Gulfan & Wanitphakdeedecha (2022): Noninsulated Microneedle RF for Melasma
M.C.B. Gulfan, R. Wanitphakdeedecha, S. Wongdama, N. Jantanapornchai, C. Yan, S. Rakchart · Dermatology and Therapy, 2022PMID: 35538360
Supports: Split-face, double-blind RCT of 30 patients (Fitzpatrick III-V) with melasma receiving 3 treatments of pulsed-type noninsulated microneedle RF (Sylfirm) at 2-week intervals. Significant improvements in melanin index, skin roughness, and mMASI scores at 6 months. Confirms the Sylfirm device is safe and effective for melasma with only a 10% recurrence rate over 6 months.
Limitations: Small sample size (30 patients, 26 completed follow-up). Single-centre study. Mixed melasma predominated (61.5%). The combination with polynucleotides did not show superiority over RF alone, limiting conclusions about combination protocols.
View on PubMed →Jung et al. (2021): Pulsed Bipolar RF for Facial Erythema in Rosacea & Acne
Y.J. Jung, Y.S. Ro, H.J. Ryu, J.E. Kim · Journal of Cosmetic and Laser Therapy, 2021PMID: 33650938
Supports: Clinical study of 31 patients with rosacea or acne vulgaris-related erythema receiving 2-5 sessions of invasive pulsed-type bipolar RF at 2-week intervals. Significant improvement in erythema index after the second treatment, maintained throughout the study period. IGA scores for erythema, pores, and smoothness all improved. No serious adverse events reported.
Limitations: Non-randomised study design without a control group. Relatively small sample size (31 patients). Variable number of treatment sessions (2-5) across patients, making dose-response assessment difficult.
View on PubMed →Ma et al. (2023): Laser-Related Therapy for Melasma — Network Meta-Analysis
W. Ma, Q. Gao, J. Liu, X. Zhong, T. Xu, Q. Wu, Z. Cheng, N. Luo, P. Hao · Journal of Cosmetic Dermatology, 2023PMID: 37737021
Supports: Systematic review and network meta-analysis of 39 RCTs (1,394 participants) comparing laser-related therapies for melasma MASI score improvement. Microneedling + topical medications ranked 3rd by SUCRA value (79.7%) — confirming that microneedling-based approaches are among the most effective modalities for melasma treatment and superior to picosecond laser or topical medications alone.
Limitations: Network meta-analysis relies on indirect comparisons between treatments not studied head-to-head. Included studies had heterogeneous protocols, follow-up periods, and Fitzpatrick skin type distributions. Does not specifically isolate RF microneedling from standard microneedling in its analysis.
View on PubMed →Niaz et al. (2025): FRM as Monotherapy for Acne Scars — Systematic Review
G. Niaz, Y. Ajeebi, H.M. Alshamrani, M. Khalmurad, K. Lee · Clinical, Cosmetic and Investigational Dermatology, 2025PMID: 39781098
Supports: Systematic review of 16 studies (481 patients) confirming fractional radiofrequency microneedling is an effective monotherapy for atrophic acne scarring. Over 80% of patients achieved a two-grade scar improvement. FRM considered safer for darker skin tones with minimal adverse effects (transient erythema). Moderate-to-high patient satisfaction with improved quality of life.
Limitations: Heterogeneous study designs (6 prospective, 6 RCTs, 3 retrospective, 1 comparative). Variable FRM device types, settings, and treatment protocols across studies. Further RCTs needed to establish standardised treatment parameters. Does not specifically evaluate Sylfirm X — findings apply to FRM as a device class.
View on PubMed →*PRP London Clinic provides these references for educational purposes. Our Clinical Board regularly reviews emerging peer-reviewed literature to ensure our protocols align with the latest advancements in regenerative medicine.