Acne is an inflammatory skin disease afflicting the majority of the world's population at some point in their lifetime, and is seen to be chronic in about 50% of cases. Acne leads to significant social withdrawal, depression, and disfiguring scars in many cases. Available treatments are characterized by high rates of relapse, dangerous side effects, and social stigma, which often leads to poor patient compliance and treatment failure. The aim of this article was to discuss and share the authors' experiences utilizing fractional radiofrequency (RF) (Morpheus8; InMode Ltd., Lake Forest, CA) in the treatment of both active acne and acne scars. A retrospective review was conducted comparing 3 treatment modalities. In total, 356 patients received acne scar treatments. The cohort comprised a high-dose isotretinoin topical therapy series (n = 128, 36%), a 6-session ablative laser series (n = 89, 25%), and a 3-session fractional RF microneedling series (n = 139, 44). Of the patients with extended 3-year follow-up, the relapse rates were: isotretinoin group, 36 of 54 (67%); laser group, 12 of 16 (75%), and fractional RF microneedling group, 7 of 29 (24%). In treating older acne scars, fractional RF microneedling technology has served as an effective tool to tighten skin and fill in atrophic scars when used in conjunction with other techniques. This technology is very effective and very safe for treating all skin types with acne and acne scars.
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