A Study Comparing the Efficacy of Monopolar Radiofrequency and Glycolic Acid Peels in Facial Rejuvenation of Aging Skin Using Histopathology and Ultrabiomicroscopic Sonography (UBM) - An Evidence Based Study.

Deepal V Wakade,Kalpana D Bhatt,Chitra S Nayak

doi:10.14712/18059694.2016.49

Deepal V Wakade, Kalpana D Bhatt + Show 1 more

Open Access

https://doi.org/10.14712/18059694.2016.49

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Abstract

Radio frequency (RF) and chemical peels have been used for nonablative skin rejuvenation. Both of these cause collagen remodeling in the dermis and neo-collagen formation resulting in facial rejuvenation. There is limited literature on the evaluation of collagen remodeling by objective methods. To compare the benefits of monopolar radiofrequency and glycolic acid peels in facial rejuvenation with regards to histopathology and Ultrabiomicroscopic sonography (UBM). In this study, forty patients with mild to moderate photoaging received four treatments with 3 weeks interval of monopolar radiofrequency on one side of face and glycolic acid peels in increasing concentrations (NeostrataR) on the other side. Pre and post treatment, 2 mm biopsies were taken from both preauricular areas and Ultrasonography using a 35 MHz probe was done from outer canthus of eye and nasolabial folds from both sides of face. A blinded assessment was done to measure the increase in the grenz zone and dermal thickness. In 35/40 patients there was a significant increase in the grenz zone on histopathology and decrease in subepidermal low-echogenic band (SLEB) on UBM of the nasolabial folds on both sides of the face (p < 0.05). Radiofrequency and chemical peels showed equal efficacy in the treatment of facial rejuvenation.

Highlights

There are two clinically and biologically distinct aging processes affecting the skin [1]
When RF energy is applied to the skin, resistance encountered by the energy flow causes heat to be produced which causes tightening to the underlying tissue structures
When comparing RF to other non-ablative techniques, RF energy differs from laser energy in that lasers tends to scatter or absorb into the upper layers of the skin, making it difficult to deliver sufficient heat into the deeper layers without damaging the skin’s surface while RF energy is able to penetrate deeper into the skin and affect the deeper dermis and subcutaneous layers causing skin tightening

Summary

Introduction

There are two clinically and biologically distinct aging processes affecting the skin [1]. The first is intrinsic aging, which affects the skin by slow, irreversible tissue degeneration. There are a myriad of therapeutic modalities that can improve photoaging These modalities may be divided into topical agents and procedural agents. Procedural agents include chemical peels, microdermabrasion, lasers, and intense pulse light and nonablative radiofrequency. Chemical peeling is a cosmetic procedure that involves the application of one or more exfoliating agents to the skin to wound the epidermis and dermis in a controlled manner. RF-based systems are appropriate for any skin type Both radiofrequency and chemical peels produce subsequent collagen remodeling and skin rejuvenation. The purpose of this study was to assess and objectively quantify the benefits of both the treatments in facial rejuvenation

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