Does RF cause pigmentation?

Does radiofrequency cause hyperpigmentation?

• 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 and radiofrequency: in summary

• Check our professional consultancy for a masterclass in radiofrequency, ultrasound cavitation, cellulite and skin tightening

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

• Destructive radiofrequency: With this method hyperpigmentation can occur quite often, especially with microneedling RF, which both punctures 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.

This is always continuous movement RF, 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 a high 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

(At the clinic we have 99.5%+ safety and only caused mild, temporary, limited post-inflammatory hyperpigmentation just once in 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 inflammation and scar tissue formation (“neocollagenesis”) and consequently skin hardening (“tightening”).

This is RF using the pulse or stamp method, i.e. RF where the handpiece is stationary while RF is emitted (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 these treatments inflammation is not a rare mistake or adverse reaction, it is the basis of the treatment), post-inflammatory hyperpigmentation can be very common with them.

As RF microneedling mechanically punctures the skin, in addition to usually being provided at extreme intensities (above the pain threshold and with the use of numbing cream), it has an even higher chance of causing post-inflammatory hyperpigmentation.

Pigmentation and radiofrequency: in summary

• All in all, extreme intensity RF provided above the pain threshold with a numbing cream, (as well as microneedling RF at ANY intensity, even low one), can cause pigmentation

• Furthermore, pigmentation can also be caused by ANY treatment - stimulative or destructive - if provided by a poorly trained practitioner, it 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 almost never cause pigmentation

Check our professional consultancy for a masterclass in radiofrequency, ultrasound cavitation, cellulite and skin tightening

Do you want to deeply understand radiofrequency, ultrasound cavitation, cellulite and skin tightening? Attend a half-day, 1-day, 2-day or 3-day professional consultancy / one-to-one training and confidently offer your clients the safest, strongest and most effective treatment possible. Service available via Zoom or at our central London practice.