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Objectives: RF needling seems to safe regardless of low dose of isotretinoin even more effect than without isotretinoin. However, mini invasive procedure within oral isotretinoin may induce longer erythema. Introduction: The efficacy of scar treatment may be limitted if the scars last longer than 6 months. Many severe acnes required the long term oral isotretinoin, thus the optimal time almost passed. However, in previous studies supported for avoiding cosmetic procedure such as laser, chemical peel, microneedling within oral isotretinoin treatment. We intent to investigate the effect and side effects of RF needling for acnes scars during oral isotretinoin treatment at the low dose. Materials / method: The record of 30 patients who was remaining low-dose of isotretinoin (0.2mg/kg/day) and 30 patients who stoped oral isotretinoin more than 6 months, accepted to scars treatment were including in this study. All patients received 3 times of RF needling treatment with the same intensity, 300 shots per time and moisturizing topical treatment for full face during a month interval. Follow-up was for 6 months to evaluate efficacy and side effects by both dermatologists and patients. Results: The scar improvement was evaluated by 2 blinded dermatologists using the photographs was higher in isotretinoin group compared to control group (p<0.05). Pore large and wrikle was reduced in both group compare to baseline (p<0.001). Patients in isotretinoin group was observed the longer duration of redness 15+/- 1 days after procedure compared to non-isotretinoin group (0<0.05). The higher prevalence of patients in isotretinoin group complained about redness compared to control group (P<0.05). Conclusion: RF needling seems to safe regardless of low dose of isotretinoin even more effect than without isotretinoin. However, mini invasive procedure within oral isotretinoin may induce longer erythema.