SkinPen or Fractora: How a Provider Chooses Between Two Kinds of Microneedling

SkinPen and Fractora are both microneedling, and the difference between them is heat. SkinPen works with needles alone. Fractora sends radiofrequency energy down through those needles, and that's the difference that decides which one suits your skin.

They sit on Redbud's menu under the same word, which hides a real fork in the road. One is the gentler, start-here treatment. The other is what we reach for when the problem sits deeper than a needle reaches.

What is the difference between SkinPen and Fractora?

Both glide a cartridge of fine needles over your skin and leave tiny, controlled channels behind. Your body reads those channels as an injury worth fixing and answers with fresh collagen. With SkinPen that's the whole treatment: the needles work mechanically, and the repair does the rest.

Fractora adds current. Its pins carry radiofrequency energy into the skin while they're sitting in it, heating the dermis, the layer underneath where collagen lives, while sparing the epidermis on top. It's working one floor down, and that deeper remodeling shows up on biopsy as softer wrinkles and denser dermis.

Deeper isn't automatically better. It's the right answer for some problems and more than you need for others.

What is each device FDA-cleared to do?

The two clearances aren't parallel.

SkinPen is cleared under the FDA's microneedling regulation, a category the agency created in 2018 because nothing like it had been cleared before. That clearance names cosmetic concerns: the appearance of facial acne scars in adults with all Fitzpatrick skin types aged 22 years and older, and wrinkles of the neck in Fitzpatrick skin types II to IV, which covers fair to olive skin tones. Two indications, two populations, an age floor.

Fractora is cleared under a different regulation, the one covering electrosurgical cutting and coagulation devices, which use high-frequency current to cut tissue and control bleeding. Its 2011 clearance reads "dermatological procedures requiring ablation and resurfacing of the skin." The 2018 and 2019 clearances in the same family read "Dermatologic and General Surgical procedures for Electrocoagulation and Hemostasis."

No clearance in the Fractora line names a wrinkle, a scar, or loose skin. Every cosmetic use of it sits outside the wording the FDA reviewed.

That's ordinary, and it isn't a reason to avoid the treatment. SkinPen gets used off label too: we treat pores and texture with it, and neither one is on its clearance. Off label means outside the wording the agency reviewed. It doesn't mean improper or unstudied. It does mean "both are FDA-cleared" says less than it sounds like it says.

Which concerns point to SkinPen, and which point to Fractora?

Start with what's bothering you, not with the device. That's the first question we ask, and it usually settles the rest.

SkinPen is for what's happening near the surface: rough or uneven texture, enlarged pores, early fine lines, skin that's gone a bit flat, and acne scarring. If you've never had a collagen treatment before, it's a sensible place to start.

Fractora is for the structure underneath: deeper wrinkles that stay put when your face is at rest, stretch marks, sun damage, scarring that hasn't budged with gentler treatment, and mild to moderate laxity, meaning skin that has started to loosen.

Acne scarring sits in both columns, which is where people get stuck. Shallow, rolling scars can respond to needles alone over a series. Deep, sharply defined scars have more tissue to remodel, and heat gives us more to work with. Which kind you have is something to look at rather than guess at.

There's no head-to-head trial of these two devices in the published reviews. So the choice is clinical judgment rather than a settled result.

Your history narrows it further. Keloid-prone skin rules out SkinPen at Redbud. Certain pacemakers and implanted devices rule out Fractora, since radiofrequency current is the mechanism. Pregnancy, breastfeeding, active skin infection and recent Accutane put both on hold.

So does your calendar. Someone who can't take a week of looking like they've had something done will skip sessions, and a half-finished series gets you less than the gentler treatment seen through.

Often enough the answer is both, in sequence: SkinPen for the surface, Fractora for the structure, spaced so your skin recovers in between. That's a plan, not a menu pick.

How different is the recovery?

Plan on about an hour in the room for SkinPen and a bit longer for Fractora, numbing included. You're numb before anything starts, so mostly you feel pressure: SkinPen is a light buzz with some prickling, and Fractora adds warmth on top.

SkinPen sends you home pink and warm, the way your face feels after a brisk walk in the cold. Expect that flush and a tight feeling for one to three days, then light flaking. Most clients are back at work the next day.

Fractora asks more of you. There's redness and swelling, sometimes tiny scabs where the pins went in, and a sandpaper feel while the surface knits back together.

Most clients are back at work in mineral makeup within 24 to 48 hours, with the skin fully settled closer to a week. Sleeping with your head slightly raised the first night helps with the swelling.

Those little scabs are the part people underestimate. Flaking you can work around. Micro-crusting you have to leave alone, and picking at it is the quickest way to trade a good result for a lasting mark.

Both want the same aftercare: SPF 30 or higher daily, and no hard workouts, saunas or hot tubs for 48 hours. Both are series treatments, SkinPen usually three sessions four to six weeks apart and Fractora two to three on the same spacing. If you're timing either one around a wedding or a holiday party, give us the date first and we'll plan backward from it.

Does your skin tone change the answer?

It changes how we get to the answer, not whether you have good options.

SkinPen uses no heat and no light, so nothing in it is aiming at pigment, and its acne-scar clearance covers all Fitzpatrick skin types. Radiofrequency isn't aiming at pigment either, which is why it's treated differently from light-based lasers in deeper skin.

A 2023 review of radiofrequency microneedling in Fitzpatrick types III to VI found a low risk of scarring or pigment change overall, though seven of the 35 studies it covered noted temporary post-inflammatory hyperpigmentation, the darkening that can follow inflammation in the skin, and its authors say a large share of that research lacks strong quality evidence. The FDA record points the same direction: one clearance in the Fractora family limits its applicator to Fitzpatrick skin types I to IV above a stated energy level.

So with radiofrequency the setting is part of the answer, not just the device, which is an argument for an experienced provider rather than a reason to rule it out. If pigment has given you trouble after a procedure, say so at your consultation. It often moves the plan toward SkinPen first.

What to expect at Redbud

Redbud is a boutique practice in northwest Denver, and nobody books you into a series before a provider has looked at your skin. A consultation starts with the thing bothering you most and ends with a plan: SkinPen, Fractora, one and then the other, or neither.

Details on each treatment live on the SkinPen microneedling and Fractora RF microneedling pages, and our SkinPen post covers that one on its own. Weighing microneedling against a peel? Our post on microneedling and chemical peels covers that, and acne scar treatments in Denver runs through the wider set. First-visit and candidacy questions live on our FAQ page.

To find out which of the two your skin is asking for, book a consultation, or call or text the clinic at 720-593-8844. Redbud Medical Spa is at 2345 7th St STE 202, Denver, CO 80211.

This article is for general education and is not medical advice. SkinPen is an FDA-cleared Class II medical device, cleared to improve the appearance of facial acne scars in adults 22 years and older with all Fitzpatrick skin types, and wrinkles of the neck in Fitzpatrick skin types II to IV. Fractora is cleared under a separate FDA regulation covering electrosurgical cutting and coagulation devices, for dermatologic and general surgical procedures; its cosmetic uses are off label. Individual results vary, and no outcome can be promised. Talk with a licensed provider about your own skin, your history and your medications before starting any treatment.