In the 2026 split-face trial, radiofrequency microneedling recovered faster and caused fewer pigment problems than fractional carbon-dioxide laser for atrophic acne scars. Rolling scars are broad, shallow dents with sloping edges that make skin look wavy.
The trial put one treatment on each side of the face. Both sides improved scars in this small exploratory sample, so neither was ineffective, according to the U.S. National Library of Medicine PubMed record the PubMed record.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- What did the 2026 split-face trial compare?
- How did recovery and pigment safety differ?
- What does this mean for rolling scars and darker skin?
- What should you ask before a procedure?
What did the 2026 split-face trial compare?
The study was a prospective randomized split-face trial. One facial side received radiofrequency microneedling and the other side received fractional carbon-dioxide laser for facial atrophic acne scars.
Both treatments improved atrophic scars in the small sample. The trial did not prove superiority specifically for rolling scars alone, according to the PubMed abstract conclusions.
How did recovery and pigment safety differ?
Radiofrequency microneedling offered faster recovery, fewer pigmentary events, higher efficacy satisfaction after the first session, and higher safety satisfaction at all follow-ups, according to the Taylor & Francis Journal of Dermatological Treatment report the Journal of Dermatological Treatment report. A 2026 meta-analysis of randomized trials found redness lasted a mean 1.72 days longer after fractional CO2 than after microneedle radiofrequency, according to the Wiley Journal of Cosmetic Dermatology the Journal of Cosmetic Dermatology meta-analysis.
That analysis also found significantly higher pain and post-inflammatory hyperpigmentation risk with CO2. Expected downtime differs markedly in practice reviews. Ablative fractional CO2 commonly involves 7-10 days out of public view with oozing and crusting then pinkness, versus about 48-72 hours of pinpoint crusting for RF microneedling.
What does this mean for rolling scars and darker skin?
For Fitzpatrick skin types III-V, fractional microneedle radiofrequency and fractional CO2 were similarly effective for atrophic scars. Radiofrequency had less downtime and less hyperpigmentation, which matters most for pigment-prone patients, according to the Journal of Cutaneous and Aesthetic Surgery study.
Rolling scars need their own plan because the main trial covered atrophic scars broadly. In a separate split-face evaluator-blinded study focused on rolling scars, multiple subcisions improved rolling-scar appearance versus untreated control at 36-week follow-up, according to Springer Medicine. In that study, 50% reported greater satisfaction on the treated side.
What should you ask before a procedure?
Samples were small, exploratory, short-term, and covered atrophic scars broadly. People with rolling scars should ask about personal pigment risk and practical recovery, based on trial limitations and recovery guidance.
Bring photos of past dark marks after pimples, peels, or burns. Ask for written aftercare, time off work, and when to call about spreading redness, crusting, or darkening.
- What is my Fitzpatrick type and prior pigmentation or melasma history?
- What sun protection do I need before and after?
- How many sessions will I likely need?
- What downtime should I expect in this clinic setting?
- Which option fits rolling scars plus my pigment risk?
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