The 2026 split-face trial studied adults with facial atrophic acne scars, which are depressed pits left after acne heals. Radiofrequency microneedling gave faster recovery and fewer pigment problems than fractional carbon dioxide laser, but only for that depressed facial scar group. Doctors treated one cheek area with radiofrequency microneedling and the other with fractional CO2 laser in the same person.
Both sides improved in that small exploratory sample, according to the U.S. National Library of Medicine PubMed in its PubMed trial record. That head-to-head design makes recovery and color changes easier to compare.
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 each treatment does
- How recovery and pigment safety compared
- Who was studied
- Who was not studied and what to check
What each treatment does
Radiofrequency microneedling uses fine needles plus heat placed in the deeper skin. Fractional CO2 laser uses focused light beams that remove tiny columns of surface skin. Both aim to trigger new collagen and soften depressed scars over time.
Sessions involve numbing, brief heat or light exposure, then redness and flaking. Radiofrequency microneedling leaves the surface more intact than ablative laser. CO2 resurfacing creates more surface wounding, so wound care and sun protection matter more.
How recovery and pigment safety compared
Radiofrequency microneedling showed faster recovery, fewer pigmentary events, and higher safety satisfaction than fractional CO2 laser in that sample. Patients also reported higher efficacy satisfaction after the first radiofrequency microneedling session and higher safety satisfaction at every check, according to the Journal of Dermatological Treatment in its journal abstract. Pigment risk still deserves attention with laser resurfacing.
Fractional CO2 resurfacing carries post-inflammatory darkening risk, especially for darker Fitzpatrick types and people with prior pigmentation or melasma history, according to the Journal of Cosmetic Dermatology in its Hang et al. review. A laser-medicine primer reports low scarring or darkening risk for skin of color with these treatments, particularly radiofrequency microneedling because heat spreads differently.
Who was studied
The trial enrolled people with depressed facial atrophic scars. These scars sit below the skin surface after inflamed acne clears. Common types include icepick, boxcar, and rolling pits.
Atrophic scars differ from raised scars that grow above the surface. The study did not test raised hypertrophic scars or keloids, which extend beyond the injury from excess collagen. If your scars are raised, thick, or growing, this trial does not describe your case.
Who was not studied and what to check
The authors called it an exploratory split-face sample, so results are preliminary. The findings do not prove equal benefit for active acne, body scars, keloid-prone people, pregnancy, or all skin types. Use this quick check before booking a consult: Bring photos of past dark spots after acne, burns, or procedures, plus a list of lightening products and retinoids you use.
- My scars are depressed facial pits, not raised or spreading scars
- My acne is quiet, with no open sores or current prescription change
- I can list pigment history, melasma, tanning habits, and Fitzpatrick type
- I can follow downtime, wound care, and strict sun protection
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