The 2026 33-patient split-face trial improved atrophic scars with both methods, but radiofrequency microneedling healed faster with fewer pigmentary events than fractional CO2 laser. Atrophic scars are sunken pits left after acne, and the findings point to recovery, pigment risk, and scar type to discuss first. Thirty patients completed the study, with one cheek treated by each method under blinded evaluation, according to the U.S.
National Library of Medicine. The work is listed by JMIR Dermatology citations as Li et al. in Journal of Dermatological Treatment 2026 volume 37 issue 1. The registered design uses split-face treatment and blinded investigators.
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 33-patient trial test?
- Which improved scars and which healed easier?
- Why does scar type come first?
- What should you ask before booking?
What did the 33-patient trial test?
The study enrolled 33 patients with facial atrophic acne scars and 30 completed it, treating one cheek area with radiofrequency microneedling and the other with fractional CO2 laser, according to the U.S. National Library of Medicine PubMed record. Investigators described it as a prospective randomized split-face evaluator-blinded exploratory trial.
The registry entry NCT04252352 describes Lumenis UltraPulse Encore fractional CO2 laser on one side and Lutronic Infini/Genius radiofrequency microneedling on the other, per the ICH GCP clinical trials registry. Blinded investigators assessed the results. The design compares two treatments in the same person.
Which improved scars and which healed easier?
Both treatments improved facial atrophic acne scars, but radiofrequency microneedling offered faster recovery, fewer pigmentary events and higher safety satisfaction than fractional CO2 laser in that sample, according to the U.S. National Library of Medicine. Patients reported higher efficacy satisfaction with radiofrequency microneedling after the first session and higher safety satisfaction at follow-up, with no significant difference in blinded physician-observed efficacy, per the ResearchGate record of the split-face publication.
A wider comparison points the same way. A March 2026 meta-analysis of 8 randomized trials with 249 post-acne scarring patients found greater scar improvement and satisfaction with fractional CO2 laser, but significantly higher pain, more post-inflammatory hyperpigmentation and longer redness than microneedling radiofrequency, according to Wiley in Journal of Cosmetic Dermatology March 2026 meta-analysis. Ask your clinician whether clearing power or healing burden matters more for your schedule and skin.
Why does scar type come first?
Atrophic scars divide into icepick, boxcar and rolling subtypes, and clinicians identify scar type first, according to Dermatology Times reporting on ODAC protocol and American Board of Facial Cosmetic Surgery Dermatology Times reporting. Icepick scars are narrow and deep. Boxcar scars have sharp edges.
Rolling scars create broad waves. Treatment follows that map. Deep icepick scars often need punch techniques while rolling and boxcar scars use subcision, fillers or resurfacing combinations. Ask for your scar mix by name before you discuss laser or needles.
What should you ask before booking?
Treat the 33-patient result as a small exploratory single-treatment split-face sample, so it cannot predict multi-session outcomes, darker-skin risk alone, or long-term recurrence, according to Springer systematic review context Springer systematic review context. Larger multicenter trials with longer follow-up are still needed.
Use your visit to fill those gaps for your case. Bring your healing history and your tolerance for downtime. Bring photos of past slow healing or dark marks to that visit.
- What is my icepick, boxcar, and rolling mix?
- How many sessions do you expect, since the trial tested one treatment?
- What downtime, redness, and pain should I plan for with each option?
- What is my pigment risk and what aftercare lowers it?
- How will we measure progress, and when would we add or switch methods?
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