Skin rejuvenation by radiofrequency therapy: methods,effects and risks

Treatment of sun‐damaged skin and wrinkles is attracting increasing interest as the possible approaches expand. Recently mono‐ und bipolar radiofrequency devices have been introduced as new treatment options for skin rejuvenation. Initial studies have demonstrated changes in collagen content of the skin as the molecular basis of skin texture improvement. However, there are many possible risks and side effects. We describe a patient referred to us with severe facial scarring as a result of a bipolar radiofrequency treatment performed by non‐medical personnel. Due to the risk of permanent tissue damage, the indications for radiofrequency interventions should be made carefully. Potential contraindications should be considered and written informed consent about all possible side effects and risk factors should be obtained. According to current knowledge, the experience of the physician using radiofrequency devices is most important in determining the outcome of this procedure. Therefore the use of radiofrequency therapy requires extensive training.     

Effects of microdermabrasion on skin rejuvenation

Abstract

Background: Microdermabrasion is a surface treatment, noninvasive, which uses a negative pressure and drives programmable inert microcrystals on the skin, causing an exfoliation. Objective: The aim of this study was to evaluate the effects of application of microdermabrasion in human skin rejuvenation. Methods: Eleven women who were undergoing abdominoplasty were considered. An area of 25 cm² in the umbilicus to the right was conditioned with microcrystals of Al₂O₃ in maximum flow, negative pressure of 200 mmHg and total of 8 past, the left side being used as control. The number of sessions ranged from one to five, with weekly intervals, and timing of sample collection ranged from 0 to 132 days. Samples were fixed in 10% formaldehyde in phosphate buffer and were evaluated histologically. Results: A mild to marked hyperpigmentation was observed and remained for a variable period. Histological findings suggest an improvement in the epidermal layer with increased thickness and reestablishing their interdigitations in the dermis initially observed an increase in collagen synthesis. The analysis showed a late stay of epidermal changes, which did not occur in the dermis. Conclusion: Under the conditions and parameters used in this work, the microdermabrasion had a positive skin structure, showing that a viable resource in promoting skin rejuvenation.     

An overview of the role of carboxytherapy in dermatology

Background

Carboxytherapy is defined as intradermal and/or subcutaneous microinjections of sterile purified carbon dioxide into different parts of the body for therapeutic aims. The vasodilatation effect and intradermal collagen reorganization associated with carboxytherapy have advantages for aesthetic dermatology and cosmetology.

Objective

In the current article, we have reviewed some of the most important indications of this modality in dermatology and aesthetic dermatology.

Method

Our review is a narrative one which has gathered some of the most important indications of carboxytherapy in dermatology and cosmetology.

Results

Carboxytherapy has successfully been applied for some dermatologic and cosmetic conditions among which skin aging, cellulite, localized fat deposits, striae distensae, infraorbital hyperpigmentation, scar, lymphedema, androgenetic alopecia, alopecia areata, psoriasis, morphea, and vitiligo are the most important.

Conclusion

Carboxytherapy can be considered as a safe, minimally-invasive modality used for rejuvenation, restoration, and recondition of the skin.     

A novel non-invasive radiofrequency dermal heating device for skin tightening of the face and neck

Background: Loose, lax skin is a common cosmetic complaint. Previous non-invasive skin tightening devices had modest efficacy and were associated with pain or downtime. New technologies may allow for effective skin tightening with a series of radiofrequency (RF) treatments with no downtime. Objective: To evaluate the efficacy and safety of a novel bipolar RF device for skin tightening. Methods: Fifteen consecutive female patients were enrolled in the case series; 14 completed the study and were included in the analysis. The device under investigation is a novel, bipolar RF device allowing for achievement and maintenance of optimal dermal temperatures to stimulate collagen remodeling and skin tightening. Patients underwent a series of 4–6 weekly treatments. Three blinded, experienced cosmetic physicians evaluated paired pre-treatment and post-treatment photographs and determined the associated improvement, if any. Results: All patients (14/14) were determined to have a clinical improvement, as the pre-treatment and post-treatment photographs were correctly identified by the evaluators. It was observed that 21% (3/14) of patients had significant improvement, 50% (7/14) had moderate improvement, and 29% (4/14) had mild improvement. No pain, side effects, or adverse events were observed. Conclusions: This novel bipolar RF device represents a safe, effective treatment option for non-invasive skin tightening.     

The efficacy of conditioned media of adipose-derived stem cells combined with ablative carbon dioxide fractional resurfacing for atrophic acne scars and skin rejuvenation

Objective: To evaluate the effects of conditioned medium of adipose-derived stem cells (ADSC-CM) on efficacy and side effects after fractional carbon dioxide laser resurfacing (FxCR) when treating subjects with facial atrophic acne scars or with skin rejuvenation needs. Materials and methods: Twenty-two subjects were enrolled in the study and divided into two groups. Nine subjects were included in skin rejuvenation group and thirteen subjects were included in acne scar group, and all subjects underwent three sessions of FxCR. ADSC-CM was applied on FxCR site of one randomly selected face side. Evaluations were done at baseline, 1 week after first treatment, and 1 month after each treatment. The outcome assessments included subjective satisfaction scale; blinded clinical assessment; and the biophysical parameters of roughness, elasticity, skin hydration, transepidermal water loss (TEWL), and the erythema and melanin index. Biopsies taken from one subject in skin rejuvenation group were analyzed using hematoxylin and eosin, Masson's Trichrome, and Gomori's aldehyde fuchsin staining. Results: ADSC-CM combined with FxCR increased subject satisfaction, elasticity, skin hydration, and skin elasticity and decreased TEWL, roughness, and the melanin index in both acne scars and skin rejuvenation groups. Histologic analysis showed that ADSC-CM increased dermal collagen density, elastin density, and arranged them in order. Conclusion: ADSC-CM with FxCR is a good combination therapy for treating atrophic acne scars and skin rejuvenation.

Trial registration: JSPH2012-082 – Registered 14 Feb 2012     

Effects of the Nd:YAG 1320-nm laser on skin rejuvenation: Clinical and histological correlations

Abstract

The neodymium:yttrium-aluminum-garnet (Nd:YAG) laser is a popular non-ablative treatment used for skin rejuvenation. The purpose of this prospective study was to evaluate the clinical effects, coupled with a quantitative assessment, of the histological changes in response to Nd:YAG 1320-nm laser treatment of periocular wrinkles. Six volunteers with Fitzpatrick skin types III and IV and Glogau class I–II wrinkles were subjected to 3 months of Nd:YAG 1320-nm treatment in the periocular area (six sessions at 2-week intervals). Volunteers were photographed, and skin biopsies were obtained at baseline as well as 3 and 6 months after the start of treatments. Quantitative evaluation of total elastin, newly synthesized tropoelastin, collagen types I, III and VII, and newly synthesized collagen was performed using a computerized morphometric analysis. A noticeable clinical and histological improvement was observed after Nd:YAG 1320-nm treatment. Collagen types I, III and VII, as well as newly synthesized collagen, together with tropoelastin showed a statistically significant increase in response to treatment, while the mean level of total elastin was significantly decreased after treatment. Our data suggest that Nd:YAG 1320 nm is an effective treatment for skin rejuvenation as it stimulates the repair processes, and reverses the clinical, as well as the histopathological, signs of skin aging.     

Application of subcutaneous radiofrequency after liposuction on midface: A minimally invasive technique for midface rejuvenation

Background

Popular demand for minimally invasive soft tissue tightening is continuously on the rise. In recent years, subcutaneous radiofrequency or radiofrequency-assisted liposuction (RFAL) has been reported to produce the desired surgical outcome on lower-face and body tightening. However, few studies are found using subcutaneous radiofrequency for midface rejuvenation.

Aims

This study was performed to review our surgical method for the midface rejuvenation using subcutaneous radiofrequency combined with liposuction and to evaluate the clinical outcomes.

Patients/Methods

This retrospective observational study involved 31 patients with mild-to-moderate mid-face laxity. All patients received liposuction combined with subcutaneous radiofrequency on midface from June 2020 to June 2022. Clinical results were assessed objectively using photographs and subjectively by a patient satisfaction survey.

Results

All patients recovered well without major complications. High patient satisfaction was attained. The mean score of midface laxity (GGS) as evaluated by jury decreased from 3.3 preoperatively to 1.6 postoperatively.

Conclusions

Our midface tightening technique is safe and effective for patients with a mild-to-moderate midface aging appearance.

Level of Evidence

Therapeutic IV.     

Macrocystis pyrifera ferment-containing creams for optimizing facial skin rejuvenation

Background

There is an increasing demand for facial skin rejuvenation. Specialized aesthetic skincare treatments may be one of the first steps to help prevent or treat facial signs of aging. This article discusses aesthetic skin care for facial skin rejuvenation, particularly data on two creams containing Macrocystis pyrifera ferment.

Methods

The authors convened a dermatology advisory board to discuss challenges and practices in using skincare for facial rejuvenation, combining their expert opinion and experience on facial rejuvenation with preclinical and clinical data on two creams containing Macrocystis pyrifera ferment and a review of the literature.

Results

Preclinical and clinical studies on Macrocystis pyrifera ferment and two creams containing the ferment exhibit anti-inflammatory, anti-aging, and healing properties. In preclinical studies, the ferment demonstrated collagen type I enhancing properties in ex vivo skin models, and skin cells treated with the ferment migrated faster than untreated cells in the in vitro study. In clinical studies measuring visible anti-inflammatory activity, the ferment alone and the ferment-containing products significantly decreased erythema, and in anti-aging studies, they improved visible skin aging parameters. Finally, in clinical studies on the stratum corneum, the two creams increased moisture levels and decreased transepidermal water loss (TEWL), reflecting healing by enhancing barrier strength and recovery.

Conclusions

The Macrocystis pyrifera ferment and creams containing the ferment are effective skin care treatment products to decrease the visible effects of inflammation and signs of aging while promoting healing by enhancing barrier resilience and recovery.     

Combination of microneedle radiofrequency (RF), fractional RF skin resurfacing and multi-source non-ablative skin tightening for minimal-downtime,full-face skin rejuvenation

Background: In the recent years, there is a growth in demand for radiofrequency (RF)-based procedures to improve skin texture, laxity and contour. The new generation of systems allow non-invasive and fractional resurfacing treatments on one platform. Objective: The aim of this study was to evaluate the safety and efficacy of a new treatment protocol using a multisource RF, combining 3 different modalities in each patient: [1] non-ablative RF skin tightening, [2] fractional skin resurfacing, and [3] microneedling RF for non-ablative coagulation and collagen remodelling. Methods: 14 subjects were enrolled in this study using EndyMed PRO^? platform. Each patient had 8 non-ablative treatments and 4 fractional treatments (fractional skin resurfacing and Intensif). Results: The global aesthetic score was used to evaluate improvement. All patients had improvement in skin appearance. About 43% had excellent or very good improvement above 50%, 18% had good improvement between 25 and 50%, and the rest 39% had a mild improvement of < 25%. Downtime was minimal and no adverse effect was reported. Conclusions: Our data show significant improvement of skin texture, skin laxity and wrinkle reduction achieved using RF treatment platform.     

Electro-optical synergy (ELOS™) technology for nonablative skin rejuvenation: a preliminary prospective study

BACKGROUND AND OBJECTIVES: In this preliminary prospective study, we evaluated the efficacy and safety of nonablative wrinkle treatment using combined radiofrequency (RF) and optical energy (Polaris). The dual energy technology of Polaris, called ELOS, which stands for electro-optical synergy, uses synchronous pulses of bipolar RF current and pulsed visible light (diode laser) delivered in the same pulse. MATERIALS AND METHODS: Twenty-four subjects with periorbital and perioral wrinkles received six treatments at 4-week intervals with the Polaris WR (Syneron, Inc., Israel, 900 nm, max. RF energy 100 J/cm(3), max. laser energy 50 J/cm(2)). Each treatment consisted of two passes over the treatment area using pulsed optical and RF parameters that were determined by the patient's skin phenotype and distribution of target chromophores. The follow-up period was 3 months after the last treatment. RESULTS: Independent scoring of blinded photographs showed a wrinkle score improvement of at least 1 (0 = no improvement, 1 = medium, 2 = good, 3 = excellent improvement) 3 months after the last of six treatment sessions. There was no difference between periorbital and perioral wrinkle reduction. Fifty-eight per cent (14/24) of the subjects reported a notable wrinkle reduction; 16% noted mild to moderate oedema and erythema lasting for no more than 1 day. Scarring or pigmentary changes were not detected. The average pain score was 0.6 (0 = no pain, 5 = intolerable pain). CONCLUSION: Multiple treatments with the Polaris WR produced objective and subjective reduction of periorbital and perioral wrinkles. The occurrence of side-effects and pain was very low. The clinical effect may be caused by matrix coagulation of the deep dermis by the RF and selective thermolysis of blood vessels with the 900 nm diode laser.     

A 12-week clinical and instrumental study evaluating the efficacy of a multisource radiofrequency home-use device for wrinkle reduction and improvement in skin tone,skin elasticity,and dermal collagen content

This study was performed in order to evaluate the safety and efficacy of a new handheld home-use multisource radiofrequency device on facial rejuvenation. Forty-seven male and female subjects were enrolled. All subjects received a NEWA^® 3DEEP^? home-use device (EndyMed Medical, Caesarea, Israel) to be used on facial skin three times per week for the first four weeks and then reduced to two times per week for the following eight weeks. Assessments included expert clinical grading for efficacy, instrumental evaluation, image analysis, and photography. Forty-five subjects completed the study; all subjects reported the treatment to be painless with only mild erythema lasting up to 15 minutes post-treatment. No other adverse events were reported. Statistically significant improvements were noted in the appearance of marionette lines, skin brightness, elasticity, firmness, lift (facial), lift (jawline), texture/smoothness, tone, and radiance/luminosity by expert visual assessment. Statistically significant improvements in skin firmness and elasticity were found using a Cutometer MPA 580, as well as in collagen and hemoglobin content of the skin using a SIAscope. The results of this study indicate that the NEWA^® multisource radiofrequency home-use device is effective in self-administered skin rejuvenation.