Radiofrequency Microneedling Versus Fractional Laser for the Treatment of Atrophic Acne Scars: A Systematic Review and Meta‐Analysis
Gotof Abdesalam Mustafa, Faisal Fahad AlSuwailem, Fatma H. J. AlAmiri, Rawan Hassan Alzaidi Alotaibi, Zainab Mahmoud Baqer, Leena Abdullah Alotaibi, Sabah Faisal AlQabandi, Reham Alawi Taqi, Suha Giselle Ghanem, Azhar Abbas AhmedABSTRACT
Background
Atrophic acne scars are a common and distressing complication of acne vulgaris, with limited consensus on optimal treatment. Radiofrequency microneedling (RFM) and fractional laser are widely used modalities, but their comparative effectiveness remains unclear.
Aims
To compare the efficacy and safety of RFM versus fractional laser in treating atrophic acne scars.
Methods
A systematic review and meta‐analysis were conducted following PRISMA guidelines. Five databases were searched up to February 2026 for randomized and prospective comparative studies. The primary outcome was ECCA score reduction; secondary outcomes included clinical improvement, patient satisfaction, and adverse events.
Results
Eight studies were included. Both RFM and fractional laser demonstrated statistically significant improvements in acne scar severity across multiple outcome measures ( p < 0.05). Patient satisfaction was consistently high, with up to 95% of patients reporting satisfaction in RFM‐treated groups. Several studies demonstrated comparable clinical improvement between RFM and fractional laser, particularly in terms of dermal remodeling and texture enhancement. In addition, RFM was associated with a favorable safety profile, showing fewer pigment‐related adverse events and shorter downtime compared to fractional laser, while reported side effects in both groups were generally mild and transient.
Conclusions
RFM and fractional laser are effective for atrophic acne scars. RFM may offer similar efficacy with improved tolerability. Further high‐quality studies are needed to confirm these findings.