Fractional Bipolar Radiofrequency Research Articles

Efficacy and safety of bipolar fractional radiofrequency vs. 2940-nm Er:YAG ablative fractional laser in striae distensae treatment: A split abdomen study.

Striae distensae (SD) is a challenging cosmetic condition. Ablative fractional laser (AFL) is an effective method for treating SD. Recently, fractional radiofrequency (FRF) has been shown to be a promising treatment for SD; however, few studies have shown the differences between FRF and AFL in the treatment of SD. This study aimed to evaluate and compare the clinical efficacy and safety of bipolar FRF with 2940-nm erbium yttrium aluminum garnet (Er:YAG) AFL in the treatment of SD. Twenty volunteers with abdominal SD were enrolled in this study. One half of the abdomen was treated with 2940-nm Er:YAG AFL, whereas the other half was treated with bipolar FRF, with three sessions at 4-week intervals. Photographic evaluations of clinical improvement were conducted by two independent investigators before and after treatment, and the patients provided self-assessments. Two participants underwent three punch biopsies, one before treatment and two obtained from bilateral representative skin lesions on the abdomen 3 months following the final treatment. Clinical improvements were observed in SD on both sides of the abdomen after the two treatments. Post-treatment skin biopsies revealed increased thickness in the epidermis and dermis, and higher collagen and elastin density compared to those at the baseline. No statistically significant differences were observed in the clinical outcomes between the two treatment approaches. The efficacy and safety of bipolar FRF treatment are comparable to those of 2940-nm Er:YAG AFL treatment, providing an alternative and effective treatment for SD.

Safety, tolerability and short-term efficacy of transvaginal fractional bipolar radiofrequency therapy for symptoms of stress and or mixed incontinence in conjunction with genitourinary syndrome of menopause.

Radiofrequency (RF) energy application stimulates collagen and elastin remodeling to restore the elasticity, and moisture of the superficial vaginal mucosa. This is the first study to report on the use of microneedling to deliver RF energy to the vaginal canal. Microneedling increases the response of the collagen contraction and neocollagenesis in deeper layers of tissue, thus increasing the support to the surface. The novel intravaginal microneedling device used in this study allows penetration of the needles to 1, 2, or 3 mm. A prospective study to evaluate the safety and short-term outcome of a single fractional RF treatment of the vaginal canal in a series of women with coexistent stress or mixed incontinence (MUI) and genitourinary syndrome of menopause (GSM). Twenty women who had symptoms of SUI and or MUI in conjunction with GSM were given a single vaginal treatment that consisted of fractional bipolar RF energy using the EmpowerRF platform with the Morpheus8V applicator (InMode). RF energy was delivered into the vaginal walls via 24 microneedles, at a depth of 1, 2, and 3 mm. Outcomes were evaluated by "cough" stress test, questionnaires (MESA SI, MESA UI, iQoL, UDI-6) and evaluation of vaginal tissue through the VHI scale at 1-, 3-, and 6-months post-treatment compared to baseline. Biopsies were performed at baseline and 3-months on five patients for histological reference and tissue evaluation. Eight out of eight outcomes measured from baseline to 6-months post-treatment showed improvement. The parameters scored in the questionnaires including frequency, urgency, nocturia, urge incontinence, and stress incontinence showed significant improvement in all areas at the 1-, 3-, and 6-month follow-up sessions compared to baseline. The results showed evidence that fractional RF energy delivered vaginally is safe, well tolerated, and provide short term improvement of SUI and or MUI in conjunction with GSM.

Rejuvenating and contouring effect of bipolar fractional microneedle radiofrequency on the lower eyelid

Rejuvenating and contouring effect of bipolar fractional microneedle radiofrequency on the lower eyelid

Complex treatment of patients with hormone-dependent atrophic scars

BACKGROUND: There are a large number of different methods of treating striae, starting with local therapy with various oils, ending with hardware techniques, but standardized treatment protocols have not yet been developed, which forces us to look for new promising combined treatment regimens
 AIMS: To study the effectiveness of therapeutic complexes in patients with atrophic hormone-dependent scars.
 MATERIAL AND METHODS: 145 patients with hormone-dependent scars with different AP phenotypes were followed up. In groups 1A and 1B, phototherapy was performed using broadband incoherent light-IPL therapy. In groups 2A and 2B, exposure was performed using bipolar fractional radiofrequency therapy. In groups 3A and 3B, the patient underwent a mesoroller microneedling procedure. PRP therapy was performed in groups 1B, 2B, and 3B. A visual analog scale (VAS) was used to evaluate the effectiveness.
 RESULTS: Comparing the data obtained, it should be noted that, regardless of the age of the scar (red, white), the developed complex methods of therapy showed greater effectiveness than monotherapy with pulsed broadband light, RF microneedles or microneedling.
 CONCLUSION: The combination of RF-therapy and PRP-therapy showed the greatest effectiveness against all clinical symptoms of AR, IPL-therapy with plasma with cells and plasma-with-cells microneedling showed a comparable high efficiency in different periods of AR existence.

Efficacy of fractional laser, radiofrequency and IPL rejuvenation of periorbital region

The purpose of this study was to assess skin elasticity, the reduction in the number and the depth of wrinkles and changes in the other skin defects (bags under the eyes, dark circles under the eyes, skin hyperpigmentation in the ageing eye area following the use of non-ablative fractional laser, bipolar radiofrequency and intense pulsed light). Moreover, the study was also comparison which device brought better results than the others. This study included 71 patients (66 women, 5 men), aged 33–63 years (the average age was 45.81 years) with skin phototypes II and III. Twenty-four patients received five treatment sessions with a 1410-nm non-ablative fractional laser in 2-week intervals, 23 patients received five treatment sessions with a bipolar radiofrequency in 1-week intervals and 24 patients received five treatment sessions with an intense pulsed light in 2-week intervals. The treatment was applied on the skin in the eye area. The Cutometer (Courage + Khazaka electronic) reference test was used as an objective method for the assessment of skin elasticity. A questionnaire was used to compare baseline state with changes that occurred after the series of treatment sessions. The results of cutometric measurements of R2, R6 and R7 parameters and the results of questionnaires indicated that non-ablative fractional laser therapy, bipolar radiofrequency and intense pulsed light improved skin elasticity. Of the three treatments, the most significant percentage improvement in the R6 parameter was demonstrated by non-ablative fractional laser therapy which gave better final results than the other methods (p < 0.0001). No other statistically significant relationships were found between RF and IPL. In the (subjective) opinion of study participants (questionnaire), all used methods resulted in the reduction of the amount and the depth of wrinkles. However, they did not observe significant impact of individual treatment method on the signs of skin ageing, including discolorations within eye area, bags (fatty hernia), dark circles (vascular/pigmentary) and oedema (predisposition to water retention). Non-ablative fractional laser therapy, bipolar radiofrequency and intense pulsed light improved skin elasticity and the reduction of wrinkles. The most significant improvement of elasticity was demonstrated by laser therapy. It seems necessary to expand the group with the effect of individual treatments against bags and dark circles under the eyes.

Commentary on: Bipolar Fractional Radiofrequency Treatment of Suprapatellar Skin Assessment Using Noninvasive Devices and Microbiopsy

Commentary on: Bipolar Fractional Radiofrequency Treatment of Suprapatellar Skin Assessment Using Noninvasive Devices and Microbiopsy

Bipolar Fractional Radiofrequency Treatment of Suprapatellar Skin Assessment Using Noninvasive Devices and Microbiopsy.

Noninvasive treatments for skin tightening are gaining popularity. However, no studies have assessed bipolar fractional radiofrequency treatment on suprapatellar skin. The purpose of this study was to evaluate the efficacy of bipolar fractional radiofrequency treatment on suprapatellar skin. Twenty patients received 1 bilateral suprapatellar bipolar fractional radiofrequency treatment. They returned 7 days, 3 weeks, 3 months, and 6 months posttreatment. Noninvasive measurements were obtained at each visit, including high-resolution ultrasonography, optical coherence tomography, transepidermal water loss and skin elasticity. Microbiopsies were collected in the treatment area for histologic and gene expression analyses. Three clinicians completed photographic evaluations comparing texture and laxity at baseline vs 6 months posttreatment. Fifteen subjects completed all 6 visits. Both transepidermal water loss and dermal-epidermal junction roughness were increased at 3 weeks and 3 months posttreatment. Both attenuation coefficient and stiffness were increased significantly at 3 and 6 months posttreatment. Blood flow 0.5 mm below the surface and expression of epidermal hyaluronic acid and inflammatory genes IL-1b and IL-6 were significantly higher at 7 days posttreatment compared with pretreatment and 3 months posttreatment. There were no statistically significant changes in collagen- or elastin-related genes and proteins at 7 days or 3 months posttreatment. An improvement in texture and laxity was observed at 6 months posttreatment in 17.7% and 24.4% of photographs, respectively. Radiofrequency treatment by microneedling of suprapatellar skin shows limited effects in decreasing skin laxity and improving skin appearance. At a molecular level, the treatment resulted in lower elastin and hyaluronic acid levels and increased dermal-epidermal junction roughness based on histology and optical coherence tomography imaging.

Multimodal Radiofrequency Application for Lower Face and Neck Laxity.

A multicenter retrospective study was conducted between January 2013 and December 2018 using a combination of bipolar RF and fractional bipolar RF for the treatment of facial aging. Data collection included demographic information, Baker Face/Neck Classification, amount of energy used, adverse events, and patient satisfaction. Four cadaver dissections were also conducted to correlate the underlying neuromuscular anatomy with RF treatment of the lower face and neck. Two hundred forty-seven patients (234 women and 13 men) were included in the study. Average age was 55.1 years (SD, ±8), body mass index was 24.3 (±2.4), and 9% (23/247) of patients were active smokers at the time of treatment. Patients had an average Baker Face/Neck Classification score of 3.1 (SD, ±1.4). The procedure was performed under local anesthesia in 240/247 cases (97.2%). Patients objectively improved their Baker Face/Neck Classification score by 1.4 points (SD, ±1.1). Ninety-three percent of patients indicated that they were pleased with their results and would undergo the procedure again. Complications recorded for our cohort included prolonged swelling >6 weeks (4.8%, 12/247), hardened area >12 weeks (3.2%, 8/247), and marginal mandibular neuropraxia (1.2%, 3/247), which all resolved without further intervention. When considering possible control variables, age seems to be a significant factor. That is, older patients were more likely to benefit from a larger magnitude of the treatment effect (as demonstrated by a decrease in the Baker rating from pre- to posttreatment) when compared with younger patients. However, both groups did demonstrate significant improvements across time. While this combination RF treatment (FaceTite bipolar RF and fractional bipolar RF) does not aim to replace a facelift/necklift in appropriate candidates, it does broaden the plastic surgeons' armamentarium to potentially fill a treatment gap.

Efficacy and Safety of a Sublative Bipolar Fractional Radiofrequency System Combined With Topical Tretinoin in Treating Striae Gravidarum: A Randomized Pilot Study.

Striae gravidarum is a common skin condition resulting after pregnancy, caused by fibroblast dysfunction. Although not considered a disease, it may be considered cosmetically unpleasant to sufferers and remains as a therapeutic challenge to date. To evaluate the efficacy and safety of a sublative bipolar fractional radiofrequency (FRF) system, associated with 0.1% topical tretinoin, in treating striae gravidarum. Eighteen Chinese women with striae gravidarum on the abdomen were enrolled in the study. The target area of each patient was divided into 4 sites randomly: control, tretinoin, FRF, and tretinoin and FRF. Fractional RF was used 3 times, with 3-month intervals. Changes to striae gravidarum were evaluated through subjective scaling and objective measures, using both high-frequency ultrasound and histological study. Both subjective assessment and skin thickness differences demonstrated significant improvement in the combination site (p < .001). Average optical density and density percentage of neocollagen and elastic fibers were also markedly increased in the combination site (p < .05). The adverse effects of FRF were limited to mild pain and transient erythema, edema, and microcrusts. The combined therapy of FRF and topical tretinoin may be a potential method in treating striae gravidarum, with satisfactory efficacy and limited side effects.

Histologic Effects of Fractional Laser and Radiofrequency Devices on Hyaluronic Acid Filler.

Hyaluronic acid fillers (HAFs) and energy-based devices are frequently used sequentially. However, the effect of using fractional devices directly over HAF is unclear. To evaluate histologic changes after fractional laser and radiofrequency (RF) therapies applied over preinjected HAF. Abdominoplasty skin samples were divided into 8 zones. Intradermal injections of HAF were performed to 7 zones with 1 zone as untreated control. Six of 7 HAF injected zones were then treated with the following devices: 1,540-, 1,550-, 1927-, and 10,600-nm fractional lasers, and fractional bipolar RF delivered through insulated and noninsulated microneedles. After treatment, biopsies were collected for H&E staining. Histology revealed HAF in the mid to deep dermis. Treatment with 1,540-, 1,550-, 1927-, and 10,600-nm lasers did not result in any morphologic changes of HAF, although thermal changes from 1,540- and 1,550-nm lasers were in very close proximity to the filler. The RF devices demonstrated thermal damage of HAF along the microneedle tracks. Hyaluronic acid filler is unaffected by fractional lasers in this model. Fractional RF devices, which produce deeper dermal penetrations, will cause thermal damage of HAF. Caution is advised in using microneedle RF over recently injected filler. Study limitations include use of nonfacial skin and lack of inflammatory response in an ex-vivo model.

Novel fractional bipolar radiofrequency device for the treatment of aged Asian skin

Background and Objective: Selecting an ideal method for restoring youthful skin among Asian patients is complicated because of their intrinsic skin color. Bipolar fractional radiofrequency (FRF) gains increasing attention for acne scar treatment in Asian patients. Nevertheless, clinical experience on FRF treatment of aged Asian skin remains limited. Our study aims to assess the efficacy and safety of FRF and tolerance against in aged Asian skin. Methods: Patients with wrinkles on different regions (forehead=8, lateral canthus=10, c=12, and neck=12) received three treatments (50-60 mJ/pin) with a bipolar FRF device Digital photographs, improvement and tolerance of the patients were taken at each visit. Results: The wrinkling scale significantly decreased in each type of wrinkles after 2 and 3-months of follow-up (P<0.05). The satisfaction of the patients with regard to the treatment of their wrinkles was consistent with the findings of the investigator. Side effects, such as dryness, transient erythema, pain were detected. All these symptoms are tolerable. Conclusions: FRF device is an effective and safe treatment for skin rejuvenation for aged Asian.

Clinical and Histological Studies of Suborbital Wrinkles Treated with Fractional Bipolar Radiofrequency.

Fractional bipolar radiofrequency (FRF) has been well established for facial rejuvenation, but there is no report showing its efficacy for the treatment of suborbital wrinkles. The aim of this study was to investigate and objectively evaluate the clinical efficacy and side effects of FRF for the treatment of suborbital wrinkles, including observation of histological changes of the suborbital skin along the therapy. Thirty-two female patients with suborbital wrinkles underwent three sessions of FRF at 3-week intervals with a follow-up period of 6 months after treatment. Two independent dermatologists with standardized photographs evaluated improvement grade. Most patients improved according to photographic assessments and the differences between results at 1 and 6 months were not statistically significant (p > 0.05). The median score of pain rated by patients using a visual analog scale (0-10 points) was 4.4 ± 1.2. Most patients rated themselves as satisfied (68.8%) and very satisfied (9.4%). Ten subjects (31.3%) experienced hyperpigmentation in 24 of all together 96 treatments (25.0%). Skin biopsies of three patients were routinely obtained, processed, and stained, and the histological changes had shown that 1-month after the end of the treatment, both the collagen and normal elastic fibers increased in accordance with the clinical efficacy. The study suggested that FRF is a safe and effective method to treat suborbital wrinkles.

Enhanced high-energy protocol using a fractional bipolar radiofrequency device combined with bipolar radiofrequency and infrared light for improving facial skin appearance and wrinkles.

Fractional bipolar radiofrequency treatment and treatment with bipolar radiofrequency combined with infrared light have been shown in previous trials to safely and effectively improve the appearance of facial wrinkles. To evaluate a high-energy protocol with combined bipolar radiofrequency and infrared light energies for improvement in photoaged facial skin. Seventy-two patients presenting with mild to moderate facial wrinkles underwent a single full-face treatment (n=54) or two treatments (n=18) at 6-week intervals. Independent blinded assessment and investigator assessment were performed, using the Fitzpatrick Wrinkle and Elastosis Scale (0-9) and the Global Aesthetic Improvement scale. Patients also completed a self-assessment questionnaire concerning satisfaction with the treatment. All patients achieved some degree of improvement in their wrinkles and skin appearance, following a single treatment or two treatments with the enhanced-energy protocol. Blinded evaluation demonstrated 71% and 70% of the patients showing improvement of one unit or greater on the Fitzpatrick Scale, at the 12-week and 24-week follow-ups post-treatment, respectively. Similar results were reported by investigators. Under the Global Aesthetic Improvement Scale, investigators observed 87%, 91% and 81% of patients showing improvement at the 6-, 12-, and 24-week post-treatment end, respectively. Patients tolerated the treatments well and were satisfied with the clinical results. The enhanced-energy treatment protocol, with fractional bipolar radiofrequency treatment and treatment with bipolar radiofrequency combined with infrared light applications, yields significant improvement of skin texture, wrinkling, and overall appearance following a single treatment. The results appear gradually over time and are maintained for at least 6months' post-treatment.

Long-Term Clinical and Histological Effects of a Bipolar Fractional Radiofrequency System in the Treatment of Facial Atrophic Acne Scars and Acne Vulgaris in Japanese Patients: A Series of Eight Cases.

This retrospective case series was designed to compare the long-term safety and efficacy of bipolar fractional radiofrequency (FRF) therapy as a treatment for atrophic acne scars (ASs) and acne vulgaris. Few clinical and histological studies have examined the long-term utility of bipolar FRF therapy as a treatment for ASs and acne in people with darker skin. Eight Japanese patients with ASs and mild-to-severe acne on both cheeks were treated with a bipolar FRF system (eMatrix; Syneron). Five treatment sessions with the same settings (coverage rate: 10%; peak energy: 62 mJ/pin; two passes) were carried out at 1-month intervals, and the patients were followed up for at least 1 year after the final treatment. Assessments of ASs and acne severity were performed and samples were removed for histological examination. We demonstrated that mild ASs responded better than moderate and severe ASs, and at least 50% improvement in scar severity was seen in 50% of patients after the final treatment. Six patients remained disease free at 1.5 years without the use of any additional therapies. The biopsy specimens showed a marked improvement characterized by a decrease in dermal pilosebaceous units and perivascular inflammatory cell infiltrates with an increase in elastin content and collagen deposition in the upper dermis. Bipolar FRF treatment showed long-term effectiveness against mild ASs and acne in Asian patients and had minimal side effects.

A Fractional Bipolar Radiofrequency Device Combined with a Bipolar Radiofrequency and Infrared Light Treatment for Improvement in Facial Wrinkles and Overall Skin Tone and Texture.

A variety of techniques and energy-based technologies are currently utilized for the treatment of facial wrinkles. Fractional bipolar radiofrequency treatment and treatment with bipolar radiofrequency combined with infrared light have both been reported to be safe and effective for the non-invasive treatment of wrinkles and overall facial rejuvenation. A multicenter, prospective clinical trial evaluated a protocol of treatment with a device incorporating bipolar radiofrequency and infrared light followed by treatment with a fractional bipolar radiofrequency device for facial wrinkle reduction and improvement in the overall appearance of aged facial skin. Fifty-six patients with mild to moderate facial wrinkles received three full-face treatments (forehead, nose, cheeks, periorbital, and perioral areas) at 4 to 6 week intervals and were evaluated at 12 and 24 weeks after the last treatment. Clinical photographs at baseline and follow-ups were assessed by both the investigators and patients using the Global Aesthetic Improvement scale. Treatment safety was evaluated. Study participants also completed a satisfaction and improvement questionnaire. Fitzpatrick Wrinkling and Elastosis Score was decreased significantly at three months (P < .01; paired t test) and at six months (P < .001; paired t test) after the final treatment. Investigators' assessments of overall improvement in facial appearance, demonstrated 88% improvement at 12 weeks and 82% at 24 weeks after the final treatment. Subject evaluations were similar, consistently reporting improvement in wrinkles and overall facial skin appearance throughout the study, and high a degree of satisfaction with their final results. Subjects tolerated the procedures well, with only transient mild to moderate erythema and edema occurring in most patients, and without complications. A combined protocol of bipolar radiofrequency and infrared light treatment followed by fractionated bipolar radiofrequency treatment results in safe, well tolerated, and effective improvement in overall skin tone and texture and reduction of facial wrinkles. 4 Therapeutic.

Use of radiofrequency in cosmetic dermatology: focus on nonablative treatment of acne scars

Acne is a common affliction among many teens and some adults that usually resolves over time. However, the severe sequela of acne scarring can lead to long-term psychological and psychiatric problems. There exists a multitude of modalities to treat acne scars such as more invasive surgical techniques, subcision, chemical peels, ablative lasers, fractional lasers, etc. A more recent technique for the treatment of acne scars is nonablative radiofrequency (RF) that works by passing a current through the dermis at a preset depth to produce small thermal wounds in the dermis which, in turn, stimulates dermal remodeling to produce new collagen and soften scar defects. This review article demonstrates that out of all RF modalities, microneedle bipolar RF and fractional bipolar RF treatments offers the best results for acne scarring. An improvement of 25%–75% can be expected after three to four treatment sessions using one to two passes per session. Treatment results are optimal approximately 3 months after final treatment. Common side effects can include transient pain, erythema, and scabbing. Further studies are needed to determine what RF treatment modalities work best for specific scar subtypes, so that further optimization of RF treatments for acne scars can be determined.

Assessment of efficacy and safety of a bipolar fractionated radiofrequency device for the treatment of wrinkles of the face and neck

Objective To evaluate the clinical efficacy and safety of a fractional bipolar radiofrequency device for the treatment of wrinkles of the face and neck.Methods This study enrolled 39 volunteers (including 37 females and 2 males aged 35-60 years) with Fitzpatrick skin type Ⅳ-Ⅴ and Fitzpatrick wrinkle scale score of 4-6.All the subjects received three sessions of treatment with a fractional bipolar radiofrequency device at intervals of 4-6 weeks.Follow-up visits were scheduled at one month after each treatment session for evaluation of efficacy (using standardized photography),subjective satisfaction and adverse effects.Results After three sessions of treatment,all the subjects experienced a significant decrease in Fitzpatrick wrinkle scale compared with baseline values,and wrinkle improvement score increased with the increase in treatment sessions.The Fitzpatrick wrinkle scale score for forehead wrinkles,glabella wrinkles,fishtail lines and neck wrinkles in these subjects after three sessions of treatment significandy differed from that before treatment (all P ＜ 0.01).Significant differences were also observed in the wrinkle improvement score for forehead wrinkles between these subjects after two sessions and one session of treatment (P ＜ 0.01),and observed in that for glabella wrinkles,fishtail lines and neck wrinkles between these subjects after three sessions and one session of treatment (P ＜ 0.05 or 0.01).Side effects were mild with no significant downtime.Conclusion Fractional bipolar radiofrequency may be a safe and effective option for the treatment of wrinkles of the face and neck in individuals with Fitzpatrick skin type Ⅳ-Ⅴ. Key words: Fractional bipolar radiofrequency; Skin aging; Treatment outcome

The clinical experience and efficacy of bipolar radiofrequency with fractional photothermolysis for aged Asian skin.

Bipolar radiofrequency (RF) technology is developed based on fractional thermolysis, and the literature concerning the efficacy of the rejuvenation and treatment of acne scars has been reported in Europe and the United States of America. Therefore, we examined bipolar RF treatment using fractional thermolysis to evaluate the efficacy and safety of the treatment of Asian photo-aging skin, particularly 'wrinkles' and 'sagging.' Ten Japanese women (mean age: 58.6, skin type III-IV) received three fractional bipolar RF treatments every 4-6weeks. For the objective evaluation, we evaluated the improvement of the wrinkles on the forehead, lateral canthus (crow's feet) and lower eyelid, and the sagging of the nasolabial fold using digital photographs captured using Visia(™) . For the subjective evaluation, the participants were asked to describe the improvements observed in the wrinkles on the forehead, lateral canthus (crow's feet) and lower eyelid, and sagging nasolabial fold and to evaluate the level pain experienced using a 10-point VAS score. The objective evaluation in each category showed significant improvements in the wrinkles on the lateral canthus (crow's feet) and lower eyelid. As for the nasolabial fold, 60% of the subjects showed improvements, scoring from good to excellent (51-100% improvement), although there was a little improvement of the wrinkle on the forehead. Similar improvements were observed in the subjective evaluation. During each treatment, oedema and erythema were observed in all participants, but the oedema disappeared the following day in all cases. However, mild erythema persisted for an average of 3.1days. Micro debris disappeared after an average of 5.2days. The participants were satisfied, as we allowed them to apply make-up the next day. There were no other severe adverse reactions observed during the treatment. The 10-point VAS score was 3.8, and no participants dropped out due to discomfort. Little improvement was observed in the forehead wrinkles in either the objective or the subjective evaluation. The results obtained in this study indicate that fractional bipolar RF is an effective and safe treatment for the 'wrinkling' and 'sagging' of Asian photo-aging skin.

Objective evaluation of the clinical efficacy of fractional radiofrequency treatment for acne scars and enlarged pores in Asian skin.

Ablative fractional lasers can effectively treat acne scars and enlarged pores, but cause considerable pain and downtime for patients, as well as potentially causing postinflammatory hyperpigmentation (PIH), especially in Asian skin. To evaluate the efficacy of a novel bipolar radiofrequency (RF)-based fractional device to treat acne scars and enlarged pores in Asians with objective measurements and histologic assessments. Thirty-one Korean patients with acne scars and enlarged pores received 4 consecutive fractional RF treatments at 3-week intervals. Outcome assessments included photography, global evaluation by investigators in a blind manner, patient assessment, objective biophysical measurements of elasticity and color, and histological changes compared with untreated lesions. Follow-up assessments by physicians 3 months after the last treatment revealed that patients showed clinical improvement. Patient self-assessments paralleled physicians' assessments. Objective biophysical measurements showed significant improvements in elasticity (R2, R5, and R7) and the melanin/erythema index, together with increases in the levels of procollagen Types I and III, as well as elastin. There were no cases of PIH, and adverse events were limited to mild ones. Fractional bipolar RF provides clinical efficacy with safety in acne scars and enlarged pores through dermal matrix remodeling combined with tolerable epidermal ablation.

Histological studies of facial acne and atrophic acne scars treated with a bipolar fractional radiofrequency system.

Various fractional radiofrequency (FRF) treatments have demonstrated significant beneficial effects and minor side-effects on atrophic acne scars and acne vulgaris by creating micro-thermal injuries in the skins. However, histological studies to identify the precise mechanism responsible for the success of bipolar FRF treatments are lacking. In this study, six human subjects with these diseases were histologically analyzed after treatment with a bipolar FRF system (eMatrix; Syneron, Yokneam, Israel) and the effects of multiple passes were compared. Histopathological results showed that two-pass FRF treatment created deeper dermal thermal injury zones compared to one-pass treatment. Periadnexal collagen was coagulated, as well as that in the sebaceous glands, as evaluated in all cases with two-pass FRF treatment. No severe side-effects were observed after treatment. Our experience suggests that the level of dermal thermal injury is directly related to the number of passes, and that a large benefit of this treatment for these diseases is the preservation of adnexal structures.