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Fraxel vs RF Microneedling

Fraxel: A laser that heats thousands of microscopic columns in the skin and leaves the skin between them untouched. Used for sun damage, acne scars, and rough texture. It takes a course of treatments and a few days of looking sunburned each time.

RF Microneedling: Microneedling with heat added. Insulated needles carry radiofrequency energy to a set depth in the skin, so the healing response comes from both the puncture and the heat. It is used for indented acne scars, texture, and mild sagging.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist
Last updated: 10/22/2026
Editorial illustration for Fraxel, based on the entry’s treatment or equipment reference.Editorial illustration for RF Microneedling, based on the entry’s treatment or equipment reference.
Choose ifKey differencesWhat is it?What it treatsTreatment areasSkin tonesHow it worksBefore your treatmentDay of treatmentAfter your treatmentRisksCostQuestionsRelated

Choose Fraxel if…

Choose for acne scars or sun damage with a few days of downtime per session instead of the week-plus of ablative lasers.

  • Rolling or boxcar scars
  • Sun spots and rough texture
  • You can plan 3–5 sessions

Choose RF Microneedling if…

Choose for acne scars and texture with some tightening, with a lower pigment risk than resurfacing lasers.

  • Rolling or boxcar acne scars
  • Mild sagging too
  • Deeper skin tone where lasers are riskier
Alternatives, not combined

Can you have both?

Both build collagen for scars and texture. RF microneedling is safer for darker skin; Fraxel is often stronger for pigment. One is usually chosen.

Key differences

● Fraxel
● RF Microneedling
DowntimeNone → 2+ weeks
3–7 days
3–7 days
PainMinimal → Needs anesthesia or sedation
Moderate
Moderate
Results showImmediately → 3+ months
1–3 months
1–3 months
How long it lastsWeeks → Years or permanent
Years or permanent
Years or permanent
Visits neededOne → Every few months
A longer series (4–6+)
A short series (2–3)
Cost per visit$ → $$$$$
$$$
$$$
ReversibleYes, can be undone → No, permanent
No, permanent
No, permanent

What is it?

Fraxel

RF Microneedling

What is it?

It is a nonablative fractional laser.

Fraxel heats microscopic zones while sparing skin in between.

Platforms differ.

Wavelength and device determine the treatment.

It is not CO2 resurfacing.

It is less intensive than ablative lasers.

It is not risk-free.

Burns, redness and pigment changes can occur.

It combines needles and energy.

Radiofrequency energy is delivered into or beneath the skin.

It is a medical procedure.

It differs from conventional microneedling and home rollers.

Serious complications are reported.

The FDA has noted burns, scarring, fat loss and nerve damage.

Device and depth matter.

These should be discussed before consenting.

What it treats

Evidence level
Fraxel
RF Microneedling
Strong evidenceMost established uses
Acne scarring on light skin. Small sharply cut pits and broad shallow dips across a cheek, several sitting inside faint flat pink marks, with no active spots.

Acne Scarring

Improves rolling and boxcar scars.

AI-generated educational illustration of Sun Spots: 1. Sun Spots Header — Light Skin; Lighter skin. Not a clinical photograph.

Sun Spots

Clears sun damage.

Acne scarring on light skin. Small sharply cut pits and broad shallow dips across a cheek, several sitting inside faint flat pink marks, with no active spots.

Acne Scarring

Improves rolling and boxcar scars.

Rolling Scars.

Rolling Scars

Heat remodels soft dips.

Moderate evidenceSome supportive research
A relaxed forehead with faint shallow horizontal fine lines.

Wrinkles and Fine Lines

Smooths texture.

Sagging Skin on light skin.

Sagging Skin

Mild tightening.

Limited evidenceEarly or small studies
Flat tan patches with soft irregular edges across the forehead and upper cheek of an adult with light skin, the surface completely smooth.

Melasma

Low settings may help some.

Enlarged Pores on light skin.

Enlarged Pores

May shrink pores.

Little evidence
Ice Pick Scars on light skin.

Ice Pick Scars

Too deep for most sessions.

Ice Pick Scars on light skin.

Ice Pick Scars

Needs TCA CROSS or punch excision.

A relaxed forehead with pronounced deep horizontal furrows.

Deep Wrinkles

Modest change on deep folds.

Can make it worse
Redness and fine superficial vessels across a light-skinned cheek and nose.

Rosacea

Can worsen redness.

—

Treatment areas

Treatment areas

Face and hands.

Face and neck; depths and coverage depend on the treatment plan.

Skin tones

Skin tone
● Fraxel
● RF Microneedling
Lighter skin
Low risk
Redness and swelling for days.
Low risk
Redness and swelling for days.
Medium skin
Some risk
Dark marks possible; lower settings help.
Low risk
Insulated needles protect the surface.
Deeper skin
Some risk
Safer than ablative lasers at lower density with an experienced provider.
Some risk
Lower pigment risk than lasers; grid marks or dark spots possible.

How it works

Fraxel

RF Microneedling

How it works
Fraxel DUAL diagram: 1927 nm reaches up to 0.3 mm and 1550 nm up to 1.6 mm, depending on settings.
RF Microneedling mechanism diagram. Needles enter the skin: A device places fine electrodes at a selected depth. RF energy heats nearby tissue: Controlled heating occurs around active needle segments. Repair remodels tissue: The healing response can change collagen and skin texture.
Diagram explanation

Fractional heat zones leave surrounding tissue untreated. Superficial 1927 nm treatment helps fade uneven pigmentation; deeper 1550 nm treatment triggers repair and collagen remodeling.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

Needles enter the skin: A device places fine electrodes at a selected depth. RF energy heats nearby tissue: Controlled heating occurs around active needle segments. Repair remodels tissue: The healing response can change collagen and skin texture.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

Before your treatment

Fraxel
RF Microneedling
2–4 weeks before

4 weeks before: Sun: Avoid tanning, self-tanner and sunburn.

Pigment preparation: For deeper skin tones, providers may prescribe a pigment-lowering cream for 2–4 weeks and test near the ear.

Pigment cream and sun: Do not arrive tanned or sunburned.

Pigment cream and sun: On deeper skin tones, many providers prescribe a pigment-blocking cream for two to four weeks first.

The week before

Cold sores: Tell your provider; preventive antiviral medicine often starts the day before.

Hair removal: Stop waxing, threading and hair-removal creams.

Actives: Stop retinoids, retinol and acids 3–7 days before.

Actives and hair removal: Stop retinoids, benzoyl peroxide and exfoliating acids about 5 days before.

Actives and hair removal: No waxing or hair removal creams on the area.

Day of treatment

Fraxel
RF Microneedling
Before you arrive

Arrive with clean skin and no makeup.

Arrange a ride if you will have strong settings or oral pain medicine.

Clean face: Clean face, no makeup.

Clean face: If injected anesthetic is planned, expect a long appointment and a ride home if anything sedating is used.

Arrival & prep

Skin is cleaned and photographed. Numbing cream stays on for 45–60 minutes.

Skin is examined and photographed, and the provider maps depths for each area — shallower around the eyes and forehead, deeper over scarred cheeks and the jaw.

Treatment

The laser passes over the skin while cold air cools it.

Expect prickly heat that builds with each pass, often strongly uncomfortable—especially on the forehead and around the mouth.

The handpiece is pressed on the skin and fired one stamp at a time in a grid, not glided.

A full face takes 20 to 45 minutes, often with passes at several depths. With cream alone the sting is sharp, worst on the forehead and jaw; with injected anesthetic it is mostly pressure and heat.

Before you leave

Skin feels hot, red and swollen. Ice packs and a bland ointment are usually applied.

Red, hot and swollen, with a visible grid of small dots.

After your treatment

Fraxel
RF Microneedling
First 24 hours

Days 1–2: Redness and swelling, especially around the eyes.

Days 1 to 2: Swelling is worst the first morning, especially around the eyes and jaw, enough to change how your face looks.

Days 2–7

Days 3–7: Rough, bronzed skin flakes away. Do not scrub or pick.

Days 3 to 10: Swelling drops, redness fades to pink, and the skin feels sandpapery with the grid faintly visible.

Beyond 1 month

1–3 months: Time to results.

Scar improvement can last years; sun damage can return with sun exposure.

Months 1 to 6: Firmness and texture keep changing after the visible healing.

Time to results
Not specified

1–3 months, improving to 6

How long results last
Not specified

Years for scars

Risks

Risks
  • Dark patches
  • Worsening redness
  • Cold sores
  • Acne or white bumps
  • Lighter patches
  • Dark patches
  • A visible grid that will not fade
  • Prolonged swelling or redness
  • A hollow or a change in face shape
  • A cold sore outbreak

Cost

Per session

About $900–1,500 for a full face in the US. Smaller areas cost less.

In the US, a full-face session generally runs about $700 to $1,500, and a package of three commonly falls between $2,000 and $4,000.

Full course

Several thousand dollars. Packages may reduce the per-session price.

Not specified
Insurance

Cosmetic treatment is not covered. Coverage for surgical or injury scars is uncommon.

Insurance does not cover it, since it is classed as cosmetic.

Questions

Fraxel

RF Microneedling

Individual Questions
How many Fraxel sessions will I need?

Three to five, two to four weeks apart. Sun damage sometimes needs fewer, acne scars usually need the full course, and deeper skin tones are treated at lower settings, which means more sessions.

Does Fraxel get rid of acne scars?

It improves them rather than removing them. Studies of nonablative fractional lasers show partial improvement in scar depth and appearance over a course. Deep icepick scars respond least and are often better treated by combining the laser with subcision or filler.

How much downtime is there really?

Plan for a week. Two days of redness and swelling, then a few days of rough, bronzed skin that flakes off. Most people cover it with makeup from day three and look normal by day seven.

Does it hurt?

With an hour of numbing cream and cold air, most people call it hot and strongly uncomfortable rather than unbearable, and it stops as soon as the laser does. The forehead and around the mouth are the worst.

Is it safe for deeper skin tones?

It can be done, but differently. The main risk is temporary dark patches. Lower settings, more sessions, pre-treatment creams and strict sun protection all lower that risk, and the provider experience with your skin tone matters more than the device.

Is Fraxel the same as CO2 laser?

No, though one device sold under the Fraxel brand is a carbon dioxide laser. The Fraxel most people mean is nonablative, heating the skin without removing the surface. A carbon dioxide laser removes tissue, does more per session, and brings one to two weeks of downtime and more pigment risk.

Is Morpheus8 the same as RF microneedling?

Morpheus8 is one brand of radiofrequency microneedling device. Profound, Vivace, Genius, Secret RF, Scarlet and Sylfirm X do the same job. Needle insulation, depth, energy and the operator determine the outcome.

Does it work on acne scars?

Partly, and over a course. Rolling and boxcar scars become shallower across about three sessions. Icepick scars respond poorly. Expect improvement, not clearance.

Will it tighten my jawline?

Modestly, if the laxity is mild and early. It firms rather than lifts. Skin that visibly hangs will not respond, and a surgical consultation is the more honest next step.

How much does it hurt?

More than plain microneedling. Numbing cream alone leaves a sharp hot sting, so many providers add injected anesthetic or nerve blocks at deeper settings. With those it is mostly pressure and heat.

Is it safe on deeper skin tones?

Generally safer than ablative lasers, since melanin does not absorb the energy. Dark marks are still possible from the heat, sometimes in the grid pattern, and they fade over months. Ask about insulated needles and conservative starting settings.

Can it cause fat loss in the face?

Yes, and it is the risk worth understanding. Deep, high-energy settings in a thin face can shrink the fat under the skin, leaving a hollow that does not reliably return. Conservative settings built up over sessions, and a provider who takes the question seriously, are the protection.

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