Evaluation of the efficacy and safety of fractional bipolar radiofrequency with high-energy strategy for treatment of acne scars in Chinese

Background: Fractional technology overcomes several problems of ablative lasers such as a high incidence rate of post- inflammatory hyperpigmentation (PIH). A new technology fractional radiofrequency, which induces deep dermal heating and leaves the epidermal less affected results in less adverse effect in Chinese. Objective: To evaluate the efficacy, safety and tolerance of fractional bipolar radiofrequency (RF) in the treatment of acne scars in Asian people with the strategy of high energy. Methods: Twenty-six healthy Asian patients with acne scars received four monthly high energy (85–95mj/pin) treatments with a fractional bipolar RF device. Improvement and tolerance were evaluated at each treatment and a 4-week and 12-week follow-up visit. Results: Twenty-three patients completed the study. Acne score showed a significantly decrease at 4-week and 12-week follow-up visits. Patients’ evaluation of global improvement and satisfaction increased at the 12-week visit compared with baseline. Side effects were limited to transient pain, erythema, dryness and low risk of PIH. Conclusion: Treatment with high energy of fractional bipolar RF is safe and effective for acne scars in Asian people. Common side effects such as PIH, eschars are less than fractional lasers.     

A novel fractional micro-plasma radio-frequency technology for the treatment of facial scars and rhytids: A pilot study

Abstract

Introduction: Fractional ablative and non-ablative lasers have gained popularity in the treatment of acne scars and rhytids due to their efficacy and improved tolerability. Plasma and radio frequency (RF) have also emerged as methods for ablative or non-ablative energy delivery. We report preliminary experience with a novel fractional micro-plasma RF device for the treatment of facial acne scars and rhytids. Methods: Sixteen patients with facial acne scars or rhytids were treated at 4-week intervals. Treatment parameters were titrated to an immediate end point of moderate erythema. The clinical end point for cessation of treatment was the attainment of satisfactory clinical results. Results were monitored photographically up to 3 months after treatment. Results: Acne scars showed marked improvement after two to four treatments. Facial rhytids demonstrated reduced depth after two treatments and marked improvement after four treatments. Treatment was well tolerated by all participants, with transient erythema and short downtime. These results provide initial evidence for the safety and effectiveness of fractional micro-plasma RF as a low-downtime and well-tolerated modality for the treatment of acne scars and facial rhytids.     

Treatment of acne vulgaris with fractional radiofrequency microneedling

Fractional radiofrequency microneedling is a novel radiofrequency technique that uses insulated microneedles to deliver energy to the deep dermis at the point of penetration without destruction of the epidermis. It has been used for the treatment of various dermatological conditions including wrinkles, atrophic scars and hypertrophic scars. There have been few studies evaluating the efficacy of fractional radiofrequency microneedling in the treatment of acne, and none measuring objective parameters like the number of inflammatory and non‐inflammatory acne lesions or sebum excretion levels. The safety and efficacy of fractional radiofrequency microneedling in the treatment of acne vulgaris was investigated. In a prospective clinical trial, 25 patients with moderate to severe acne were treated with fractional radiofrequency microneedling. The procedure was carried out three times at 1‐month intervals. Acne lesion count, subjective satisfaction score, sebum excretion level and adverse effects were assessed at baseline and at 4, 8 and 12 weeks after the first treatment as well as 4, 8 and 12 weeks after the last treatment. Number of acne lesions (inflammatory and non‐inflammatory) decreased. Sebum excretion and subjective satisfaction were more favorable at every time point compared with the baseline values (P < 0.05). Inflammatory lesions responded better than non‐inflammatory lesions (P < 0.05). Adverse effects such as pinpoint bleeding, pain and erythema were noted, but were transient and not severe enough to stop treatment. Fractional radiofrequency microneedling is a safe and effective treatment for acne vulgaris.     

Safety and efficacy of hybrid energy and trifractional technologies in the treatment of acne scars: An open-label clinical trial

Introduction: This study determines the safety and efficacy of a novel device—Surgen that utilizes hybrid energy (HE) technology and trifractional (TF) technology in the treatment of acne scars in Filipino patients. Methods: Open-label clinical trial on eight subjects who underwent 4 weekly HE treatments followed by 2 TF treatments spaced 3 weeks apart. Efficacy was evaluated by dermatologists’ (investigator and two blinded dermatologists) and patients’ assessment and grading of post-treatment digital photographs. Subjects also reported level of satisfaction and comfort. Adverse events were recorded. Results: Dermatologists’ grading of acne scars improvement—58.3% of subjects showed slight to moderate improvement, 8.3% showed marked improvement, and 33.3% was graded as unchanged after HE treatments. After 2 additional TF treatments grades improved further, with 37.5% showing mild to moderate improvement, 37.5% showing marked improvement, and 25% graded as unchanged. Dermatologist's scoring using the global acne scoring system resulted in improvement of 75% of patients after 4 HE sessions and 100% after TF treatments. Subjects’ grading showed a similar trend: 75% of subjects reported that they were satisfied and 25% slightly satisfied after the complete protocol. Conclusion: A treatment protocol combining HE and TF technology is safe, effective, and comfortable in the treatment of acne scars.     

Clinical studies of the treatment of facial atrophic acne scars and acne with a bipolar fractional radiofrequency system

Few clinical studies have examined the utility of bipolar fractional radiofrequency (FRF) therapy as a treatment for atrophic acne scars and active acne in people with darker skin. This study was designed to compare the safety and efficacy of bipolar FRF therapy as a treatment for atrophic acne scars and acne vulgaris. Twenty‐three Japanese patients with atrophic acne scars and mild to severe acne on both cheeks were treated with a bipolar FRF system (eMatrix; Syneron, Yokneam Illit, Israel). Five treatment sessions were carried out at 1‐month intervals, and the patients were followed up for 3 months after the final treatment. Assessments of scar severity and the number of acne lesions and 3‐D in vivo imaging analysis were performed. Evaluations of the treatment outcomes and their effects on the patients’ quality of life (QOL) were also carried out. We demonstrated that the improvement in scar volume was marked in the patients with mild scars and was at least moderate in 23 (57.5%) of the treated areas. With regard to the number of acne lesions, the treated areas exhibited significantly fewer lesions compared with the baseline at each time point (P < 0.05). The patients’ assessments of the treatment outcomes and their QOL indicated that both had improved significantly by the end of the study. Furthermore, significant reductions in the patients’ sebum levels, skin roughness and scar depth were observed. Bipolar FRF treatment significantly improved the atrophic acne scars and acne of Japanese patients and had minimal side‐effects.     

Treatment of acne scars by fractional bipolar radiofrequency energy

Abstract

Background/Objective: A variety of modalities are available for the treatment of acne scars. This prospective, IRB-approved study evaluates the efficacy and tolerance of fractional bipolar RF energy in the treatment of facial acne scars. Methods: Healthy subjects (n =?15, 13 females, aged 35.7?±?5.6 years [mean ± SD], skin types I–V) with mild to moderate acne scars received three monthly treatments with a fractional bipolar RF device. Improvement and tolerance were evaluated at each visit, including a 1-month and 3-month follow-up visit. Results: Ten subjects completed the study. Physician-assessed acne scar severity was significantly reduced at 1 month and 3 months. Adverse effects were limited to transient erythema. Dryness, bruising and crusting erosion were limited. Subject-assessed stinging/burning, stinging (alone), tingling, itching and burning were also limited and consistent with each treatment. Subject-assessed fine lines and wrinkles, brightness, tightness, acne scar texture, pigmentation were all improved significantly. Satisfaction was high in 67–92% of subjects. Conclusion: Fractional bipolar RF energy is a safe and effective modality for the treatment of acne scars.     

The use of 1540 nm fractional photothermolysis for the treatment of acne scars in Asian skin: a pilot study

Background: Various modalities have been used to treat acne scars, but limited efficacy and considerable side effects have restricted their proper use. Recently, a new-generation fractional photothermolysis modality has been introduced that has deeper penetrating ability; however, a 1540 nm fractional photothermolysis study has not yet been performed.
Objectives: To evaluate the efficacy and safety of 1540 nm fractional photothermolysis for the treatment of acne scars in Asian skin.
Methods: Sixteen volunteers (Fitzpatrick skin types III–IV) with mild to moderate acne scars were enrolled. Acne scar lesions were treated with 1540-nm fractional photothermolysis (Starlux^™ 1540). Three treatment sessions were performed for each patient 4 weeks apart. Outcome assessments included the following four methods: (1) clinical evaluation of the photographs that were taken before and after the treatment; (2) comparison of the quality of life (QOL) of the patients before and after the treatment; (3) patients' satisfaction with the treatment; and (4) comparison of the quantity of collagen and elastic fibers in the skin biopsies before and 12 weeks after the last treatment.
Results: A mild to moderate clinical improvement was observed in most of the patients. Moreover, the QOL of all the patients improved, and all of them were satisfied with the results of the treatment. Significant collagen and elastic-fiber increases were also observed after the treatment, and side effects were limited to transient erythema and edema, which occurred in 50% of the patients. No severe side effect was observed.
Conclusions: 1540 nm fractional photothermolysis is an effective and safe method for improving acne scar, even in Asian skin.     

侵入性微针射频与等离子点阵射频治疗痤疮凹陷性瘢痕的自身对照研究

目的 比较侵入性微针射频与等离子点阵射频治疗面部痤疮凹陷性瘢痕的疗效及安全性。方法 2017年1 - 3月,中南大学湘雅医院皮肤科收集30例痤疮凹陷性瘢痕患者,将每例患者两侧面部按随机数字表分为侵入性微针射频侧与等离子点阵射频侧,治疗间隔8 ~ 12周,共进行3次治疗。治疗前后由研究者采集患者面部照片对瘢痕评分,根据痤疮瘢痕临床分级标准权重评估整体改善度,由医生对皮损改善度进行主观评分;记录治疗后患者的不良反应;患者自评疼痛度及满意度,用德国皮肤生理检测仪记录治疗前后面部表皮含水量、经表皮失水率、皮脂含量等数据。结果 30例患者均完成3次治疗及3次随访。疗效：3次治疗后,侵入性微针射频侧评分为3.00 ± 0.91,22例获得 > 50%改善,而等离子点阵射频侧评分为3.57 ± 0.57,29例获得 > 50%改善,等离子点阵射频总体疗效优于侵入性微针射频（t = 2.894,P = 0.005）。对于Ⅴ型和U型瘢痕,侵入性微针射频侧与等离子点阵射频侧的整体改善率比较,差异无统计学意义（均P > 0.05）,对于M型Rolling瘢痕,侵入性微针射频侧整体改善率为（36.5 ± 2.1）%,低于等离子点阵射频侧［（48.7 ± 3.4）%,P < 0.01］。侵入性微针射频侧疼痛评分为5.54 ± 0.57,明显低于等离子点阵射频侧（8.07 ± 0.79）,差异有统计学意义（P < 0.01）。3次治疗后,侵入性微针射频侧与等离子点阵射频侧的患者满意度比较,差异无统计学意义（χ2 = 0.10,P > 0.05）,表皮含水量、TEWL、皮脂含量等指标差异无统计学意义（均P > 0.05）。两治疗侧均出现红斑、渗出或出血等不良反应。结论 对于V型、U型瘢痕等较小的痤疮瘢痕,等离子点阵射频与侵入性微针射频治疗均可临床应用。而较大的M型Rolling瘢痕,优先选择等离子点阵射频治疗。     

In vivo animal histology and clinical evaluation of multisource fractional radiofrequency skin resurfacing (FSR) applicator

Abstract

Objective. Acne scars are one of the most difficult disorders to treat in dermatology. The optimal treatment system will provide minimal downtime resurfacing for the epidermis and non-ablative deep volumetric heating for collagen remodeling in the dermis. A novel therapy system (EndyMed Ltd., Cesarea, Israel) uses phase-controlled multi-source radiofrequency (RF) to provide simultaneous one pulse microfractional resurfacing with simultaneous volumetric skin tightening. Methods. The study included 26 subjects (Fitzpatrick's skin type 2–5) with moderate to severe wrinkles and 4 subjects with depressed acne scars. Treatment was repeated each month up to a total of three treatment sessions. Patients’ photographs were graded according to accepted scales by two uninvolved blinded evaluators. Results. Significant reduction in the depth of wrinkles and acne scars was noted 4 weeks after therapy with further improvement at the 3-month follow-up. Conclusion. Our data show the histological impact and clinical beneficial effects of simultaneous RF fractional microablation and volumetric deep dermal heating for the treatment of wrinkles and acne scars.     

Treatment of atrophic facial acne scars with fractional Er:YAG laser in skin phototype III–IV: A pilot study

Background: Fractional ablative lasers have recently been used for the treatment of skin scars. The objective of this study was to assess the efficacy and safety of the fractional erbium-doped yttrium aluminum garnet (Er:YAG) laser (2940 nm) in the treatment of skin scars. Materials and methods: A total of 9 patients (8 female, 1 male) with Fitzpatrick skin types III and IV suffering from atrophic facial acne scars were treated with a fractional Er:YAG laser for 2–5 (mean 3.3) sessions 4–6 weeks apart. One independent investigator assessed the efficacy, using standardized photographs, before and 1 month after the last treatment. The patients’ satisfaction rate was also evaluated. Results: The treatment was well tolerated by all patients without any anesthesia. The downtime was 2–3 days. All patients showed improvement in scars: excellent in 1, good in 1, and fair in 7 patients. Six patients were highly satisfied and 3 were satisfied with treatment. No adverse effect was noted. Conclusion: A fractional Er:YAG laser can deliver an effective and minimally invasive treatment for acne scars.     

单针射频治疗中度痤疮疗效评价

目的：比较单针射频和红蓝光治疗面部中度寻常型痤疮的临床疗效并评估单针射频治疗的安全性。方法：收集我院面部中度寻常型痤疮患者,分为射频组和对照组,分别给予单针射频治疗和红蓝光联合针清治疗,共治疗8周,比较两种不同治疗组的疗效,记录患者对单针射频治疗的主观评价和不良反应。结果：共纳入我院2019年8~12月40例患者,其中射频组20例,对照组20例。射频组痊愈+显效患者12例高于对照组（3例）,差异具有统计学意义（P＜0.05）。射频组总有效率90%与对照组（85%）比较,差异无统计学意义（P>0.05）。射频组14例患者自觉改善。两组患者均未出现明显不良反应。结论：单针射频治疗面部中度寻常型痤疮疗效优于传统红蓝光联和针清治疗。     

点阵式Er：YAG激光治疗痤疮瘢痕及毛孔粗大的疗效观察

目的 探讨点阵式掺铒钇铝石榴石（Er:YAG）激光对于面部凹陷性痤疮瘢痕及毛孔粗大的疗效。方法 轻至中度凹陷性痤疮瘢痕41例,予中长脉宽、能量800 ～ 1200 mJ、定点连续发射4 ～ 8个脉冲。毛孔粗大23例,予中脉宽、能量800 ～ 1000 mJ、定点连续发射2 ～ 4个脉冲。疗程为3 ～ 5次,每次间隔1个月。由医生对治疗后皮损改善程度进行评价,由患者对疗效进行满意度评价。应用三维皮肤成像仪获取皮肤立体图像,评价治疗对皮肤粗糙度的影响。结果 医生评估痤疮瘢痕患者皮损改善程度为82.93%,毛孔粗大患者皮损改善程度为86.96%;两种皮损患者满意率分别为88.80%和91.30%;与治疗前相比,治疗后表示粗糙度的Ra值及Rz值分别下降18.74%和21.01%（P < 0.001）。结论 点阵式Er:YAG激光可有效改善面部轻中度凹陷性痤疮瘢痕及毛孔粗大。     

Efficiency and safety of microneedling fractional radiofrequency in the treatment of Chinese atrophic acne scars: A retrospective study of 3 consecutive treatments with 1-month intervals

Background

Atrophic acne scars (AAS) impact the aesthetic appearance, inducing social and psychological problems. Effective and safe therapy for AAS is urgently needed now. Microneedling fractional radiofrequency (MFRF) has emerged as a minimal invasive alteration for treating AAS lately, while the existing data on Chinese population was few.

Aims

We aimed to explore the effectivity and safety of MFRF in Chinese patients with facial AAS and analyze the response of different subtypes to MFRF treatment.

Methods

We conducted a retrospective analysis using data from medical records and clinical photographs of 40 Chinese patients with AAS with Fitzpatrick skin type III-IV, all of them had received 3 MFRF treatments with 1-month intervals and were followed up 3 months after the last treatment. The clinical severity was assessed through échelle d'évaluation clinique des cicatrices d'acné (ECCA) score at each visit. Clinical photographs were taken by VISIA. Patients were asked to evaluate their satisfaction of the treatment using a 5-point Likert scale at the last visit.

Results

ECCA score decreased more than a half at the last visit based on the baseline. Among the three types of AAS, the M-shaped scars respond most quickly to MFRF and the U-shaped scars improved the most after 3 months follow-up. A significant improvement was seen in clinical appearance, parallel to the change of ECCA, indicating the remarkable improvement of AAS after the MFRF treatment. Concomitant active acne was controlled along with the improvement of AAS. Statistics from VISIA showed excellent improvement in pores and texture as well. Side effects including pain and erythema were transient and mild. The number of MFRF treatment sessions was positively associated with the degree of improvement. Of the total 39 patients who had given a score of satisfaction, more than 89% (35 patients) were very satisfied or satisfied with the outcome.

Conclusions

To sum up, our study reveals that MFRF provides high efficiency in treating Chinese AAS patients with high satisfaction and low risk of adverse effects. M-shaped scars are the most sensitive type to the treatment, but the U-shaped scars improve most at the last visit. The simultaneous minimization of pores and improvement of skin texture imply the increased collagen stimulated by MFRF. Regular MFRF should be considered a good choice in treating AAS.     

黄金微针射频与超脉冲CO2点阵激光治疗面部痤疮所致的不同类型凹陷性瘢痕的疗效比较

 目的 比较黄金微针射频与超脉冲CO₂点阵激光治疗不同类型面部凹陷性痤疮瘢痕的临床疗效及安全性。方法 选取我院门诊2019年8月—2021年8月诊治的80例凹陷性痤疮瘢痕患者为研究对象,采用随机数字表法分为治疗组和对照组,每组各40例。治疗组采用黄金微针射频治疗;对照组采用超脉冲CO₂ 点阵激光治疗。比较两组疗效,并按临床亚型（V型、U型和M型）对患者进行分类和评价。结果 两组患者治疗后痤疮瘢痕临床评分量表（ECCA）权重评分均降低,但差异无统计学意义（t=0.46, P=0.644）。 两组患者总体有效率比较差异无统计学意义（X²=1.89,P=0.176）。两组瘢痕亚型比较,治疗组M型瘢痕疗效较好（t=2.34, P＜0.05）,对照组V型瘢痕疗效较好（t=-2.36, P＜0.05）,而两组U型瘢痕疗效无明显差异（t=0.24, P＞0.05）。治疗组患者术中疼痛程度、术后红肿期程度评分均低于对照组,痂皮脱落愈合时间短于对照组,差异均有统计学意义(均P＜0.05)。结论 黄金微针射频与CO₂点阵激光均能有效地改善面部凹陷性痤疮瘢痕,其中前者对M型瘢痕疗效显著,后者对V型瘢痕疗效显著。提示临床工作中可对痤疮瘢痕进行亚型分析,进而选择性治疗,必要时可联合治疗,起到协同作用。     

Energy-based devices in the treatment of acne scars in skin of color

Background

Acne scarring is disfiguring and psychologically taxing on patients. Many energy-based modalities have emerged and been studied for the treatment of acne scarring; however, there is a paucity of these studies in skin phototypes IV–VI.

Objective

To review the medical literature and discuss the most significant studies regarding safety and efficacy of energy-based devices (ablative lasers, non-ablative lasers, and radiofrequency microneedling) in the treatment of ethnic skin (skin phototypes IV–VI).

Methods

A literature search was conducted using the PubMed database and bibliographies of relevant articles.

Results

Ablative and non-ablative lasers have proven to be effective for treatment of acne scars in ethnic skin. The risk of developing adverse effects such as post-inflammatory hyperpigmentation is contingent upon several factors including skin phototype, laser device, fluence, and moreso density settings. Non-ablative fractional lasers have been considered first line for the treatment of acne scars in skin of color due to their better safety profile; however, they are less efficacious and require more treatments compared to ablative lasers. Studies regarding efficacy and safety of radiofrequency microneedling for treatment of acne scarring in skin of color are limited, but are promising.

Conclusion

Ablative lasers, non-ablative lasers, and radiofrequency microneedling are all useful treatments for acne scarring in ethnic skin when appropriate settings are used. Further head-to-head studies are needed to evaluate their efficacy and safety in darker skin phototypes V–VI.     

Safety and efficacy of fractional bipolar radiofrequency treatment in Fitzpatrick skin types V–VI

Abstract

Purpose: To evaluate the safety and efficacy of a bipolar fractionated radiofrequency device for the improvement skin texture, fine lines and wrinkles in the treatment of skin types V through VI. Design: Fifteen subjects, skin types V and VI, between the ages of 40 and 64 were enrolled. Each received three treatments to the full face with fractionated bipolar RF device (Syneron Inc., Irvine, USA) spaced 30 days apart. Patients were evaluated by the study investigator and a blinded investigator at each treatment and 90 days after the last treatment for the treatment safety and efficacy. Summary: A statistically significant improvement in wrinkles, texture and fine lines was noticed in most subjects. Any adverse events in particular post inflammatory hyperpigmentation or hypopigmentation were not seen in any of the patients. Conclusion: Our study suggests that the use of this fractionated radiofrequency device is a safe and effective method of skin rejuvenation for skin types V through VI.     

Cosmetic therapies for Chinese patients with acne taking concomitant or recent intake of oral isotretinoin: A retrospective study

Background

The current standard recommendation is to initiate the cosmetic therapies after discontinuing taking oral isotretinoin for at least 6 months. However, this recommendation has been questioned in several recent publications, and it is difficult to operate in clinical practice as early initiation of effective treatment is desirable for patients with acne sequelae.

Objective

The purpose of this study is to evaluate the efficacy and safety of chemical peeling and light/laser or radiofrequency treatments combined with oral isotretinoin for patients with acne vulgaris and acne scars.

Method

A retrospective study of 511 patients on/or recently administered with isotretinoin treated with glycolic acid, intense pulsed light, nonablative fractional laser, fractional radiofrequency, and ablative carbon dioxide laser. A total of 1352 interventions were performed. The medical follow-up lasted for at least 1 year. The efficacy and safety of different procedures were evaluated.

Results

A total of 511 patients, who were treated with isotretinoin orally or stopped for <6 months, received 477 sessions of glycolic acid chemical peeling treatment, 588 sessions of intense pulsed light treatment, 61 sessions of nonablative fractional laser treatment, 101 sessions of fractional radiofrequency treatment, and 125 sessions of ablative fractional carbon dioxide laser treatment. No hypertrophic scars and keloids were found, and the incidence of serious adverse reactions such as scarring, erythema, blisters, and postinflammatory hyperpigmentation did not increase.

Conclusions

It is safe to perform skin procedures in patients with acne and acne scars during or after discontinuation of isotretinoin for <6 months. Invasive treatments such as ablative fractional carbon dioxide laser treatment can be performed, as appropriate, by an experienced physician. The guideline of avoiding chemical and physical procedures in such patients taking oral isotretinoin should to revised.     

Subcision for treatment of rolling acne scars in Iraqi patients: a clinical study

Background Acne scarring is a common dermatologic problem causing a great cosmetic disfigurement. Subcision is one of the effective modalities for treatment of rolling acne scars. Objective To evaluate the efficacy and safety of subcision for rolling acne scars in Iraqi patients. Patients and Methods Forty patients (21 males and 19 females) with moderate to severe grades of facial rolling acne scars were enrolled in this study. Subcision was done for all patients. Patients were followed up at 2, 6, 12 weeks, and 6 months after the last session. The response to treatment was evaluated by objective and subjective methods. Results Thirty‐four patients completed the study and follow up period. Eight of them were complaining of severe and 26 of moderate grade of acne scars. At the end of the study, 18 (52.94%) patients had mild grade, 15 (44.11%) patients had moderate grade, and one (2.92%) patient had severe grade. This change was statistically highly significant (P‐value = 0.0000001). The average scar score before treatment was 13.264 ± 1.675; and it improved to 9.47 ± 2.71 after 6 months (P‐value = 0.0000001). Regarding the photographic assessment, the difference in the visual analogue scale before and after the treatment was statistically highly significant (P‐value = 0.0000001). All patients were satisfied regarding the improvement after treatment with varying degrees. All reported side‐effects were mild and transient. Conclusion Subcision is a safe, easy to perform, well‐tolerated, and valuable surgical technique for treatment of rolling acne scars.     

Efficacy and safety of a single treatment using a 10,600-nm carbon dioxide fractional laser for mild-to-moderate atrophic acne scars in Asian skin

BackgroundAblative laser therapy with carbon dioxide is effective for acne scars; however, the long downtime limits its use, especially in types III and IV skin. The fractional ablative 10,600-nm carbon dioxide laser system reportedly maximizes efficacy and minimizes side effects. The goal of this study was to evaluate the efficacy and safety of an ablative 10,600-nm carbon dioxide fractional laser system in a single treatment session on atrophic acne scars in Asian patients.MethodsTwenty-five patients with atrophic acne scars were enrolled. The laser fluences were delivered using the Deep FX mode. Comparative photographs were taken with VISIA complexion analysis. Physician evaluation and patient satisfaction were graded on a four-point scale.ResultsAt follow-up 1 month after treatment, four patients showed 51–75% improvement, 16 had 26–50% improvement, and five had minimal or no improvement. At 3 months, two patients had excellent results (76% and 100% improvement). Postinflammatory hyperpigmentation was present in six of the 25 (24%) patients; by 3 months' follow-up, this had faded in five of six cases.ConclusionA single treatment with the carbon dioxide fractional laser system is effective for acne scars in Asian patients, with minimal and acceptable side effects.     

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.