Abstract
Background
Radiofrequency (RF) microneedling is increasingly used for acne management; however, real-world evidence for its clinical effects and safety remains limited.
Objectives
The aim of this study was to describe the clinical response and safety of POTENZA RF microneedling (RFMN) for acne vulgaris in routine practice.
Methods
The authors retrospectively analyzed data from adults treated at a tertiary dermatology center in Seoul, Republic of Korea. Adult patients (≥18 years) with clinically diagnosed acne vulgaris who received POTENZA RFMN treatment were included. The primary outcome was clinical improvement (assessed by the physician and/or reduction in lesion counts). Secondary outcomes included adverse events (AEs). Continuous variables were summarized per distribution.
Results
The cohort included 50 patients (median age, 24 years; 60% male) with predominantly Fitzpatrick skin types III. All procedures used bipolar RF (50% medium, 50% high); no boosters. Median sessions were 3. Clinical improvement occurred in 94% (47/50). Lesion counts decreased from 45 to 18.5 (P < .001). The mean percentage reduction was 48.3% ± 24.5%. AEs occurred in 10% (5/50), all mild/transient (erythema, pruritus, and stinging), and no serious AEs.
Conclusions
In real-world practice, POTENZA RFMN was associated with high clinical improvement, substantial lesion reduction, excellent tolerability, and universal patient-reported benefits. These findings support its pragmatic use for acne in patients with Fitzpatrick skin types III and IV and warrant confirmation in prospective controlled studies.
Level of Evidence
4 (Therapeutic) 
Acne vulgaris is one of the most common dermatologic conditions worldwide, affecting ∼94% of the global population at some point in life and ranking as the eighth most prevalent disease globally.1 Although often associated with adolescence, acne can persist or develop in adulthood, leading to significant physical and psychological consequences. The disease results from a multifactorial process involving follicular hyperkeratinization, increased sebum production, microbial colonization by Cutibacterium acnes, and inflammation mediated by androgenic and immune pathways.2 These mechanisms are influenced by environmental, genetic, and lifestyle factors, as well as by skin phototype, with a higher prevalence of postinflammatory hyperpigmentation and scarring among individuals with darker skin tones.3,4
In addition to its cutaneous manifestations, acne imposes a substantial psychosocial burden. Several studies have linked acne to anxiety, depression, and reduced quality of life, with some reports suggesting an association with suicidal ideation.5-9 These findings underscore the need for effective and safe therapeutic strategies that address both the physical and emotional aspects of the condition.
Over the past decade, acne management has evolved from traditional pharmacologic approaches to include a growing range of energy-based devices. Radiofrequency (RF) technologies have gained attention for their ability to induce dermal remodeling, regulate sebaceous gland activity, reduce C. acnes colonization through thermal effects, and control inflammation while minimizing epidermal damage.10-13 Unlike ablative laser systems, RF microneedling (RFMN) combines mechanical injury and controlled thermal coagulation to promote neocollagenesis, dermal tightening, and enhanced skin texture, with minimal downtime.14
The POTENZA RFMN system (Jeisys Med Inc., Seoul, Republic of Korea) represents an advanced generation of this technology, integrating monopolar and bipolar RF delivery at variable frequencies and customizable needle depths. It is designed to achieve deeper, more uniform thermal stimulation and has shown potential benefits in the management of acne and its sequelae, such as scarring and dyschromia.15-18 Despite its increasing adoption in aesthetic dermatology, there is limited structured clinical evidence evaluating its clinical response and safety specifically for active acne vulgaris lesions in real-world practice.
The objective of this study is to describe the clinical response of POTENZA RFMN for the treatment of acne in real-world practice based on physician-documented improvement and visual assessment of pre- and posttreatment photographs. Furthermore, this work provides practical evidence for integrating RFMN into acne treatment protocols.
The secondary objectives of this study are
to describe the patterns of clinical response as reported by dermatologists in routine clinical notes, including reduction in lesion number, severity, or distribution;
to assess changes in skin texture or pigmentation as qualitatively described by physicians or visually observed in photographic records;
to describe the incidence, type, and resolution of adverse events (AEs) associated with Potenza treatment, as recorded in patient medical files.
METHODS
Study Design and Setting
A retrospective observational before-and-after study was conducted to evaluate the clinical outcomes and safety of POTENZA RFMN for the management of acne vulgaris. The study was conducted at a single dermatology center (Hallym University Kangnam Sacred Heart Hospital Dermatology Center) in Seoul, Republic of Korea, where all treatments were administered as part of routine clinical care between May 2022 and May 2025. As this study relied on routine clinical practice, follow-up intervals and photographic documentation were not fully standardized across patients. The study adhered to the principles of the Declaration of Helsinki and was approved by the local ethics committee (HKS 2025-07-017). All data were de-identified before analysis to protect patient confidentiality.
Participants
Eligible participants were adults (≥18 years) with a clinical diagnosis of acne vulgaris who had received at least 1 POTENZA RFMN treatment session. Inclusion required standardized pretreatment and posttreatment facial photographs or detailed clinical records documenting acne severity and outcomes. Exclusion criteria included concurrent treatment with other energy-based devices for acne, initiation, or modification of systemic acne medications within 3 months before treatment, insufficient medical documentation, and general contraindications to RF procedures (eg, pregnancy, pacemaker use, or active infections). The processes of patient identification, screening, eligibility assessment, and final inclusion are summarized in Figure 1 in accordance with the STROBE guidelines.
Figure 1.
Patient flow diagram.
Intervention
POTENZA (Jeisys Med Inc., Seoul, Republic of Korea) microneedling RF treatments were performed using the insulated (I-25) or noninsulated (N-25) microneedle tip in bipolar RF mode (Figure 2A-C). An insulated tip is indicated for treating deep acne scars and for deep tissue remodeling, whereas a noninsulated tip is suitable for active acne and textural improvement.
Figure 2.
(A) POTENZA RFMN system. (B) I25 (insulated microneedle). (C) N25 (noninsulated microneedle).
Before treatment, the skin was gently cleansed under aseptic conditions, and topical lidocaine cream was applied under occlusion for ∼30 min for local anesthesia. The needle depth was typically set to 1.0 to 2.0 mm, and medium-to-high energy settings (700-1000 mJ/pulse) were used based on lesion severity and patient tolerance. A single pass was typically performed with minimal overlap. Sessions were conducted under aseptic conditions, and the number of sessions, energy parameters, and treatment areas were tailored to each patient. Each treatment session lasted ∼10 to 15 minutes (Video). After treatment, patients were instructed to use gentle cleansing, apply moisturizer as needed and sunscreen regularly, and avoid excessive sun exposure, scrubbing or exfoliation, and vigorous exercise or heat-related activities for 24 to 48 h. In this cohort, most patients were treated without dermal boosters. Sessions were performed in patients with clinically active acne vulgaris and were generally not administered during acute, severely inflamed flares.
Outcome Measures
The primary outcome was physician-documented clinical improvement in acne severity as recorded in patient charts. Improvement was defined as a reduction in the number or severity of inflammatory and non-inflammatory lesions, or improvement in the Investigator's Global Assessment (IGA) score after treatment. Baseline IGA scores were not consistently available in the medical records; therefore, they could not be uniformly analyzed.
Secondary outcomes included the incidence and type of AEs. AEs were classified according to severity, duration, and resolution.
Data Collection
Data were manually extracted from electronic medical records using a structured case report form. The variables included demographic characteristics, acne subtype (inflammatory, comedonal, or mixed), Fitzpatrick skin type, number of sessions, RF mode, energy level, use of dermal boosters, and concomitant systemic acne medications (oral antibiotics and isotretinoin). Inflammatory acne was defined as acne predominantly characterized by papules, pustules, or nodules; comedonal acne as acne predominantly characterized by open and/or closed comedones with minimal inflammation; and mixed acne as acne showing both inflammatory and comedonal lesions. Information on concurrent topical acne therapies was inconsistently documented and therefore could not be systematically analyzed or adjusted for. Lesion counts and IGA scores were obtained when documented. For photographic data, pre- and posttreatment high-resolution images were anonymized and independently assessed by a dermatologist blinded to the treatment stage.
Statistical Analysis
All analyses were performed using R software (version 4.2; R Foundation for Statistical Computing, Vienna, Austria). Continuous variables (eg, age, duration of acne, number of sessions, and energy level) were tested for normality using the Shapiro–Wilk test. Normally distributed data are reported as means ± standard deviation, whereas non-normally distributed variables are reported as medians and interquartile ranges (IQRs). Categorical variables are summarized as frequencies and percentages. Changes in lesion counts before-and-after treatment were compared using the paired t-test or Wilcoxon signed-rank test, depending on the data distribution.
AEs are described by type and frequency. Correlations between sessions and percentage reduction, as well as between age and improvement, were evaluated using Spearman's rank correlation. To identify predictors of treatment response, we initially planned a multivariable logistic regression. However, given the potential for quasi-complete separation due to high responder rates, Firth's penalized likelihood approach was prespecified to ensure stable coefficient estimates and reduce small-sample bias. All statistical tests were 2-tailed, with P < .05 considered statistically significant.
RESULTS
A total of 50 patients were included in the analysis. The median age was 24 years (IQR 21-28), with 60% male (n = 30) and 40% female (n = 20). The median duration of acne was 5 years (IQR 3-7.75 years). Most participants were Fitzpatrick skin type III (92%, n = 46) and type IV (8%, n = 4). Acne type was inflammatory in 44% (n = 22), mixed in 42% (n = 21), and comedonal in 14% (n = 7). Scarring was present in 76% (n = 38). The baseline total lesion count was 47.8 ± 25.9. Regarding concomitant systemic acne medications, 5 patients (10%) were receiving oral doxycycline 50 mg/day and 4 patients (8%) were on isotretinoin 10 mg/day at the time of treatment; however, dosages remained stable throughout the study period without escalation. Treatments were performed with bipolar RF using either medium (50%, n = 25) or high energy levels (50%, n = 25); no dermal boosters were used. The median number of sessions was 3.0 (IQR 2.0-4.75), with 46% receiving 1 to 2 sessions (n = 23), 28% receiving 3 to 4 sessions (n = 14), and 26% undergoing ≥5 sessions (n = 13). Baseline characteristics are shown in Table 1.
Table 1.
Baseline Characteristics
| Variable | All participants (n = 50) |
|---|---|
| Age, years | 24.0 (21.3-28.0) |
| Sex, n (%) | |
| Female | 20 (40.0) |
| Male | 30 (60.0) |
| Duration of acne, years | 5.0 (3.0-7.8) |
| Fitzpatrick skin type, n (%) | |
| Type III | 46 (92.0) |
| Type IV | 4 (8.0) |
| Acne type, n (%) | |
| Inflammatory | 22 (44.0) |
| Mixed | 21 (42.0) |
| Comedonal | 7 (14.0) |
| Scarring, n (%) | |
| Absent | 12 (24.0) |
| Present | 38 (76.0) |
| RF mode, n (%) | |
| Bipolar | 50 (100.0) |
| Energy level, n (%) | |
| Medium | 25 (50.0) |
| High | 25 (50.0) |
| Booster type, n (%) | |
| None | 50 (100.0) |
| Number of sessions | 3.0 (2.0-4.8) |
| Adverse events, n (%) | 5 (10.0) |
| Baseline lesion count, median (IQR) | 45 (26.25-66) |
| Posttreatment lesion count, median (IQR) | 18.5 (10.5-34.3) |
| Clinical improvement, n (%) | |
| Yes | 47 (94.0) |
| No | 3 (6.0) |
| IGA score (0-4), median (IQR) | 1.0 (1.0-2.0) |
| Clear (0) | 5 (10.0) |
| Almost clear (1) | 24 (48.0) |
| Mild (2) | 21 (42.0) |
IGA, Investigator's Global Assessment; RF, radiofrequency.
Primary Outcome
Clinical improvement was achieved in 94% of patients (n = 47), whereas 6% (n = 3) showed no improvement as assessed by physicians and photographs. The total lesion count decreased from a baseline median of 45 (IQR 26.25-66) to 18.5 posttreatment (IQR 10.5-34.25; Table 2) (Figure 3). The Wilcoxon signed-rank test indicated a statistically significant reduction (V = 1225; P < .001). The mean percentage reduction in lesion count was 48.3% ± 24.5%, confirming a marked therapeutic effect (Figure 4). On the IGA (0-4), only posttreatment IGA scores could be reliably analyzed; the median posttreatment score was 1.0 (IQR 1.0-2.0), distributed as clear (0): 10% (n = 5), almost clear (1): 48% (n = 24), and mild (2): 42% (n = 21). No patients had moderate (IGA 3) or severe (IGA 4) acne at the final assessment.
Table 2.
Primary and Secondary Outcomes
| Outcome | Value |
|---|---|
| Lesion count (pre), median (IQR) | 45 (26.25-66) |
| Lesion count (post), median (IQR) | 18.5 (10.5-34.3)* |
| Clinical improvement, n (%) | 47 (94.0) |
| Lesion count reduction (%) | 48.3 ± 24.5 |
| ≥50% reduction, n (%) | 26 (52.0) |
| ≥75% reduction, n (%) | 12 (24.0) |
| Adverse events, n (%) | 5 (10.0) |
| Treatment discontinuation | 0 (0.0) |
*P < .001, Wilcoxon signed-rank.
Figure 3.
Comparison of median lesion count before and after intervention.
Figure 4.
Improvement of acne scars in a 26-year-old male patient. Frontal view: (A) before treatment, (B) after treatment sessions, and (C) after 6 months of the treatment. Right profile: (D) before treatment, (E) after treatment sessions, and (F) after 6 months of the treatment. Left profile: (G) before treatment, (H) after treatment sessions, and (I) after 6 months of the treatment.
Secondary Outcome
Safety
No serious AEs occurred. AEs reported here represent clinically significant or persistent symptoms that prompted clinical notation. Expected physiologic responses to thermal injury, such as transient erythema (<24 h) and mild stinging during the procedure, were nearly universal but were not categorized as AEs unless they persisted beyond the immediate posttreatment period.
DISCUSSION
This retrospective, single-center, observational before-and-after study describes the real-world clinical outcomes and safety associated with POTENZA RFMN in patients with acne vulgaris. The results demonstrated clinical improvement, with 94% of patients showing physician-reported improvement and an average lesion reduction of 48.3%, consistent with previous research on the effect of RFMN in acne management. These findings should be interpreted as descriptive, real-world observations rather than definitive estimates of efficacy, given the retrospective design and absence of a comparator group.
RF devices promote dermal remodeling, regulate sebaceous gland activity, and attenuate inflammation without causing significant epidermal disruption.10-13 The combined monopolar and bipolar RF energy delivery in Potenza allows for deeper and more uniform thermal stimulation, improving outcomes in inflammatory and mixed acne.19 Additionally, heat-induced protein denaturation and coagulation create an inhospitable environment for C. acnes proliferation. The mechanical microperforation component enhances trans-epidermal drug delivery and stimulates wound-healing cascades that promote collagen remodeling and improve acne scarring.20 Furthermore, RF energy has been shown to modulate inflammatory pathways, including downregulating matrix metalloproteinases and inflammatory cytokines.21 Systematic reviews have demonstrated that fractional RFMN achieves significant reductions in lesion severity with fewer adverse effects and less downtime compared with fractional CO2 or Er:YAG lasers.18 However, direct comparisons with these modalities cannot be made in the present study.
The safety profile observed in this retrospective cohort is consistent with previously reported real-world experience of RFMN in acne management. In this study, most participants had Fitzpatrick skin type III, a phototype traditionally considered at higher risk for postinflammatory hyperpigmentation.3,4 Within this cohort, no persistent pigmentary changes or acne exacerbations were documented, and the reported AEs were mild and self-limited, consisting mainly of transient erythema, pruritus, and stinging sensations.
However, only 4 patients (8%) had Fitzpatrick skin type IV, and none had Fitzpatrick skin type V or VI. Therefore, no conclusions regarding safety or clinical outcomes can be drawn beyond Fitzpatrick skin types I and III. Any interpretation of applicability to darker skin phototypes should be made with caution and requires confirmation in larger, prospectively designed studies specifically powered to evaluate pigmentary safety.
In addition to its observed response, remodeling effects are likely mediated by controlled thermal injury, which stimulates collagen and elastin synthesis, modulates metalloproteinase activity, and facilitates transforming growth factor β–driven re-epithelialization.16,17 These biological mechanisms not only improve acne lesions but also contribute to the management of postacne scarring, a key concern in aesthetic dermatology.
Although subgroup analyses revealed no statistically significant differences by acne type, energy level, or Fitzpatrick skin type, a trend toward greater improvement with increasing number of sessions was observed. This suggests a potential cumulative effect of treatment exposure, consistent with previous studies that have proposed that repeated RFMN sessions enhance dermal remodeling and clinical response. These subgroup findings should be interpreted cautiously, because the study was not powered to detect subgroup differences, and treatment parameters were not fully standardized. However, the relatively small-sample size and heterogeneity of treatment regimens limit the strength of these conclusions.
This study has several strengths. First, it provides real-world data from routine clinical practice, enhancing external validity. Second, a comprehensive outcome assessment, including objective assessment (lesion counts and IGA scores), provides insight into treatment effects. Nevertheless, baseline IGA scores were not consistently available, limiting the ability to quantify global severity change using standardized scales.
Several methodological considerations should be taken into account when interpreting these findings. First, the retrospective design and reliance on medical record data may introduce information bias, particularly in the absence of standardized photographic documentation or consistent follow-up intervals.
An important limitation of this study is the presence of concomitant acne therapies. Although systemic medications, including oral antibiotics and isotretinoin, were documented with stable dosing throughout the treatment period, topical acne therapies were frequently used as part of routine clinical care but were not systematically documented in the medical records. Furthermore, because baseline acne severity grade was inconsistently documented, a standardized pretreatment disease severity assessment could not be performed for all patients. Hence, these co-interventions could not be fully adjusted for in the analysis. Consequently, the observed clinical improvements cannot be attributed solely to RF microneedle treatment, because they may be partially attributable to concurrent therapies. This limitation precludes isolating the device's independent effect and restricts interpretation to descriptive within-subject changes over time. Further, the high responder rate (94%) led to quasi-complete separation in the logistic regression models, limiting their stability and interpretability.
Despite these limitations, this study provides valuable real-world evidence of the clinical utility of POTENZA RFMN in acne management. These outcomes are particularly relevant for patients seeking nonpharmacological or adjunctive therapies that target both inflammatory lesions and textural irregularities. From a pragmatic standpoint, treatment regimens of ∼3 to 4 sessions at moderate-to-high energy levels suggested potential benefits for most patients, although individualized adjustments remain essential.
Future research should confirm these findings in prospective, controlled trials using standardized imaging and blinded assessments. Comparative studies against standard acne therapies or other energy-based devices, as well as longer-term follow-up evaluating durability and pigmentary safety, will be critical to defining the comparative effectiveness and optimal role of Potenza RF in acne management.
CONCLUSIONS
In real-world practice, the POTENZA RFMN demonstrated a meaningful clinical improvement in acne, with significant lesion reduction. The treatment showed excellent tolerability, with only mild, transient adverse effects, supporting its favorable safety profile in patients with Fitzpatrick skin types III and IV. However, given the retrospective nature of this study, prospective controlled clinical trials are needed to validate these outcomes, optimize treatment parameters, and assess the long-term benefits of this approach.
Disclosures
Drs Kim and Lee have received research grants from Jeisys Med Inc. (Seoul, Republic of Korea). Ms Baek is an employee, and Dr Kumar is a consultant at Jeisys Med Inc.
Funding
This research was supported by funding from Hallym University, Seoul, Republic of Korea. Jeisys Med Inc. (Seoul, Republic of Korea) funded the Open Access publication of this article.
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