Radiofrequency Microneedling for Facial Rejuvenation: A Systematic Review

BACKGROUND: Radiofrequency microneedling (RFMN) is a prominent minimally invasive treatment for facial rejuvenation. While individual studies report positive outcomes, a comprehensive synthesis of evidence across efficacy, safety, and patient satisfaction is lacking. OBJECTIVES: To synthesize evidence on the aesthetic, safety, tolerability, and psychological outcomes of RFMN for facial rejuvenation. METHODS: We conducted this systematic review in accordance with PRISMA and JBI guidelines. We systematically searched four electronic databases (PubMed, Embase, CENTRAL, LILACS) for studies published between 2015 and 2025. We included 22 studies. We assessed risk of bias using a JBI tool and conducted a thematic synthesis of aesthetic outcomes, patient satisfaction, and safety. We evaluated confidence in the findings using the GRADE-CERQual approach. RESULTS: Our synthesis of 20 studies (558 participants) found that RFMN treatments consistently improved aesthetic outcomes, with significant improvements in skin texture and tightening supported by high Global Aesthetic Improvement Scale scores. We found a favorable safety profile, where adverse events were predominantly mild and transient (erythema and edema were most common), and no serious complications were reported. Pain was typically mild to moderate and well-tolerated. Patient satisfaction was remarkably high, with most studies reporting rates exceeding 90%, which was strongly correlated with the procedure's efficacy and minimal downtime. CONCLUSION: The synthesis of evidence indicates that RFMN is an effective and well-tolerated intervention for facial rejuvenation, characterized by robust clinical outcomes and exceptionally high patient satisfaction. These findings solidify its role as a cornerstone treatment in modern aesthetic practice. TRIAL REGISTRATION: PROSPERO Registration number: CRD420251152380.