The needles are similar; the energy is not. Genius adds radiofrequency delivered at the needle tip, which heats a measured volume of dermis rather than only puncturing it, and for scarring that generally means more change per session. There is no head-to-head randomised trial of the two, so that is clinical experience rather than a trial result — what the trials do show is that microneedling carries materially less risk of pigmentation.
Overview
Collagen induction, short recovery
Collagen induction with a short recovery, suitable for every skin type, at any time of year.
A medical microneedling device passes fine needles vertically into the skin to a set depth — many thousands of closely spaced channels across a treatment. Each channel is a controlled micro-injury, and the healing response to it is new collagen.
Because no light energy is involved, there is no melanin-related pigment risk. That makes microneedling usable in every Fitzpatrick type and throughout the year, including in patients for whom laser is a poor choice.
A full facial treatment takes around twenty minutes. Surface irregularities improve within weeks; deeper concerns such as scars and established wrinkles need repeated treatment over months. Where more is required than microneedling alone can deliver, radiofrequency microneedling is the next step up.
At a glance
- Treatment timeAbout 20 minutes for a full face
- AnaestheticTopical anaesthetic
- DowntimeRedness and light flaking for 2–3 days; normal by day 3–4
- SessionsA course of 4–6, spaced about 4 weeks apart
- ResultsTexture within weeks; scars and lines over months
- Combines withPeels, bio-stimulation, medical skincare
How it works
Injury, signal, collagen
Vertical needle penetration to a controlled depth produces micro-channels without tearing the surface. The wound-healing cascade that follows recruits fibroblasts and lays down new collagen and elastin in the treated plane.
Depth is set for the indication: shallower for texture, tone and pore size; deeper for scarring and established lines.
Recovery is short. The skin is slightly red and flaking for a couple of days, and looks entirely normal by day three or four — substantially less than fractional CO2 laser, with correspondingly less achieved per session.
Indications
Suited to
- Reduction of scars, including acne scarring
- Reduction of stretch marks
- Enlarged pores and surface irregularity
- Fine lines and early wrinkling
- All skin types, year-round, with no pigment risk from light
- Patients who cannot accommodate laser downtime
- Active acne in the area to be treated
- A marked tendency to keloid scarring
- Active infection, including cold sores
- Immunosuppression, or a chronic skin disease that is not controlled
- Ice-pick scarring, which needs TCA CROSS rather than needling
- Anyone expecting it to match ablative resurfacing — it does not, and that is the trade
In the clinic
Step by step
Topical anaesthetic
Applied and left in place for around thirty minutes.
Treatment
The device is passed over the treatment area at a set depth, with additional passes over specific concerns.
Immediately after
The skin is pink, warm and may show pinpoint bleeding. A calming serum and occlusive are applied.
Days one to three
Redness and light flaking. Make-up from day two. SPF 30+ daily.
Repeat at four to six weeks
A course of four to six treatments produces cumulative change.
Recovery
Downtime, honestly
The same day
Pinpoint bleeding during the treatment, then redness resembling moderate sunburn and mild swelling. Pain during the procedure is, in several comparative studies, higher than with laser — it is the least glamorous thing about a treatment usually sold as gentle.
Days one to two
Redness fading, mild swelling settling. Most of the published series record two to three days of oedema.
Days two to four
Dryness and fine flaking. Make-up is usually fine from day two or three.
Weeks four onwards
Improvement becomes visible from around the third session. Collagen deposition continues for three to six months after the course ends, which is when it should be judged.
Risks
What can go wrong
Expected
Redness, pinpoint bleeding, mild swelling for two to three days, dryness and flaking.
Uncommon
Hyperpigmentation — rare, and markedly rarer than with ablative fractional laser. Tram-track marks from excessive pressure or dragging. Milia. Reactivation of cold sores.
Rare but serious
Granulomatous reaction to a product applied during the treatment. There are at least five published cases, one requiring methotrexate to settle, and all of them follow the same error: a cosmetic serum applied to skin whose barrier has just been opened.
That last risk dictates a rule we do not bend. Needling makes thousands of channels into the dermis, so anything applied during the treatment is effectively being injected. Only sterile preparations intended for intradermal use go on the skin during a session — never a vitamin C serum, never a cosmetic “booster”, however well reviewed. It is also the single strongest argument against home rollers.
Evidence
What the evidence shows
Consistent but weakA review restricted to randomised trials — nine studies, 341 participants — found microneedling effective for atrophic acne scarring, with improvement visible from three sessions and results comparable to topical tazarotene, non-ablative fractional laser and TCA CROSS. Fractional erbium:YAG outperformed it. Every combination tested — with a glycolic peel, with Jessner’s, with polylactic acid, with subcision — outperformed microneedling on its own.
The reference text on the subject nonetheless states that strong evidence of efficacy is not evident in the literature, and that much of the recommendation rests on anecdote. We would rather quote that than the figure usually quoted instead — the “400 per cent increase in collagen”, which is a histological measurement from a small sample at six months, not a measure of how anyone looked.
Where the evidence is genuinely strong is comparative safety. Pooled across seventeen studies, fractional CO2 carried roughly three times the risk of post-inflammatory hyperpigmentation that standard microneedling did. That, rather than superior efficacy, is the real case for choosing it — and in darker skin it is a decisive one.
If you are travelling
Fly the same day if you must; you will simply look as though you caught the sun.
The course is four to six sessions at four-week intervals, which is the real planning question for anyone travelling. Where that is impractical, radiofrequency microneedling achieves more per session and may be the better use of fewer visits.
No follow-up needs to be in person. The course is assessed on photographs at three months.
Questions
Good to know
If your question is not here, ask it in the enquiry form — Dr. Henningsen answers these personally.
Ask a question- How does it compare to Genius RF microneedling?
- Is it safe in darker skin?
Yes. Because no light energy is used, there is no melanin-related risk, and microneedling is a mainstay in darker skin types.
- Can I have it in summer?
Yes, with daily sun protection. This is one of the few resurfacing-adjacent treatments that is not season-dependent.
- Does it hurt?
With topical anaesthetic, most patients describe it as tolerable — a scratchy, vibrating sensation rather than pain.
Consultation
Ready to talk about your skin?
Consultations with Dr. Henningsen are arranged individually. Tell us what you would like to change and we will come back to you with the options, the honest downtime and the realistic result.