NeoGen vs Tixel: Two Devices, One Indication, and the Better Trial

We offer NeoGen and we do not offer Tixel. That is worth stating at the top, because it should make you read the rest more carefully rather than less.

The two devices get compared constantly and for good reason: both resurface skin without a laser, both are sold on the promise of less recovery than ablative treatment, and both are most often recommended for the same thing, which is the crepey, lined skin around the eyes. If you are weighing them up, the useful question is not which mechanism sounds better. It is which one has been tested, on how many people, and for how long.

On that question, Tixel is ahead.

What each device does

NeoGen passes radiofrequency through nitrogen gas to make plasma, and delivers that as controlled thermal pulses to the skin surface. The energy is absorbed by the skin itself rather than by a colour target, nothing enters the skin, and the treated surface is not vaporised: it dries out and stays in place as a natural dressing while new skin forms underneath, then flakes away.

Tixel is thermomechanical. A tip of small heated pyramids makes brief, direct contact with the skin, transferring heat by touch rather than through gas or light. It is fractional, meaning it treats a pattern of points and leaves untreated skin between them.

That last difference is the one people miss. NeoGen treats the whole field with no untreated islands. Tixel treats a fraction of it and relies on the untreated skin between the points to speed healing. Neither approach wins outright. One buys you full coverage, the other buys you a faster week.

The trials, side by side

Both devices have a randomised trial on periorbital wrinkles. They are not the same size of evidence.

NeoGen’s is a randomised controlled evaluator-blinded trial of eighteen people published in 2019. One side of the face received three sessions three weeks apart and the other side was left untreated. The treated side scored better on wrinkle grading, on instrument measurement of skin wrinkling, and on melanin index. Patients were followed to fourteen weeks. The study’s funding included the device manufacturer.

Tixel’s is a randomised controlled trial of sixty-eight patients published in 2022, run across two centres in Israel and the United States, covering Fitzpatrick skin types I to VI. Patients received three to five treatments and were assessed six months after the last one by three physicians who had no involvement in the treatment. Improvement in wrinkle classification averaged 1.6 points, and the comparison arm was not an untreated face but an active treatment, a non-ablative fractional 1565nm laser, which performed equivalently.

Line the two up and the gap shows in four places.

• Size. Sixty-eight against eighteen.
• Skin types. Tixel’s trial covered types I to VI. Energist’s protocols stop at IV, and types V and VI appear nowhere in them.
• Follow-up. Six months after the last treatment, against fourteen weeks.
• Comparator. Tixel was measured against a working laser. NeoGen was measured against an untreated cheek, which tells you the treatment does something without telling you it beats the alternatives.

Pick on evidence and you pick Tixel. We are not going to dress that up.

Where the downtime claim gets interesting

Tixel is marketed on speed of recovery, and the trial partly supports that: roughly 80% of patients were back at work and at social activities two days after treatment.

The same paper is less quoted on what else it found. Crusting lasting beyond 48 hours was reported by 52% of the Tixel patients, against 16% in the laser comparison arm. So the picture is not “no downtime”. It is most people functioning normally within two days, with half of them still visibly crusted while they do it.

NeoGen’s published recovery is longer and better documented. In the low-energy study, re-epithelialisation was complete at four days and redness lasted six days on average, with the first session taking nine days to settle against four or five for the sessions after it. At the higher settings used in the acne scarring study, skin bronzed and then peeled over four to six days.

So Tixel gets you back to work sooner. NeoGen covers every millimetre it passes over and reaches the lash line. Trade one against the other.

So why do we have NeoGen

Neither reason is that it beat Tixel on evidence.

Coverage is the first. NeoGen treats the entire field, leaving no untreated skin between points, and the dried layer that forms covers the whole area instead of a scatter of dots. Skin that is evenly lined or sun-damaged all over responds to that better than to a pattern.

The eyelid is the second. Nothing enters the skin and no pigment is needed for the energy to land, so your clinician can work closer to the lash line than with any needling or light-based device we own. Nothing else on our menu could do that, which is why the eye area is what we lead on.

If you have read the trials above and concluded that Tixel is the better-evidenced device for periorbital wrinkles, that is a defensible reading and we would not argue you out of it. There are clinics within reach of Newark that offer it.

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