's important to note RF microneedling still isn't necessarily a one-size-fits-all kind of deal. There are different devices, needle depths, and settings that are all important factors, and an experienced practitioner can help guide you to the right treatment.

Before getting into the details with device types, though, it’s important to understand how microneedling works. 

How does RF microneedling work? 

A microneedling device usually consists of a hand piece housing ultra-tiny needles. As for the treatment itself, the radiofrequency energy is delivered to the target area as the microneedles penetrate multiple layers of the skin. "The radiofrequency energy heats the tissue, causing a controlled thermal injury in the dermis, which is your middle layer of skin," explains Dr. Nosworthy. "This heat energy helps to further stimulate collagen production and tighten the skin." Your provider will gently press the device over the numbed treatment area and the needles will press into your skin. Again, depths can be tailored to your specific skin and goals. 

RF microneedling vs traditional microneedling

While both treatments create micro injuries in the skin, which in turn trigger collagen production, the addition of radiofrequency energy takes things to the next level by heating the skin tissue. "The combination of microneedling and radiofrequency stimulates collagen production more effectively than either treatment alone," Dr. Vergara says, leading to better skin tightening, wrinkle reduction, and firmness. Plus, you'll likely need fewer sessions. 

"Radiofrequency microneedling enters the deep layers of the skin and uses heat for skin tightening, which can provide better results," says Dr. Vergara. "For the best outcome, a series of three treatments every three to four weeks apart are needed." On the other hand, with traditional microneedling, a patient would need about six sessions to fully treat a condition like acne scarring, for example. 

The different types of microneedling devices

Not all RF microneedling devices are created equal, so during your consultation, you should ask your provider which device type they plan to use for your specific concerns. In general, microneedling devices are split into four types: fractional, non-fractional, bipolar, and monopolar. Here’s a quick breakdown of each (though don’t stress—your physician will choose the best for your skin needs):

Fractional RF microneedling

According to Dr. Nosworthy, fractional RF uses insulated needles to deliver energy to targeted areas of your skin. "RF energy is only delivered through the tips past the epidermis, which is the top layer of skin, leading to faster healing and less downtime," she says. This type of RF microneedling is best for addressing fine lines, wrinkles, acne scars, and laxity.

Dr. Vergara uses Matrix Pro (a fractionated RF device) which has the smallest needle size on the market—which translates to less pain and downtime—while being able to "deliver energy in three different depths with one entry or pulse." Essentially, it can go deeper into the skin with one pass than other devices that can require multiple passes. Morpheus8 is another popular fractional RF device loved by experts and celebs for its powerful depths and its efficacy on larger treatment areas, like the stomach and arms. 

Non-fractional RF microneedling

Non-fractional RF devices deliver RF energy through solid microneedles that heat the whole treatment area (unlike fractional RF, which delivers heat to targeted areas). "Non-fractional treatments are typically more aggressive and may require more downtime compared to fractional RF microneedling," Dr. Nosworthy says. "Non-fractional RF microneedling is often used for topical concerns—like hyperpigmentation and acne scars—and also for deeper tissue remodeling.”

Bipolar RF microneedling

"Bipolar RF microneedling devices have two—'bi'—electrodes on either side of the treatment area to deliver radiofrequency energy," Dr. Nosworthy says. "This technology is designed to heat the tissue between the electrodes, stimulating collagen production and tightening the skin," she says, making bipolar RF ideal for anyone looking to improve skin texture and laxity. 

Bipolar differs from fractional and non-fractional because it delivers radiofrequency energy via two electrodes (rather than needles). So while it will heat up more skin tissue thanks to its two electrodes, bipolar devices usually don’t penetrate as deep in the skin’s layers as non-bipolar devices. 

Monopolar RF microneedling

Monopolar RF microneedling devices use a single (mono) electrode to deliver energy into your skin (unlike bipolar, which uses two—hence “bi”). "The energy flows between the electrode and a grounding pad placed on your body, creating a circuit that heats the targeted tissue," says Dr. Nosworthy. Monopolar RF microneedling is commonly used for skin tightening and body contouring, and tends to be the least "intense" of all RF microneedling devices.

What concerns does RF microneedling treat?

RF microneedling treats a wide range of skin concerns, including wrinkles, fine lines, skin laxity, enlarged pores, uneven skin tone, and bumpy or scarred texture. Experts say the treatment can also address stretch marks (although you should manage your expectations on results, since nothing can completely get rid of stretch marks). 

Here's just a brief look at what RF microneedling can address—and how:

Fine lines and wrinkles

"RF microneedling stimulates collagen production and skin tightening, which can help reduce the appearance of fine lines and wrinkles, particularly on the face, neck, and chest," Dr. Nosworthy says. 

Skin laxity

The heat generated by radiofrequency energy makes it perfect for tightening skin. According to Dr. Nosworthy, RF microneedling "promotes collagen remodeling and skin tightening, making it an effective treatment for improving skin laxity and sagging."

Acne scars

RF microneedling stimulates collagen production and skin regeneration, leading to "smoother and more even skin texture," says Dr. Nosworthy. That's why experts highly recommend the treatment for acne scars, like icepick or rolling scars.

Enlarged pores

While you technically can't shrink the physical size of your pores, RF microneedling can help minimize their appearance by stimulating collagen production and evening out your skin texture.

Uneven skin tone and texture

"RF microneedling can address uneven skin tone, rough texture, and sun damage by promoting collagen production and skin renewal, leading to more even skin over time," Dr. Nosworthy says.

Stretch marks

Overall, skin rejuvenation triggered by collagen production can help minimize the appearance of (but not fully get rid of) stretch marks, while also helping to firm and tighten skin.

Who’s a good candidate for RF microneedling? 

Both Dr. Nosworthy and Dr. Vergara agree that RF microneedling is great for a wide range of patients. Ideal candidates include anyone looking to tighten your skin, even out your skin tone, smooth bumpy skin textures, and reduce the look of enlarged pores or stretch marks. 

Unlike many other minimally invasive treatments on the market, RF microneedling is generally a safe option to use on non-reactive skin types and skin tones. However, you should always work with a dermatologist who is well-versed in working with a diverse range of patients to ensure you receive the highest level of care. 

What can I expect during a RF microneedling treatment? 

Once you consult with a dermatologist and book an appointment for microneedling, you should prepare yourself for your appointment (which, we promise won’t be as scary as it seems). From start to finish, it's important to have open communication with your dermatologist about the best methods for preparing your skin for treatment. Knowing what will happen during and after treatment, as well as discussing specific aftercare instructions post-procedure, is key for optimal results. 

Before the procedure:

There's no need to abstain from any specific skin-care products leading up to your session, unless otherwise noted by your doctor. However, if you find anything to be sensitizing your skin or causing irritation, you'll want to pause use ahead of time. You'll also want to ensure you don't have any active skin infections or open wounds at the time of treatment. 

Once you've arrived at your doctor's office, they will prep your skin for the procedure. "Before the RF microneedling treatment, your doctor will clean the area with alcohol," says Dr. Vergara. "Topical anesthesia is usually applied for 40 minutes prior, then the area is marked before we begin." 

During the procedure:

"During a radiofrequency microneedling treatment, a device with fine needles is used to create controlled micro injuries in the skin while delivering radiofrequency energy to the deeper layers of the skin," Dr. Nosworthy says. Think of it like a fancy stapler with tons of tiny needles that get pressed into the skin.

The number of passes your doctor will do depends on the severity of your individual skin concerns. In terms of pain, you will be numbed, but you may still experience mild discomfort and stinging depending on the device and your skin's density. According to Dr. Nosworthy, some of her patients do find the service painful, but again, this truly depends on the person. 

Downtime should be minimal and the treatment area might be red and inflamed immediately after. Generally, if you’re treated with a one-pass device, there will be less inflammation. However, if you need multiple passes, your skin might be redder and swollen for a few days (or, in some cases, a week). The duration of your treatment will also depend on the areas and concerns being treated. A session focused on the face might move much quicker than one focused on a larger area like the stomach.

After the procedure: 

According to Dr. Nosworthy, aftercare will vary depending on the patient and the intensity of the treatment. But generally speaking, Dr. Vergara suggests washing the treated area twice daily with a mild cleanser in lukewarm water and gently patting dry. She also suggests following up with a moisturizer or serum formulated for sensitive skin, or one specifically created for post-procedure healing. 

"Patients should also avoid strenuous exercise, hot baths, saunas, and activities with excessive sweating for several days post-treatment," Dr. Vergara adds. "Ingredients like retinol and vitamin C should be avoided for one week post-procedure on the treated area." 

Patience is key in terms of when you can expect to notice results. "It's typically gradual and [skin will] improve over time as the collagen remodeling process continues," Dr. Nosworthy says. That said, taking a photo prior to treatment may be a good idea to help you track and evaluate your progress if you’re doing multiple sessions, she suggests.

What are the side effects of RF microneedling? 

Immediately after microneedling, your skin might be red, swollen, and sensitive for a few hours, but it should return to normal within a few days to a week. Dr. Vergara says that you may also experience bruising, dryness, flaking, itchiness, infection, or hypopigmentation (lightening of the skin) in rare cases. "RF microneedling is a minimally invasive procedure with minimal downtime compared to more aggressive treatments," Dr. Nosworthy says. However, if you experience any of these side effects that worsen, make an appointment to see your dermatologist asap for treatment. 

How much does RF microneedling cost? 

The cost of RF microneedling will vary depending on several factors, including your location, the expertise level of your provider, the specific device used, and the number of sessions you choose to undergo. However, Dr. Vergara and Dr. Nosworthy generally estimate that treatment can cost anywhere from $200 to $2,000 per session. 

Does RF microneedling really work? 

The effectiveness of RF microneedling depends on the individual patient, how their skin responds to these treatments, and the effectiveness of the particular device. Dr. Vergara, however, loves RF microneedling. "I think it is an amazing treatment to prevent [the signs of aging] and maintain a 'youthful' appearance," she says. She adds that due to its benefits, it may even help delay or prevent the desire for invasive plastic surgery in the future. 

However, Dr. Nosworthy is only partially convinced RF microneedling is the best option for many of her patients. While she understands why the procedure has increased in popularity over the years, some have given her the feedback that they aren't a fan of having to do multiple initial sessions followed by maintenance treatments, while others find the pain to be unbearable. All things worth considering, which is also why working with an experienced provider is crucial to ensure device settings and depths are safe and suitable for your skin. 

Final takeaways 

Look, the truth is, no one needs to get any minimally invasive, anti-aging treatment done—even this one. Aging is a natural process, and getting a procedure done is a personal choice. If skin laxity, acne scars, fine lines, or even enlarged pores are on your list of skin concerns, then you might be a good candidate for RF microneedling.

Still, it's best to speak with a highly experienced dermatologist who works with a variety of RF devices and has a diverse range of clients (check their Instagram! Read their reviews!). This will ensure they can develop a personalized treatment plan by recommending the best device for your needs, and can safely and effectively work with all skin types, textures, and tones. 

Hero Illustration by Janet Mac