Radiofrequency and Radiofrequency Microneedling in Skin of Color: A Review of Usage, Safety, and Efficacy

Syder, Nicole; Chen, Alessandra; Elbuluk, Nada

doi:10.1097/dss.0000000000003733

Cited by 4 publications

(5 citation statements)

References 48 publications

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“…This may be related to the energy parameters. Although radiofrequency treatment only targets water molecules and not melanocytes, 19,20 increasing the energy parameters can generate more heat to stimulate dermal collagen remodeling more effectively. However, excessive heat can also elevate the risk of hyperpigmentation.…”

Section: Enrolled Subjects 20mentioning

confidence: 99%

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

Shen,

Jin,

Huang

et al. 2024

J of Cosmetic Dermatology

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BackgroundStriae 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.AimsThis 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.Patients/MethodsTwenty 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.ResultsClinical 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.ConclusionsThe 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.

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Section: Enrolled Subjects 20mentioning

confidence: 99%

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

Shen,

Jin,

Huang

et al. 2024

J of Cosmetic Dermatology

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“…The key components that allow for safe treatment in skin of color include the following: energy delivery to precise depths, coated needles, and the ability to set the energy intensity. 4 Adjusting the depth of the energy application allows the provider to spare the superficial epidermis and lessen the chance of untoward effects. The coated needles spare superficial layers of the skin as long as the pulse is administered in an appropriate manner.…”

Section: Radiofrequency Microneedlingmentioning

confidence: 99%

“…In a systematic review of 35 articles addressing the use of RF or RF microneedling (RFM) in skin of color, both modalities of treatment had a low risk of scarring or hyperpigmentation in skin of color and were successfully used for rhytids, acne scarring, and skin rejuvenation. 4 In general, skin tightening devices including infrared, RF, and ultrasound-based technologies can be used on all skin types as melanin is not a chromophore at these wavelengths and the epidermis is spared. However, judicious technique by an experienced practitioner should be used to avoid inadvertent thermal injury to the epidermis.…”

Section: Radiofrequency Skin Tightening Devicesmentioning

confidence: 99%

Cosmetic Treatments with Energy-Based Devices in Skin of Color

Chao,

Porter,

Hessler

2023

Facial Plast Surg

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The use of energy-based devices in cosmetic treatments for patients with higher Fitzpatrick skin types is a topic of concern due to the increased risk of complications such as hyperpigmentation and scarring. Advancements in technology have enabled the development of safe and effective energy-based modalities for improving skin tone, texture, and signs of aging in patients with higher Fitzpatrick skin types. This article reviews various modalities that have shown positive outcomes in Fitzpatrick skin types 4 to 6.Radiofrequency (RF) skin tightening devices have emerged as a noninvasive method for improving skin laxity by stimulating collagen and elastin production without generating excessive heat, making them suitable for darker skin tones. Microfocused ultrasound (MFUS) is another noninvasive option for skin tightening and lifting. By producing thermal coagulation in the deeper layers of the skin, MFUS stimulates collagen production, resulting in improved skin tightness. Fractional laser resurfacing, both ablative and nonablative, offers effective treatment options for various concerns such as acne scars, skin texture, and dyspigmentation. Nonablative fractional lasers, which target water rather than melanin, are particularly safer for darker skin types. Broadband light devices that emit different wavelengths have shown success in skin rejuvenation, improving wrinkles, pore size, erythema, telangiectasias, and dyspigmentation. Additionally, RF microneedling combines the benefits of both modalities, delivering safe treatment for skin laxity and textural concerns. The short-pulse neodymium-doped yttrium aluminum garnet (Nd:YAG) laser has become a transformative tool for patients with Fitzpatrick skin types 4 to 6. This laser targets melanin, hemoglobin, and water, providing improvements in hyperpigmentation, acne, fine lines, and scar texture. Combining the short-pulse Nd:YAG laser with other treatments like chemical peels or microneedling has shown synergistic effects and enhanced outcomes. Understanding these modalities and tailoring treatments to specific concerns is crucial for safe and effective solutions in patients with higher Fitzpatrick skin types.

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“…The significant clinical benefits of FRM have been evaluated in several studies. 4,5 Electric currents can be delivered to tissue in either monopolar or bipolar mode using FRM devices. The microneedles act as the electrodes for FRM.…”

Section: Introductionmentioning

confidence: 99%

“…The high frequency electrical currents tend to spread toward the center of the bulk tissue, 3 thus minimizing epidermal damage and reducing post‐inflammatory pigmentation and unwanted downtime. The significant clinical benefits of FRM have been evaluated in several studies 4,5 …”

Section: Introductionmentioning

confidence: 99%

Histological evaluation of monopolar and bipolar radiofrequency microneedling treatment in a porcine model

Wang,

Hamblin,

Zhang

et al. 2024

Lasers Surg Med

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Background and ObjectiveFractional radiofrequency microneedling (FRM) is widely used as an option for skin rejuvenation, however there is a lack of histological evidence for the various energy delivery systems available. The objective was to assess thermal denaturation of tissue and the wound healing response in monopolar mode versus bipolar mode. Histological analysis was performed to demonstrate the efficacy of automatic impedance feedback system in monopolar mode.Study Design and MethodsIn this study, the acute thermal effects caused by monopolar FRM treatment to the dorsal skin of pigs were assessed histologically by hematoxylin & eosin (H&E) staining. Then, one session of either monopolar or bipolar FRM was used to treat one or the other side of the pig using varying power levels and pulse widths. The acute and chronic tissue reactions were assessed using H&E, immunofluorescence, and western blot analysis at 0, 14, 30, and 90 days after treatment. The efficacy of the impedance feedback system was also monitored histologically.ResultsHigh‐energy FRM treatment produced tissue loss and necrosis. The power level and pulse duration significantly affected the coagulation amount. Histopathology at 0, 14, 30, and 90 days showed that the skin tissue reaction was more pronounced for bipolar compared to monopolar FRM. Immunofluorescence showed the expression of TGF‐β, Ki67, MMP3, and elastin increased dramatically with both modes, but were higher in the bipolar FRM treated side. The automatic impedance feedback system could effectively adjust the output energy.ConclusionsWe found that bipolar FRM produced greater thermal effects, more collagen coagulation, and more pronounced molecular changes compared with monopolar mode in a porcine animal model.

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Radiofrequency and Radiofrequency Microneedling in Skin of Color: A Review of Usage, Safety, and Efficacy

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 4 publications

References 48 publications

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

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

Cosmetic Treatments with Energy-Based Devices in Skin of Color

Histological evaluation of monopolar and bipolar radiofrequency microneedling treatment in a porcine model

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