A Real-World Retrospective Cohort Study Evaluating Clinical Effects and Safety of Radiofrequency Microneedling for the Treatment of Rosacea

Background: Radiofrequency Microneedling (RFMN) targets vascular, inflammatory, and dermal remodeling pathways in rosacea; however, evidence from routine practice remains limited. Objective: To evaluate the clinical effects and safety of POTENZA ® RFMN in adults with rosacea in a real-world setting. Methods: We conducted a retrospective cohort study of 50 adults with clinically diagnosed rosacea treated with RFMN at a dermatology center (Hallym University Kangnam, Seoul, Republic of Korea). Severity was assessed longitudinally using the Rosacea Area and Severity Index (RASI) and erythema index from standardized photographs and the medical records. Missing data were addressed using multiple imputation and linear mixed-effects models. A substantial proportion of patients (68%) received concomitant oral antibiotics, and severity scoring relied on retrospective evaluation of photographs and medical records. Safety outcomes included adverse events, pain scores, lesion fading, texture improvement, and patient-reported satisfaction. Results: Fifty patients (80% women; median age, 33 years) were included. The median rosacea duration was 54 months (IQR 24– 81), and most had Fitzpatrick phototype III (76%). Missingness was consistent with a missing-at-random mechanism, as patients lost to follow-up had lower baseline disease severity. The mean RASI decreased from 11.9 to 9.08 (difference − 2.79; 95% CI − 3.48 to − 2.11; p< 0.001). The mean erythema index decreased from 2.48 to 1.58 (difference − 0.90; 95% CI − 1.14 to − 0.66; p< 0.001). Lesion fading occurred in 80% of the patients, and texture improvement occurred in 72%. Mild adverse events occurred in three patients (6%) and resolved within 96 hours. Conclusion: RFMN (POTENZA®) was associated with significant longitudinal improvements in rosacea severity and erythema, with favorable tolerability. Given the retrospective design, concomitant antibiotic use, and photographic scoring, these findings should be considered hypothesis-generating and warrant confirmation in prospective controlled studies.