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BACKGROUND Many studies have evaluated radiofrequency microneedling (RFMN) in various dermatologic conditions. However, the efficacy and safety of RFMN, and how it compares with other energy-based devices in a clinician's armamentarium, remains unclear. OBJECTIVE To review higher-quality evidence supporting RFMN and the dermatologic conditions which it can be used in. MATERIALS AND METHODS A search was conducted in MEDLINE and EMBASE from inception to May 13, 2020, using the terms: “radiofrequency microneedling” OR “fractional radiofrequency” OR “radiofrequency needling” OR “radiofrequency percutaneous collagen induction.” Only randomized, split body or blinded studies with original data on humans were included. Non-English or non–dermatology-related studies were excluded. RESULTS Forty-two higher-quality studies were included after applying the inclusion and exclusion criteria. There were 14 studies for skin rejuvenation, 7 for acne scars, 6 for acne vulgaris, 5 each for striae and axillary hyperhidrosis, 2 for melasma, and 1 each for rosacea, cellulite, and androgenetic alopecia. CONCLUSION Radiofrequency microneedling is an effective intervention that can be used repeatedly and safely in combination with other treatment modalities and in individuals with darker skin phototypes. Radiofrequency microneedling–induced dermal remodeling and neocollagenesis are slow and progressive but continue to improve even 6 months after treatment.

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Increasing understanding of cytokines as major drivers of immune-mediated diseases has revolutionized targeted treatments for these conditions. As the pathogenesis of autoimmune conditions is mediated by a complex interplay of various cytokines, Janus kinase (JAK) inhibitors have been of particular interest due to their ability to target multiple cytokines simultaneously. However, due to safety concerns with first generation JAK inhibitors, most notably from JAK2 and JAK3 inhibition, interest has shifted to more selective inhibition of TYK2. Three key TYK2 inhibitors that have advanced furthest in clinical trials for treatment of dermatologic autoimmune conditions are deucravacitinib (BMS-986165), brepocitinib (PF-06700841), and PF-06826647. This review outlines the current understanding of the efficacy and safety of these three TYK2 inhibitors from completed phase I and II studies and summarizes studies currently in progress for dermatologic conditions.

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