New-generation radiofrequency technology.
Krueger N1, Sadick NS.
1Division of Cosmetic Science, University of Hamburg, Germany.
Radiofrequency (RF) technology has become a standard treatment in
aesthetic medicine with many indications due to its versatility,
efficacy, and safety. It is used worldwide for cellulite reduction; acne scar revision; and treatment of hypertrophic scars and keloids, rosacea, and inflammatory acne
in all skin types. However, the most common indication for RF
technology is the nonablative tightening of tissue to improve skin
laxity and reduce wrinkles. Radiofrequency devices are classified as
unipolar, bipolar, or multipolar depending on the number of electrodes
used. Additional modalities include fractional RF; sublative RF;
phase-controlled RF; and combination RF therapies that apply light,
massage, or pulsed electromagnetic fields
(PEMFs). This article reviews studies and case series on these devices.
Radiofrequency technology for aesthetic medicine has seen rapid
advancements since it was used for skin tightening in 2003. Future
developments will continue to keep RF technology at the forefront of the
dermatologist’s armamentarium for skin tightening and rejuvenation.
Indian J Dermatol Venereol Leprol. 2012 Mar-Apr;78(2):146-52. doi: 10.4103/0378-6323.93630.
The safety and efficacy of a combined diode laser and bipolar
radiofrequency compared with combined infrared light and bipolar
radiofrequency for skin rejuvenation.
Choi YJ1, Lee JY, Ahn JY, Kim MN, Park MY.
1Seoul National University Bundang Hospital, Korea.
As the demand for noninvasive procedures for skin rejuvenation is
increasing, combined diode laser and radiofrequency and combined
infrared and radiofrequency devices have recently emerged.
To compare Polaris WRA(TM), a combination device of diode light and
RF, and ReFirme ST(TM), a combination device of infrared and bipolar
RF, in terms of safety and efficacy on skin rejuvenation.
Fourteen Korean volunteers of skin type II-IV, with facial laxity
and periorbital rhytids, received three treatments at 3-week intervals
with combined diode laser and bipolar radiofrequency (laser fluence 30
J/cm2, RF fluence 90 J/cm3) on the right half of their faces and
combined infrared light and bipolar radiofrequency (RF fluence 120
J/cm3) on the left half of their faces. Clinical photos of front and
bilateral sides of the subjects’ faces were taken at baseline and at 6,
9, 12 weeks after the treatment initiation. The investigators’ and the
subjects’ global assessments were performed.
There is no statistically significant difference in the overall
outcome between Polaris WRA(TM) and Refirme ST(TM) based on pre- and
post-treatment objective measurements. Polaris WRA(TM) was more
effective than Refirme ST(TM) at reducing wrinkles when therapeutic
results of the two appliances were compared based on the patient
satisfaction measurements. After the treatment with both instruments,
histological increase in the production and rearrangement of collagen
fibers at the dermal layer was observed. The density of the collagen
fibers was more increased with the Polaris WRA(TM)-treated facial area
than that of Refirme ST(TM). Treatment was generally well tolerated, and
there was no serious complication.
In this study, both the lasers appeared to be safe, and effective
methods for treating skin laxity and facial wrinkles. Combined diode
laser and radiofrequency was more effective than combined infrared and
radiofrequency at reducing wrinkles and pores when the therapeutic
results of both the appliances were compared.
Am J Clin Dermatol. 2009;10(3):153-68. doi: 10.2165/00128071-200910030-00002.
The Asian dermatologic patient: review of common pigmentary disorders and cutaneous diseases.
Ho SG1, Chan HH.
1Department of Medicine, The University of Hong Kong, Hong Kong SAR, China.
The Asian patient with Fitzpatrick skin types III-V is rarely
highlighted in publications on cutaneous disorders or cutaneous laser
surgery. However, with changing demographics, Asians will become an
increasingly important group in this context. Although high melanin
content confers better photoprotection, photodamage in the form of
pigmentary disorders is common. Melasma, freckles, and lentigines are
the epidermal disorders commonly seen, whilst nevus of Ota and acquired
bilateral nevus of Ota-like macules are common dermal pigmentary
disorders. Post-inflammatory hyperpigmentation (PIH) occurring after
cutaneous injury remains a hallmark of skin of color. With increasing
use of lasers and light sources in Asians, prevention and management of
PIH is of great research interest. Bleaching agents, chemical peels,
light (IPL) treatments, and fractional skin resurfacing have all been
used with some success for the management of melasma. Q-switched (QS)
lasers are effective for the management of epidermal pigmentation but
are associated with a high risk of PIH. Long-pulsed
neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers and IPL sources
pose less of a PIH risk but require a greater number of treatment
sessions. Dermal pigmentary disorders are better targeted by QS ruby, QS
alexandrite, and QS 1064-nm Nd:YAG lasers, but hyper- and
hypopigmentation may occur. Non-ablative skin rejuvenation using a
combination approach with different lasers and light sources in
conjunction with cooling devices allows different skin chromophores to
be targeted and optimal results to be achieved, even in skin of color.
Deep-tissue heating using radiofrequency and infra-red light sources
affects the deep dermis and achieves enhanced skin tightening, resulting
in eyebrow elevation, rhytide reduction, and contouring of the lower
face and jawline. For management of severe degrees of photoaging,
fractional resurfacing is useful for wrinkle and pigment reduction, as
well as acne scarring. Acne,
which is common in Asians, can be treated with topical and oral
antibacterials, hormonal treatments, and isotretinoin. Infra-red diode
lasers used with a low-fluence, multiple-pass approach have also been
shown to be effective with few complications. Fractional skin
resurfacing is very useful for improving the appearance of acne
scarring. Hypertrophic and keloid scarring, another common condition
seen in Asians, can be treated with the combined used of intralesional
triamcinolone and fluorouracil, followed by pulsed-dye
laser. Esthetic enhancement procedures such as botulinum toxin type A
and fillers are becoming increasingly popular. These are effective for
rhytide improvement and facial or body contouring. We highlight the
differences between Asian skin and other skin types and review
conditions common in skin of color together with treatment strategies.
Facial Plast Surg. 2005 May;21(2):131-8.
The radiofrequency frontier: a review of radiofrequency and combined radiofrequency pulsed-light technology in aesthetic medicine.
Sadick N1, Sorhaindo L.
1Department of Dermatology, Weill Medical College of Cornell University, USA. firstname.lastname@example.org
Radiofrequency (RF) and combined RF light source technologies have
established themselves as safe and effective treatment modalities for
several dermatologic procedures, including skin tightening, hair and leg
vein removal, acne
Vopr Kurortol Fizioter Lech Fiz Kult. 2004 Jul-Aug;(4):28-30.
Using combined magnetotherapy in patients with acne
[Article in Russian]
Kul’chitskaia DB, Orekhova EM, Vasil’eva ES.
Laser Doppler flowmetry discovered microcirculatory disorders in acne
patients. Affected are arterioles as well as capillaries and venules.
Combination of magnetotherapy with medication improves microcirculation
in acne patients. More marked positive changes occurred in the
microcirculatory system due to combined treatment compared to medication
therapy only. Thus, laser Doppler flowmetry is a new, noninvasive
method of assessing microcirculation in acne patients and can serve an
objective criterion of treatment efficacy.