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Objective:To observe the efficacy and adverse reactions of fractional radiofrequency (FRF) in the treatment of facial acne scars.Methods:Fifty-seven patients with facial acne depressed scars were enrolled with the nature of Dreno scars as the diagnostic criteria. They were treated with lattice radiofrequency. The treatment heads were arranged in a matrix with a treatment area of 1.2 cm ×1.2 cm, an energy density of 80-100 mJ/pin, and an interval of five-seven once a week. And they were followed up and evaluated for the clinical efficacy and adverse reactions 6 months after the last treatment. Scoring was carried out according to the ECCA weight scores, and the efficacy judged according to complete improvement, significant improvement, moderate improvement, and mild improvement.Results:After 3 times of fractional radiofrequency treatment of 57 patients, the effective rate was 44 cases, accounting for 77.2%; the ECCA weight scores before and after treatment were 65.9±25.0 and 47.7±20.2, respectively; the difference was statistically significant ( t=13.92, P<0.001); At the same time of improvement, 32 cases of patients' complexion, fineness of pores, and skin elasticity had been improved to varying degrees, and patient satisfaction was high. Adverse reactions were mainly mild burning sensation, erythema and edema, and some patients had pale yellow exudate, etc, which could be relieved in 5-7 days. Conclusions:Fractional radiofrequency treatment of facial acne scars is safe and effective, with short recovery period, few adverse reactions and high patient satisfaction.
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Objective To compare the clinical efficacy and safety of invasive microneedle radiofrequency versus plasma fractional radiofrequency in the treatment of atrophic facial acne scars.Methods A total of 30 patients with atrophic acne scars were enrolled from the Department of Dermatology of Xiangya Hospital affiliated to Central South University between January 2017 and March 2017.By a random number table,every patient randomly received the treatment with invasive microneedle radiofrequency on one half of the face and plasma fractional radiofrequency on the other facial side once every 8-12 weeks for 3 sessions.Before and after each treatment,facial photos were taken,acne scars were scored by the ECCA grading scale (échelle d'évaluation clinique des cicatrices d'acné),and improvement rates of these lesions were evaluated subjectively by doctors.Adverse reactions were recorded after treatment,and the degree of pain and satisfaction was evaluated by the patients themselves.The Germany CK physiological index detector was used to detect the skin moisture content,transepidermal water loss (TEWL) and sebum content.Results All of the 30 patients completed 3 sessions of treatment and follow-up.After the 3 sessions of treatment,the average score on invasive microneedle radiofrequency-treated sides was 3.00 ± 0.91,and 22 patients achieved more than 50％ improvement.However,the average score on plasma fractional radiofrequency-treated sides was 3.57 ± 0.57,and 29 patients achieved more than 50％ improvement.The overall therapeutic effect of plasma fractional radiofrequency was significantly superior tothat of invasive microneedle radiofrequency (t =2.894,P =0.005).For V-shaped and U-shaped scars,there was no significant difference in the overall improvement rate between the invasive microneedle radiofrequency-treated side and plasma fractional radiofrequency-treated side (both P ＞ 0.05).For Mshaped rolling scars,the overall improvement rate was significantly lower on the invasive microneedle radiofrequency-treated side (36.5％ ± 2.1％) than on the plasma fractional radiofrequency-treated side (48.7％ ± 3.4％,P ＜ 0.01).However,the pain score was significantly lower on the invasive microneedle radiofrequency-treated side (5.54 ± 0.57) than on the plasma fractional radiofrequency-treated side (8.07 ± 0.79,P ＜ 0.01).After 3 sessions of treatment,there were no significant differences in the degree of patient satisfaction (x2 =0.10,P ＞ 0.05),skin moisture content (P ＞ 0.05),TEWL (P ＞ 0.05) or sebum content (P ＞ 0.05) between the 2 sides.Adverse reactions such as erythema,exudation and hemorrhage occurred on both of the 2 sides.Conclusions For small V-shaped and U-shaped scars,the plasma fractional radiofrequency and invasive microneedle radiofrequency both can be applied in clinic.For large M-shaped rolling scars,the plasma fractional radiofrequency can be preferentially selected.
ABSTRACT
Fractional radiofrequency(FRF)is an aesthetic technique that utilizes electric current emanating from electrode or microneedle arrays to heat the dermis in a fractional pattern, with only little damage to the epidermis. The recovery process following the heat damage involves multiple heat shock proteins, matrix metalloproteinases, cytokines, etc, which can stimulate the proliferation of collagen and elastic fibers in the dermis. It has been applied to treat wrinkles, skin laxity, acne scars and other aesthetic skin problems, and has proved to be a safe and effective cosmetic method for the improvement of atrophic acne scars, inflammatory acnes and postinflammatory erythema. It has few adverse effects, including tolerable pain, transient erythema, edema and mild crusting, so the downtime is short. FRF is more suitable for populations with dark complexions because of low risks of postinflammatory hyper?pigmentation. Recently, it has been used in combination with other devices such as lasers, or been used to assist transdermal drug delivery, and has shown remarkable therapeutic effects and favorable application prospects.
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BACKGROUND: Several studies have described the use of bipolar fractional radiofrequency (FRF) treatment not only to reverse aging or restore photo-damaged skin but also to treat acne and acne-related scarring with a low downtime and few potential complications. However, few histological studies have been conducted to identify the precise mechanism responsible for the success of bipolar FRF treatment. OBJECTIVE: To compare thermal tissue damage and wound repair after exposure to bipolar FRF and ablative CO₂ laser treatment. METHODS: We irradiated the skin of an albino rat (Sprague-Dawley, 200∼250 g) using a CO₂ laser and a bipolar FRF device. Biopsy specimens of the irradiated skin were collected on the first, third and fourteenth day after treatment. For histological analysis, the skin samples were stained with hematoxylin and eosin, Masson's trichrome, and Verhoeff-van Gieson stain. RESULTS: Immediately after bipolar FRF treatment, the skin samples showed coagulated columns in the dermis forming a pyramidal zone of sublative thermal injury. Three days after treatment, they showed re-epithelialization with minimal crust formation. Compared to the ablative CO₂ laser, bipolar FRF treatment showed lower epidermal disruption and more extensive dermal remodeling, with a rapid tissue repair response to the damage. CONCLUSION: With bipolar FRF treatment, wound repair is rapid with minimal recovery time and pigmentary complications. The bulk impact of coagulation and residual heating occurring deep within the dermis causes significant collagen contracture and remodeling, leading to effective improvement in skin texture and wrinkles, acne scars, and dyschromia in all skin types.
Subject(s)
Animals , Rats , Acne Vulgaris , Aging , Biopsy , Cicatrix , Collagen , Contracture , Dermis , Eosine Yellowish-(YS) , Heating , Hematoxylin , Hot Temperature , Re-Epithelialization , Skin , Wounds and InjuriesABSTRACT
BACKGROUND: Several studies have described the use of bipolar fractional radiofrequency (FRF) treatment not only to reverse aging or restore photo-damaged skin but also to treat acne and acne-related scarring with a low downtime and few potential complications. However, few histological studies have been conducted to identify the precise mechanism responsible for the success of bipolar FRF treatment. OBJECTIVE: To compare thermal tissue damage and wound repair after exposure to bipolar FRF and ablative CO₂ laser treatment. METHODS: We irradiated the skin of an albino rat (Sprague-Dawley, 200∼250 g) using a CO₂ laser and a bipolar FRF device. Biopsy specimens of the irradiated skin were collected on the first, third and fourteenth day after treatment. For histological analysis, the skin samples were stained with hematoxylin and eosin, Masson's trichrome, and Verhoeff-van Gieson stain. RESULTS: Immediately after bipolar FRF treatment, the skin samples showed coagulated columns in the dermis forming a pyramidal zone of sublative thermal injury. Three days after treatment, they showed re-epithelialization with minimal crust formation. Compared to the ablative CO₂ laser, bipolar FRF treatment showed lower epidermal disruption and more extensive dermal remodeling, with a rapid tissue repair response to the damage. CONCLUSION: With bipolar FRF treatment, wound repair is rapid with minimal recovery time and pigmentary complications. The bulk impact of coagulation and residual heating occurring deep within the dermis causes significant collagen contracture and remodeling, leading to effective improvement in skin texture and wrinkles, acne scars, and dyschromia in all skin types.