RF Microneedling : Sylfirm X

RF microneedling (RFM) is an awesome treatment for skin laxity & acne scarring. In the context of melasma the results are not as predictable as lasers. RFM has prolonged recovery as compared to pico lasers, in addition it has a higher rebound rate & higher side effects. Though reported to improve some cases of melasma, our clinicians avoid treating pigmentation with this treatment.


0-4 days


21 days

Treatment Time

25 minutes


SPF + pigment correctors

Dermatologist science score

The Science of RF Microneedling for Melasma

  • RF microneedling combines super fine needles with heating of the skin
  • Heat can rejuvenate the skin, in turn repairing sun damage areas
  • Increasing the tensile strength of skin can improve a minority of melasma cases
  • Microneedling also increases the permeability of skin
  • This can aid in delivery of topical pigment correctors
  • Channels secondary to microneedling can also aid in pigment exfoliation

The aim of RF microneedling for melasma is to repair sun damaged skin, one of the primary causes of melasma. Pulsed heating of the dermal layers can increase resilience of the skin, in turn improving pigmentation in a minority of patients.

What is RF microneedling?

RFM or radiofrequency microneedling is a novel treatment for melasma. It uses super sharp microneedles that deliver pulsed heat into the skin via radiowaves. Controlled heating of the skin (unlike ‘cold’ therapy like microneedling) exerts a powerful biological change in the deeper layers of skin.

Well known brands include Potenza, Silfirm X, Genius RFM, Infini, Morpheus8 & Secret RF.

Does Sylfirm X treat the cause of melasma?

RF microneedling addresses two of the many causes of melasma

  • Treatment of photodamage to the deeper layers of skin. Treatments such as Silfirm X target the basement membrane of skin & the deeper dermal layers. This increases the collagen content of skin, making it more resilient.
  • Targeting of blood vessels in the dermal layer via pulsed radiofrequency. These vessels play a role in pigment production by cells.

Other aspects of melasma need to be addressed for effective reduction in pigmentation. This includes reducing pigment production & most importantly reducing UV, visible & infrared light penetration to the skin.

What is the differences between Sylfirm X & other RF devices?

Sylfirm X is the first RF device that has been granted FDA approval for melasma. Additionally this device delivers energy via pulsed waves, meaning less bulk heating compared to one pulse.

Do I still need to use creams after RFM to treat melasma?

Yes. The role of these ingredients is to reduce pigment output that causes melasma & pigmentation.

Pigment correctors include arbutin, ascorbic acid, azelaic acid, hydroquinone, botanicals, cysteamine, retinol & niacinamide. We ALWAYS prescribe skin care to amplify your gains from treatments such as Silfirm, Potenza & Genius RF.

How many sessions are required?

Though results can be seen in one session, a series of 5 sessions are recommended for melasma

How long is each session & is it painful?

It takes 20 minutes to complete a session. Treatments are well tolerated as numbing cream is used prior to treatments.

*Deeper RF is more painful, however for melasma treatments depths are very superficial at 0.3 mm.

What is the ideal depth for RF microneedling melasma?

Much like microneedling, the ideal depth of RFM is shallow. Dermatologists generally recommend depths of around 0.2 mm.

Sylfirm X has depths ranging from 0.3 mm to 4 mm. The majority of melasma studies are around 0.3 mm deep.

What is better- lasers or RF microneedling for melasma?

Picosecond lasers like the Picosure Pro have better outcomes as compared to RF microneedling. They are more cost effective, work faster & have no downtime.

Picosecond lasers employ ultrashort pulses of light to safely shatter unwanted pigment without heating the skin. This is the fundamental difference between picosecond technology & older lasers. Picosure can clear up melasma pigmentation within a few short weeks. Results are seen as early as one week after treatment. Melasma clearance rates following laser is around 85%.

What are the side effects of RF microneedling?

The three main side effects of RF microneedling (regardless of brands) are-

  • Rebound melasma or recurrences.
  • Post inflammatory pigmentation (with incorrect settings)
  • Pigment drop-out into the deeper layers of skin.
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Other rare side effects include prolonged redness. Of the 3 side effects, pushing pigment deeper is the hardest to treat. This converts superficial melasma to deep melasma, a notoriously difficult variant to fade.

Dr Davin Lim

645K subscribers


If I can identify the cause of pigmentation, chances are I can treat it. This can only be achieved with careful real time examination…

More of our mostFrequently asked questions

What is the difference between microneedling & RF microneedling?

How does RF microneedling compare to Cosmelan peels or Dermamelan peels?

How does RF microneedling compare to Picosure laser treatment of melasma?

What is the difference between RF devices such as Morpheus8, Sylfirm X, Potenza, Genius & Infini?

What other conditions can Sylfirm X treat?

Can all skin types be treated with Sylfirm X?

How many treatments are required?

Will our treatments be effective for all cases of melasma?

A SummaryMelasma treatments with RF microneedling

Dr Davin Lim | Dermatologist
The Melasma Clinic, Brisbane | Sydney

RFM or radiofrequency microneedling shines as a treatment for deeper dermal pathology- think acne scars, enlarged pores, skin laxity, as well as deeper wrinkles. In the context of melasma & pigmentation, lasers provide far superior outcomes with less costs, side effects & recovery.

The mode of action for melasma is four fold, in the context of RF microneedling-

  • Remodeling of the junction between the epidermis and dermis or the DEJ, in addition to modulation of fibroblasts (which cross talk with melanocytes, mast cells, endothelial cells). RFM can evoke neocollagenesis, thus increasing the content of collagen type 1, found in the deeper dermis & collagen type 4, in the DEJ. By strengthening the skin & increasing the resilience, it reduces the numbers of melanocytes that breach the DEJ. UV induced photodamage, an important etiological factor in melasma, characterized by a reduction in collagen & an increase in elastosis is also addressed.
  • Modulation of vascular endothelial cells & dermal vasculature. This can reduce the vascular input of melasma via the VEGF-1 receptor. It is a crude way of shutting down the vessels (via indirect delivery of heat to the vessel walls), however in scientific publications, it can work.
  • Increased penetration of topicals via channels of RFM.
  • Transepidermal exfoliation of pigment, much akin to the theory of the ‘melanin shuttle’

Though we have tried RF microneedling melasma with various devices such as Genius, Infini, Secret, Morpheus8 & Potenza, our results have been rather dismal, with less than 10% response rate. Perhaps we are pressing the wrong button:) or possibly the pulse width of fractional or split pulsed devices like Sylfirm X has something to do with it.