Treatment of hypertrophic scars and keloids with a radiofrequency device: A study of collagen effects

Abstract

Background and Objective: To determine the efficacy and safety of the ThermaCool 1 TC radiofrequency system for treatment of hypertrophic and keloid scars and evaluate treatment associated collagen changes. Materials and Methods: Six subjects with hypertrophic and four with keloid scars were treated with the ThermaCool 1 device: one-third of the scar received no treatment (control), one-third received one treatment and one-third received two treatments (4-week interval). Scars were graded before and then 12 and 24 weeks after treatment on symptoms, pigmentation, vascularity, pliability, and height. Biopsies were taken from four subjects with hypertrophic scars and evaluated with hematoxylin and eosin (H & E) staining, multiphoton microscopy, and pro-collagen I and III immunohistochemistry. Results: No adverse treatment effects occurred. Clinical and H & E evaluation revealed no significant differences between control and treatment sites. Differences in collagen morphology were detected in some subjects. Increased collagen production (type III > type I) was observed, appeared to peak between 6 and 10 weeks posttreatment and had not returned to baseline even after 12 weeks. Conclusion: Use of the Thermage radiofrequency device on hypertrophic scars resulted in collagen fibril morphology and production changes. ThermaCool 1 alone did not achieve clinical hypertrophic scar or keloid improvement. The collagen effects of this device should be evaluated further in order to optimize its therapeutic potential for all indications.

Scar Remodeling with the Association of Monopolar Capacitive Radiofrequency, Electric Stimulation, and Negative Pressure

“…4,5 Therefore, radiofrequencies have been supposed to have favorable effects on scar remodeling, although such a correlation is actually controversial as suggested by a large number of literature reports that failed to prove any sound evidence. 6,7 …”

A New Paradigm for the Role of Aging in the Development of Skin Cancer

“…One possible new treatment strategy would be to develop methods to rejuvenate the fibroblasts to allow production of factors such as IGF-1. Though marketed for cosmetic purposes, skin-damaging agents ranging from chemical peels, laser resurfacing, heating of the skin, and other “wounding” procedures could restimulate the expression of IGF-1 in the treated fibroblasts (Meshkinpour et al ., 2005; DeHoratius and Dover, 2007). Since there appears to be a protective effect of exogenous insulin in skin cancer development (Chuang et al ., 2005), systemic treatment with IGF-1 (currently used for short-stature syndromes) could also be studied (Collett-Solberg and Misra, 2008).…”

Effects of radiofrequency procedure on hypertrophic scar due to burns

“…7 After a single application of RF and an interval of four weeks in hypertrophic scars and keloids, there were no significant clinical differences and no morphological changes in collagen fibres. 8 Our results suggest that RF at an epidermal temperature below 40°C may stimulate remodelling of collagen fibres, probably due to the effect of heat-induced protein denaturation. RF acts on collagen synthesis, initially by their denaturation, and subsequently, by increased expression of heat shock proteins.…”