Combination Resurfacing
RF Microneedling & Erbium Laser
For skin that needs work at every level. The PiXel8-RF firms and smooths from within; the erbium laser clears lines, spots, and scars from the surface. Planned and performed by our board-certified nurse practitioner for a single, more complete renewal.
How the treatments work together
Each treatment is powerful on its own, but they work on different layers. RF microneedling tightens and thickens the skin's foundation. Erbium laser smooths what shows. Pairing them gives a more complete result than either could achieve alone.
Our Approach
At St. Johns Wellness, we don’t stack treatments for the sake of it. Our board-certified nurse practitioner recommends this combination only when your skin will benefit from both: laxity or scarring that needs RF’s deeper remodeling, plus texture or pigmentation that needs the laser’s precision. If one treatment alone will get you there, that’s what we’ll suggest.
The two can be done together in one visit or spaced apart, depending on your skin and goals; we’ll advise what’s right for you. Downtime is similar to laser resurfacing alone, and results continue to build for months as collagen rebuilds beneath renewed skin.
60–90 minutes
3–7 days
Last for years
What we treat
Some skin concerns need to be rebuilt from below and refined from above. These are the ones where pairing RF microneedling with erbium laser makes the biggest difference.
Acne scars
RF remodels the scar tissue beneath while the laser levels the surface. The pairing is our most effective option for deep, pitted scarring.
Loose skin & sun damage
For skin that's both lax and sun-marked, RF tightens and the laser clears spots and texture, restoring firmness and tone together.
Deep wrinkles
Lines that have settled into the skin need support beneath and smoothing above. Treating both layers softens them more than either could alone.
Post-weight-loss skin
Tightens crepey, loose skin on the face, neck, and body while smoothing the texture and stretch marks that often come with it.
Neck & décolletage
Thin, sun-exposed skin that shows age early. The combination firms and evens it while keeping the depth gentle enough for delicate areas.
Overall skin renewal
For patients who want the most complete improvement in one plan: firmer structure, smoother texture, clearer tone, and a lasting result.
Candidacy
Am I a good candidate for combination resurfacing?
This treatment is for skin that would benefit from work at more than one depth. You’re likely a good candidate if you:
- Have loose skin along with sun damage, lines, or uneven texture
- Are dealing with deep acne scars that haven't fully responded to one treatment
- Want the most complete improvement possible in a single plan
- Can set aside about a week for recovery in exchange for lasting results
We’ll advise against it if you’re pregnant, have an active breakout or cold sore, or have a pacemaker or metal implant nearby. Everything else we’ll go through at your consultation, including whether you need both treatments or just one.
What to expect
One recovery, a more complete result
Plan for 60 to 90 minutes, including numbing. The RF microneedling is done first, then the erbium laser passes over the surface. Afterward, expect redness, mild swelling, and light peeling for three to seven days, depending on the laser depth. Most patients are back to normal, with makeup, within a week. Skin looks brighter as it heals and keeps firming for three to six months.
Before your visit
- Stop retinol, acids, and exfoliants for one week
- Avoid sun and tanning for two weeks
- Tell us about cold sores, pregnancy, or metal implants
First 48 hours
- Keep skin moist with the ointment we provide
- No makeup, exercise, or heat until peeling is complete
- Daily SPF and shade for at least four weeks
The RF microneedling and erbium laser combination at St. Johns Wellness starts at $XXX for the face, with pricing for neck, chest, and body areas quoted separately. It’s priced below the two treatments booked individually. Consultations are free, and our nurse practitioner will give you a full quote for your plan before anything is scheduled.
Because they work on different layers. RF microneedling sends energy deep into the skin to tighten and rebuild collagen, but it does little for surface pigmentation or texture. The erbium laser removes damaged surface skin with precision, but doesn’t tighten deeper tissue. Together, they address laxity, scarring, lines, and sun damage more completely than either alone.
That depends on your skin, the laser depth needed, and how much recovery you can plan for. Some patients have both in a single session with one healing window; others do better with the treatments spaced a few weeks apart. Our nurse practitioner will recommend the right approach at your consultation.
For the right skin, yes. If your concern is purely firmness, RF alone may be enough; if it’s purely surface damage, the laser alone may be enough. But for deep acne scars, loose skin with sun damage, or wrinkles that run deep and show on the surface, the combination consistently produces a more complete, longer-lasting result.
Recovery follows the laser’s timeline, since the RF adds very little on top. Expect redness, mild swelling, and peeling for three to seven days depending on the depth we choose. Most patients are back to normal, with makeup, within a week.
Many patients see significant improvement from a single combination treatment. For deeper scarring or more advanced laxity, a second session three to six months later may be recommended. Your plan will be mapped out at your consultation.
RF microneedling is safe across all skin tones. The erbium laser carries more pigmentation risk on medium to deep skin, so we assess carefully and may recommend a lighter laser depth, a test spot, or RF alone. This is always an honest conversation, never a one-size-fits-all answer.