“I have worked for 14 years with radiofrequency and after 13,000 sessions I can count the cases of (minor) hyperpigmentation after an RF treagtment on the fingers of my hands. With responsibly applied RF hyperpigmentation should be a rare occurrence, unlike laser, RF microneedling or even plain microneedling which routinely cause hyperpigmentation.”
Does radiofrequency cause hyperpigmentation?
Hyperpigmentation after RF microneedling
How can a skin treatment cause hyperpigmentation?
Can a radiofrequency treatment cause pigmentation?
Post-inflammatory hyperpigmentation with stimulative radiofrequency
Post-inflammatory hyperpigmentation with destructive radiofrequency / RF microneedling
Pigmentation vs radiofrequency: the facts
Hyperpigmentation and radiofrequency: frequently asked questions (FAQs)
Hyperpigmentation after RF microneedling
Does RF microneedling make melasma worse?
Does RF microneedling help with hyperpigmentation
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Radiofrequency and hyperpigmentation | In summary
Hyperpigmentation can result from either UV exposure or skin inflammation. Treatments like laser, radiofrequency (RF), ultrasound, and microneedling can trigger pigmentation only through post-inflammatory responses, particularly when applied at extreme intensities that burn or irritate the skin.
Mechanical treatments such as chemical peels and microneedling can also cause pigmentation by physically damaging the skin. There are two types of RF: stimulative and destructive. Stimulative RF, used for anti-ageing and skin tightening, is typically safe and unlikely to cause pigmentation when performed by trained professionals.
It operates continuously and targets deep tissue without damaging the epidermis. In contrast, destructive RF—especially RF microneedling—intentionally damages skin using high heat and stationary pulses, often resulting in inflammation and subsequent pigmentation. RF microneedling, which both punctures and heats the skin, carries a higher pigmentation risk.
Overall, pigmentation is more likely with high-intensity treatments, poor technique, faulty equipment, or accidents. Safely applied RF below the pain threshold rarely causes pigmentation.
How can a skin treatment cause hyperpigmentation?
Pigmentation occurs either as a result of UV exposure (sun, sunbed) or as a result of inflammation (post-inflammatory hyperpigmentation, PIH).
Treatments such as laser, radiofrequency, infrared, ultrasound, plasma skin resurfacing, radiofrequency microneedling, HIFU etc can only cause hyperpigmentation as a result of inflammation.
When a treatment, such as the above, is delivered at extreme intensity, either by mistake or by design, the epidermis is burned, damaged or irritated, leading to inflammation, which quite often results in post-inflammatory hyperpigmentation.
Manual, non-energy-based, treatments that puncture, abrade or irritate the skin, such as microneedling, intensive exfoliation, chemical peels etc do not involve any energy transfer, but can cause post-inflammatory hyperpigmentation by mechanically damaging or chemically irritating the skin.
Can a radiofrequency treatment cause pigmentation?
There are two types of radiofrequency:
Stimulative radiofrequency: This should not normally cause post-inflammatory hyperpigmentation, unless there is a rare adverse reaction
Destructive radiofrequency: With this method, hyperpigmentation can occur quite often - especially with microneedling RF, which both punctures the skin on the surface and burns the skin inside
Post-inflammatory hyperpigmentation with stimulative radiofrequency
Stimulative radiofrequency aims to stimulate change in the skin, for anti-ageing, skin tightening and cellulite reduction purposes.
This is a ‘continuous movement’ type of radiofrequency, i.e. RF where the handpiece moves continuously during treatment.
Stimulative radiofrequency is delivered deep into the tissues and in a safe way, i.e. at high enough intensity to be effective but not high enough to cross the pain threshold or necessitate the use of numbing cream.
As long as the treatment is provided by a well-trained, experienced and knowledgable therapist and unless a rare human error or accident occurs, stimulative radiofrequency should not cause burn, damage or irritation, which could eventually lead to hyperpigmentation.
Furthermore, as radiofrequency does not use light (it it high frequency electricity, basically) it would not cause hyperpigmentation unless a rare error or accident occurs.
(At our clinic we have 99.5%+ safety and only mild, temporary, limited post-inflammatory hyperpigmentation occurs only once a year on average - after more than a decade of providing this treatment daily.)
Post-inflammatory hyperpigmentation with destructive radiofrequency / RF microneedling
With destructive radiofrequency things are different.
Destructive radiofrequency does not aim to stimulate change in the skin but to burn/damage the skin itself, hoping that skin will then react to the burn/damage with some inflammation and scar tissue formation (which is then baptised as “neocollagenesis”) and consequently skin hardening (which is then baptised as “skin tightening”).
This kind of extreme intensity RF uses the ‘pulse’ or ‘stamp’ method, i.e. RF where the handpiece is stationary whilst RF is emitted. Each stationary RF emission then forms a pulse or a stamp). Then the handpiece moves to an adjacent spot where RF is emitted again etc.
As these kind of treatments are delivered at extreme intensities and temperatures (60-90ºC) and aim to induce inflammation by design (i.e. with those treatments inflammation is not a rare mistake or adverse reaction - it is the actual basis of the treatment), post-inflammatory hyperpigmentation can be very common with them.
Furthermore, as RF microneedling mechanically punctures the skin, In addition to also usually being provided at extreme intensities (above the pain threshold and with the use of numbing cream), RF microneedling has an even higher chance of causing post-inflammatory hyperpigmentation than extreme intensity RF.
Pigmentation vs radiofrequency: the facts
All in all, extreme intensity RF provided above the pain threshold with a numbing cream, (as well as microneedling RF at ANY intensity, even at low intensity), can cause pigmentation
Furthermore, pigmentation can also be caused by ANY treatment - stimulative or destructive - if provided by a poorly trained practitioner, if the equipment used is unsafe/unserviced or as a result of a rare human error/accident
Finally, deep-acting, high-power radiofrequency that is provided below the pain threshold by a competent practitioner, should very rarely cause pigmentation
Hyperpigmentation and radiofrequency: frequently asked questions (FAQs)
We hope everything/it/all is now clear regarding post-inflammatory hyperpigmentation and radiofrequency.
Below are some straight, quick answers to the most common questions related to this subject, to clarify finer points and add more detail.
Hyperpigmentation after RF microneedling
Post-inflammatory hyperpigmentation (from any source, not just microneedling, RF microneedling, extreme intensity RF etc) is more common with dark skin, oriental skin or black skin.
So, if you have black, dark or oriental skin and easily suffer from hyperpigmentation, don’t have such treatments.
Does RF microneedling make melasma worse?
Of course, RF microneedling can make melasma worse. Such treatments are the last things you should apply if you suffer from melasma.
Does RF microneedling help with hyperpigmentation
As described above, no, RF microneedling does NOT help with hyperpigmentation - quite the opposite, it can cause hyperpigmentation.
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At LipoTherapeia we have specialised 100% in skin tightening and cellulite reduction for more than two decades and 20,000+ sessions.
This is all we study and practise every day and have researched and tried hands-on all the important skin tightening equipment and their manufacturers.
As strong, deep acting radiofrequency and deep-acting, high-power ultrasound cavitation are the technologies of choice for skin tightening and cellulite reduction, we have invested in the best RF/ultrasound technologies in the world.
(Of course, we keep looking for new technologies every day and if/when a better technology materialises we will be the first to provide it. However, we will never follow the latest ineffective gimmick, just because it’s good marketing to offer the latest hyped up - yet ineffective and/or unsafe treatment.)
Furthermore, over the last two decades we have developed advanced RF and cavitation treatment protocols in order to make the most of our technologies, for maximum results, naturally and safely.
And for even better, faster results, we now combine our RF/ultrasound treatments with high-power red/infrared light LED treatment.
Our radiofrequency/ultrasound/LED treatments are comfortable, pain-free, downtime-free, injection-free, 99.5%+ safe and always non-invasive.
(No unsafe and ineffective RF microneedling or HIFU and no safe but ineffective acoustic wave therapy, superficial RF (bipolar/tripolar/multipolar etc), low power RF/cavitation, electrical muscle stimulation, lymphatic massage, cupping, dry brushing and no ridiculous bum bum creams.)
Our focus is on honest, realistic, science-based treatment, combined with caring, professional service, with a smile.
We will be pleased to see you, assess your cellulite, skin laxity or fibrosis, listen to your story, discuss your case and offer you the best possible treatment.
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There is no proper, real training in the science or cellulite, skin tightening, radiofrequency, ultrasound and all related technologies is non-existent - worldwide.
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