A Histological Study on the Treatment of Acne Scars with Fractional Radiofrequency: Preliminary Findings

Tokuya Omi Shigeru Sato

doi:10.4172/2155-9554.1000203

Abstract

Background and aims: After the inflammatory stage of severe acne vulgaris, atrophic scarring may occur this is problematic to both the patient and surgeon. A variety of treatment techniques including ablative and nonablative lasers have been used, however results have been inconsistent with both over- and under-treatment. Fractional radiofrequency (RF) has recently attracted attention in this field. The present study evaluated changes in the dermal morphology and ultrastructure one month post-fractional RF treatment. Patients and methods: The study subjects were 4 females and 2 males (Fitzpatrick skin type IV, mean age 39.3 yr) with moderate to severe acne scarring. They were treated with a single session of fractional RF (peak energy level of 25 J). Biopsies were obtained before, immediately after and 1 month after treatment, and examined under both light and transmission electron microscopy. Results: Before treatment, the dermis in all patients demonstrated dense connective tissue with hyperplasia of elastic fibers with sporadic depositions of elastin. Histological and ultrastructural evaluation at one month after fractional RF treatment revealed remodeling of the dermis, accompanied by elastic fiber remodeling, to give a more normallooking morphology. Conclusions: Fractional-type RF therapy is promising, not only as a means of treating acne as reported previously, but also in the treatment of acne scars through remodeling of the dermis to replace acne scar-associated morphological and ultrastructural irregularities with a more normal architecture.

Highlights

In the ordinary course of wound healing after an outbreak of acne, the inflammatory stage of acne vulgaris may often be followed by an atrophic scar, rather than keloid or hypertrophic scar formation [1]
The acne scar before fractional radiofrequency irradiation was rich in connective tissue containing capillaries and fibroblasts within the dermis with hyperplasia of the elastic fibers and small string-form structures (Figure 1)
In the electron microscopic ultrastructural observation, numerous outgrowths of elastic fibers were observed in the superficial dermis in the region of the acne scars (Figure 2)

Summary

Introduction

In the ordinary course of wound healing after an outbreak of acne, the inflammatory stage of acne vulgaris may often be followed by an atrophic scar, rather than keloid or hypertrophic scar formation [1]. This is probably because the healing process of acne-associated lesions following inflammation involves a change in the dermis associated with the characteristics of this particular dermal lesion. Fractional and unfractionated, ablative (CO2) and a variety of nonablative systems, have been reported for the treatment of acne scars [2,3,4,5]. The present study evaluated changes in the dermal morphology and ultrastructure one month post-fractional RF treatment

Methods

Results

Discussion

Conclusion