Devices

These are the procedures carried out with a device. It is not a separate layer but a filtered view; every page here is also in the procedures list.

Evidence level

Early researchRoute · Device-based

Non-ablative fractional laser

On acne scars it was matched against a 1064 nm picosecond laser across the two sides of the face and lost, 42% against 55% ECCA reduction. Pain and side effects were also higher on this side. And a separate trial reported normal wound healing when treating within one month of finishing isotretinoin — with 10 people.

Moderate evidenceRoute · Device-based

Monopolar radiofrequency

We read four randomised trials of monopolar radiofrequency. All of them — including a multicentre study analysing 212 people — used another device as the control, and all of them concluded 'not inferior'. We found no trial comparing it against doing nothing.

Not establishedRoute · Device-based

Micro-coring

An independent systematic review in 2025 counted every study of this technology — eight, three of them in pigs. The clinical studies are five, 112 patients in all, and there is not one randomised comparison. That review wrote that larger cohorts, longer follow-up and comparisons with other minimally invasive techniques are needed. The 2026 paper that followed is retrospective, single-site, 10 patients and single-sex, and its conclusion calls it 'an effective alternative to injectable fillers' — with no filler comparison arm.

Early researchRoute · Device-based

Microdermabrasion

The firmest randomised trial we found compares what to prepare skin with before photodynamic therapy. In it, microdermabrasion partially removed the stratum corneum on histology, and drug uptake came in below ablative fractional laser and similar to microneedling and curettage. There is no randomised trial on this page measuring whether it improves wrinkles or texture.

Moderate evidenceRoute · Device-based

Microfocused ultrasound

In a 2023 systematic review of 16 studies, brow lift measured 0.47–1.7 mm and submental area fell 26–45 mm². In the same data, 92% were classed as improved by the treating physician — but only 42% of patients said so themselves. The gap between those two numbers is the honest size of this procedure.

Not establishedRoute · Device-based

Low-level light therapy (LED cap)

A 26-week, multicentre, double-blind, sham-controlled trial — a rare quality of design for this layer. But 160 were randomised and 91 dropped out of the analysis, and the primary endpoint did not reach significance in any individual arm. Only a pooled analysis of the three active arms beat sham (p = .033, 28.5 hairs per cm²). Two device companies appear in the author affiliations.

Early researchRoute · Device-based

Microwave energy device

The most widely cited one-year follow-up study of this procedure was retracted in January 2026 (Skin Res Technol 2026;32(1):e70317). What remains are uncontrolled series of 10 and 20 people and a retrospective comparison of 171. We found no randomised controlled trial at all.

Early researchRoute · Device-based

Picosecond laser

In two split trials, picosecond won. On pigment (ABNOM), clearance 3.73 against 2.4 and post-inflammatory hyperpigmentation 27.77% against 54.44%; on acne scars, ECCA reduction 55% against 42% — and both trials had less pain on the picosecond side. But neither had an untreated arm, and the authors of one wrote the lack of objective evaluation into their limitations.

Moderate evidenceRoute · Device-based

Laser toning and picosecond toning

In a split-face trial pitting picosecond against Q-switched toning, there was no significant difference between them, and the melanin index did not improve significantly on either side. In a network meta-analysis of 39 studies and 1,394 participants, the top of the ranking was combination rather than laser alone, and second place went to oral tranexamic acid. Punctate leukoderma is a recognised complication.

Moderate evidenceRoute · Device-based

Microneedle radiofrequency

In a 30-person split-face trial for acne scars it was comparable to ablative fractional CO2 laser, and the CO2 side hurt more. But in a 20-person trial, alternating it with a non-ablative fractional laser was no better than the laser alone. A review of 16 studies and 481 patients called it 'likely effective' while noting that more randomised trials are needed to establish the right parameters.

Moderate evidenceRoute · Device-based

Fractional laser (Fraxel, fractional CO2)

The randomised acne scar trials we read are mostly 'something new against fractional CO2', and they almost always end in 'no significant difference in scar score'. In a 2025 picosecond comparison, mean ECCA scores did not differ (P = 0.209), and the microneedle radiofrequency comparison was similar. But pigment and erythema measures rose significantly on the CO2 side.

Moderate evidenceRoute · Device-based

IPL (intense pulsed light)

In a randomised trial following 227 people for two years, the control group received no treatment at all. Clearance of telangiectasia of 90% or more was reached by 66.36% with IPL against 0% in controls; total efficacy was 95.33% against 30.83%. In a photoaging trial, one side of the face was treated and the other left alone — and biopsy showed decreased melanin and increased collagen only on the treated side.

Whether to have it done is a decision to make with a doctor.