Blog > Acne > Is Microneedling like Sylfirm X the Best Choice for Acne Scar Treatment?

Is Microneedling like Sylfirm X the Best Choice for Acne Scar Treatment?

RF Microneedling treatment is a procedure that delivers radiofrequency energy directly to the skin layers by way of multiple micro-sized needles. The Micro Needling technology such as Sylfirm X is designed for comprehensive skin tightening and firming treatments, as well as individually tackling specific skin conditions like melasma, enlarged pores, pimple marks, acne, and pimple scars 

a lady getting her Sylfirm X microneedling treatment

Radiofrequency (RF) Microneedling Treatments for Acne Scars

Scars formation is a result of your skin’s self-healing mechanism whenever it suffers cuts, inflammation of acne, or any other skin trauma. During the healing process, new skin tissues form and help cover the wound and patch up gaps caused by the injury. When the body produces too little or too much collagen, they develop as depressed or raised scars respectively on the skin surface. We have heard about laser resurfacing procedures, fillers, and chemical peels treatments. Now, let’s explore how RF microneedling can help to treat acne scars. 

Different Types of Scars Explained 

hypertrophic and atrophic acne scars images

There are two main categories of acne scars known as atrophic scar and hypertrophic scar.  

#1 Depressed (Atrophic) Scars 

These scars are quite common and caused by tissue loss. They are also known as atrophic scars. Essentially, the scarring develops due to the skin’s inability to produce sufficient fresh tissues. The pits or indentations that form in this scenario cause imbalanced scarring on the affected skin areas. Depressed scars are most often observed in people suffering from severe acne or chicken pox. Examples of acne scars include; - 

ice pick boxcar and rolling acne scars diagram
  • Icepick scars: Typically, narrow and deep-pitted holes measuring up to 2mm are seen on the skin surface. They are commonly found on the cheeks area and resemble a “punctate” appearance.  
  • Boxcar scars: These scars have a relatively wider cross-section. They are oval or round depression with distinct edges that somewhat resemble scars left by chicken pox. They are often found on cheeks and temples.  
  • Rolling scars: Their appearance resembles wider depressions on the skin with less well defined edges. The depressions tend to be broad and shallow, and they occur primarily on the cheeks and jawline. 

#2 Raised (Hypertophic) Scars  

The other type of scars, also known as hypertrophic scars, are caused by hyper or excessive tissue generation.  These scars are thick and shaped as raised bumps on the skin surface. The raised scars form as a result of the skin’s over healing response to injury. The condition is mostly seen in body areas covered by taut skin after suffering trauma such as burns or surgery.  

#3 Brown & Red Dark Spots - Post-inflammatory hyperpigmentation (PIH) / Post-inflammatory erythema (PIE) 

Dark spots are scars that are a visible reminder of acne. The inflammatory nature of acne can lead to potential post-inflammatory hyperpigmentation, or a darkening of the skin surfaces wherever the acne has healed. In lighter-skinned people, post-inflammatory redness can develop. Hyperpigmentation can also be a side effect of acne scar treatments in people with darker skin tones. 

After some time, you’ll discover that over-the-counter medications do very little to erase acne scars. The most you can expect in terms of results is a nominal improvement in skin discoloration levels of the treated areas.  If you’re keen to significantly reduce your acne marks and scars, you need to definitely consult a certified and experienced practitioner. 

Why Choose Microneedling for Acne Scars?  

Arriving at the right treatment for acne scarring can be quite challenging. Especially since there are many different treatment options such as ablative RF, laser resurfacing, TCA cross, subcision, chemical peels and injectables. Several studies show that RF microneedling treatment like Sylfirm X is highly effective for treating acne scars. RF treatment also carries much lower risk of PIH than laser atrophic scar treatment, especially for Asian skin type.  

Radiofrequency (RF) has long been used in wireless communication. In recent years, this technology is being used in aesthetic medicine too. RF therapy depends upon the energy that high-frequency waves generate. When this energy is passed through the dermis, it leads to the generation of capillaries, elastin, and collagen. As a result of the rejuvenation, the skin also becomes relatively firmer and looks a lot younger too. Moreover, the micro-needles that deliver radiofrequency energy such as Sylfirm also set in motion a parallel healing process. Essentially, the microneedles helps to repair the deeper skin layers and stimulate healthy collagen growth. That’s why RF microneedling devices maximise the impact of scar treatment.

Apart from encouraging the growth of thicker and smoother skin growth, RF microneedling also helps in dealing with the following skin condition:

  1. Erase fine lines and wrinkles 
  2. Stretch marks 
  3. Atrophic (Depressed) Acne scars 
  4. Surgery scars (Raised Scars)
  5. Lighten hyperpigmentation 
  6. Cellulite
  7. Tightens loose, saggy skin 
  8. Reduces the appearance of enlarged pores. 

Types of Radiofrequencies Microneedling Treatment for Acne Scars. 

With several RF micro-needling options available for treating acne scars, comparing devices and evaluating the specific strengths and weaknesses can turn out to be quite a task. But remember, it is the clinical application of the devices by the doctor that is most important. Only a trained and experienced practitioner can understand their inherent differences and skilfully adapt. All these devices operate on the same principle and essentially perform similar functions. The differences are usually in terms of device design and not the individual results they achieve.  

diagram of a sylfirm microneedling effectiveness on the skin

#Intensif RF Microneedling

The Intensif RF micro-needling device is designed for the effective delivery of radiofrequency energy to the papillary dermis. It is equipped with several small and fine needles that help to break down the skin fibrosis in a controlled manner. As a result, the skin produces new collagen and elastin in an effort to repair the connective tissue. This dermal collagen remodeling process helps reduce the appearance of the scarring. 

The micro-needles can penetrate depths of up to 5 mm and are engineered to target the papillary dermis. Reaching this specific dermal layer is crucial because this is where the ageing fibroblasts and type 3 collagen reserves are located. On coming in contact with the papillary dermis, RF energy generates heat ranging between 40°C to 60°C. The heat energy helps to stimulate the production of elastin and collagen in the targeted area. Apart from keeping the skin hydrated, this treatment also helps to lighten PIH, better known as pimple marks. An added advantage of RF Micro-needling is its longitudinal action which specifically corrects the damaged skin cells without affecting the adjacent healthy areas. 

#2 Dual Wave RF Microneedling 

The USFDA-cleared RF micro-needling treatment operates with dual wave technology. A fairly recent innovation, the device is gaining popularity for its ability to treat a wider range of skin problems apart from melasma. In addition to the ultra-short pulse wave via the Sylfirm X device also generates a second wave, known as the continuous wave. This is why it is known as a dual wave RF Micro-needling procedure.

By using bipolar non-insulated microneedle electrodes, this device covers the dermal layers with a uniform electric field and maximizes the treatment.  Through adjusting the needle depth between 0.3mm and 4mm and varying the radio frequency power, multiple layers of the epidermis, basal membrane, and papillary dermis can be targeted simultaneously. In additional to collagen remodelling, this device is capable of treating multiple skin conditions at the same time, such as melasma, saggy skin, pores, and scars.    

Ultra-short Pulse Wave (PW)

Pulse wave treats melasma and PIH by targeting some of the root cause. In the case of melasma, one of the problems lies in the abnormal blood vessels that nourish the pigment cells. The ultra-short wave can target the reticular dermis, where these blood vessels are abundantly present. The ultra-short frequency also helps to strengthen the weak basal membrane and prevents the movement of pigments from the epidermis down to the dermis. Most importantly, the shorter duration of the pulse wave generates less heat, which keeps the melanocytes stable.   

Continuous Wave (CW) mode

CW is more intense as compared to the pulsed mode. The CW generates higher temperatures when it comes in contact with the skin cells. As a result of greater RF delivery along with CW modes, extensive healing will be generated around the electrodes, stimulating dermal remodelling and skin tightening. These effects reduce the overall appearance of scarring.  

Benefits of CW mode 

  1. Facial Rejuvenation - Enlarged Pores, Wrinkles, Fine Line, Skin Laxity 
  2. Body Rejuvenation  Saggy Skin on the Neck, Double Chin, Décolletage 
  3. Scars - Acne Scars, Atrophic Scars, Hypertrophic Scars, Stretch Marks 
RF Microneedling Sylfirm Wave vs Pulsed Energy diagram

The Treatment Process for Microneedling like Sylfirm X

Preparing for the RF Micro-needling procedure:

Evaluation Stage: 

s the first step, the doctor will thoroughly evaluate the types of scars you have and also understand your goals and concerns to determine the suitable acne scar treatment for you.  RF Micro-needling therapy for treating acne scars is a process that is done in outpatient mode. It usually takes between 15 to 60 minutes to complete. The procedure's duration depends on factors such as the extent of skin damage and the severity of the scars.    

Treatment Stage: 

Before the procedure begins, the targeted area will be cleansed thoroughly. Thereafter, a topical anaesthetic is applied to the skin and allowed to remain there for around an hour. After the anaesthetic has numbed the skin, the doctor will begin the RF Micro-needling procedure. 

Post-procedure Stage: 

After the procedure is completed, an ultrasound procedure paired with Dr KT's skin revitaliser solution is spread on the treated area to help cell regeneration. Finally, a soothing solution is applied to the treated area to calm the skin further.  


A number of effective treatments are available for acne scars. As every scar is unique, it is important to discuss with your doctor the various types of treatment available and what works best for you. 

Frequently Asked Questions (FAQ)  

  1. Is RF Micro-needling treatment right for you?  

    RF Micro-needling procedures are appropriate for people suffering from melasma, rosacea, redness, active acne, and severe acne scars. It is also useful for treating skin ageing issues such as dull skin, fine lines, wrinkles, and enlarged pores using available the latest technology such as Sylfirm X. The treatments are suitable for all types of skin types and tones. Each treatment needle depth is customised according to the requirements of each case.     
  1. Will the RF Micro-needling treatment take a lot of time?   

    A single session usually lasts around 15 to 60 minutes. Depending upon the number of areas to be treated, individual sessions may extend up to an hour in some cases.    
  1. How many sessions of RF Micro-needling therapy should I receive?   

    The number of sessions depends on the severity of the scars. Mild scarring may only require one session. For severe scars, some patients may require four to five sessions conducted at regular intervals of a month. 
  1. When will I see results after RF Micro-needling treatment?   

    Results will usually appear a few weeks after the treatment.      
  1. Will I feel pain during the procedures?   

    There is no pain associated with the treatment. A light tingling sensation may be felt by patients who undergo the procedure. This is because topical anaesthesia is also applied to the skin area to be treated, apart from being a minimally invasive procedure.    
  1. CO2 Laser vs RF Microneedling for Acne Scars, which is better? 

    Both CO2 lasers and RF microneedling are effective in treating acne scars. A fractional CO2 laser works by ablating or burning certain parts of the skin while leaving the surrounding tissue untouched. New skin and collagen will grow on the ablated skin.  

    In contrast, the RF microneedle penetrates through the surface of the skin and releases RF energy below the skin's surface. In addition, the needle can be adjusted to penetrate the skin at different depths, thereby treating acne scars of varying depths. Rf energy is able to induce collagen production beneath the skin surface and reduce acne scars causing less damage to the skin.

    CO2 lasers are ablative in nature, which increases the chances of PIH, especially for Asian skin types. Studies has shown that up to 83% of PIH has been observed in patients after CO2 lasers. Whereas RF microneedling has about 5-8% of PIH incidence. As a result, RF microneedling is a preferred treatment for acne scars in Asian skin.