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Nilforoushzadeh MA, Heidari N, Heidari A, Ghane Y, Hosseini S, Lotfi Z, Jaffary F, Nobari MN, Aghamiri ZS, Nobari NN. Efficacy and safety of radiofrequency in the treatment of hidradenitis suppurativa; a systematic review. Lasers Med Sci 2024; 39:139. [PMID: 38795173 DOI: 10.1007/s10103-024-04077-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/06/2024] [Indexed: 05/27/2024]
Abstract
BACKGROUND AND AIMS Hidradenitis suppurativa (HS) is an inflammatory skin disease affecting apocrine gland-bearing sites of the body. Radiofrequency (RF) is a minimally invasive method that acts by minimizing thermal damage to the dermis, resulting in collagen synthesis and scar improvement. We systematically reviewed the efficacy and safety of RF in treating HS. METHODS A systematic search was performed up to November 18th, 2023, in PubMed/Medline, Ovid Embase, and Web of Science. Clinical studies with English full texts were included. The National Institute of Health (NIH) Quality Assessment Tool for clinical trials and Methodological quality and synthesis of case series and case reports by Murad et al. were utilized for critical appraisal. RESULTS Out of 55 identified studies, 11 met our inclusion criteria with 167 subjects who underwent RF therapy alone or combined with an intense pulsed laser (IPL), known as LAight®. LAight® significantly improved clinical outcomes in mild-to-moderate HS patients based on the Dermatology Life Quality Index (DLQI), International Hidradenitis Suppurativa Score System (IHS4), Pain-Numerical Rating Scale (NRS), and Hidradenitis Suppurativa Clinical Response (HiSCR). Moreover, RF therapy alone significantly alleviated the clinical manifestations in patients with mild-to-moderate HS. Additionally, fractional microneedling RF significantly decreased HS-associated inflammatory markers. RF was found to be safe with limited adverse events. However, in moderate-to-severe HS, RF has failed to yield satisfactory results. CONCLUSION RF is a safe energy-based method with promising outcomes, especially for long-term application in mild-to-moderate HS. In moderate-to-severe cases, RF should be combined with a systemic medication for further beneficial impacts.
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Affiliation(s)
- Mohammad Ali Nilforoushzadeh
- Skin Repair Research Center, Shahid Beheshti University of Medical Sciences, Ahmadi Alley, Nelson Mandela St. 1518963113, MirdamadTehran, Iran
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Heidari
- Skin Repair Research Center, Shahid Beheshti University of Medical Sciences, Ahmadi Alley, Nelson Mandela St. 1518963113, MirdamadTehran, Iran
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Heidari
- Skin Repair Research Center, Shahid Beheshti University of Medical Sciences, Ahmadi Alley, Nelson Mandela St. 1518963113, MirdamadTehran, Iran
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Yekta Ghane
- Skin Repair Research Center, Shahid Beheshti University of Medical Sciences, Ahmadi Alley, Nelson Mandela St. 1518963113, MirdamadTehran, Iran
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedayin Hosseini
- Skin Repair Research Center, Shahid Beheshti University of Medical Sciences, Ahmadi Alley, Nelson Mandela St. 1518963113, MirdamadTehran, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Lotfi
- Skin Repair Research Center, Shahid Beheshti University of Medical Sciences, Ahmadi Alley, Nelson Mandela St. 1518963113, MirdamadTehran, Iran
| | - Fariba Jaffary
- Skin Repair Research Center, Shahid Beheshti University of Medical Sciences, Ahmadi Alley, Nelson Mandela St. 1518963113, MirdamadTehran, Iran
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Minou Najar Nobari
- Department of Orofacial Pain and Dysfunction, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Zahra Sadat Aghamiri
- Skin Repair Research Center, Shahid Beheshti University of Medical Sciences, Ahmadi Alley, Nelson Mandela St. 1518963113, MirdamadTehran, Iran
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Niloufar Najar Nobari
- Skin Repair Research Center, Shahid Beheshti University of Medical Sciences, Ahmadi Alley, Nelson Mandela St. 1518963113, MirdamadTehran, Iran.
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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2
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Zhang X, Zhou M, Liu Y, Zeng R. Recent advances in the treatment of acne using radiofrequency techniques. Lasers Med Sci 2024; 39:92. [PMID: 38499897 DOI: 10.1007/s10103-024-04039-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/11/2024] [Indexed: 03/20/2024]
Abstract
Acne is a long-lasting inflammatory skin condition that impacts the sebaceous units of the hair follicles, affecting around 85-90% of the population. Due to the potential for permanent facial scarring and negative social consequences, as well as the limitations of conventional medications like drug resistance and difficulties following treatment plans, it's crucial to investigate non-pharmacological options for treating acne, among which radiofrequency(RF) shows distinct superiority. To assess the impact of RF in the management of acne vulgaris, we conducted a thorough examination of scientific literature (including clinical trials and scientific reviews) through electronic databases like MEDLINE and PubMed. Our analysis indicates that RF could be a viable substitute for acne treatment due to its notable effectiveness and minimal adverse effects.
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Affiliation(s)
- Xin Zhang
- Department of Laser Surgery, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, 210042, China
| | - Meng Zhou
- Department of Laser Surgery, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, 210042, China
| | - Yuzhen Liu
- Department of Dermatology, Nanjing Jiangning Hospital, Nanjing, 211100, Jiangsu, China.
| | - Rong Zeng
- Department of Laser Surgery, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, 210042, China.
- Department of Dermatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, No. 120 Guanghua Rd, Kunming, 650021, Yunnan, China.
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3
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Techapichetvanich T, Manuskiatti W, Wongdama S, Viriyaskultorn N, Li JB, Jantanapornchai N. Nonablative monopolar radiofrequency for the reduction of facial pores and sebum excretion in Thai patients: A novel approach. Lasers Surg Med 2023; 55:528-535. [PMID: 37210600 DOI: 10.1002/lsm.23681] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/07/2023] [Accepted: 05/11/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Enlarged facial pores are visible topographic features of the skin that have been associated with cutaneous photoaging and increased sebum production. It has remained a common dermatologic concern, gaining a significant number of in-clinic consults. Available treatment modalities often operate on a single mode of action, consequently offering limited and short-term outcomes. OBJECTIVE This study aimed to evaluate the long-term efficacy and safety of a nonablative monopolar radiofrequency (NMRF) for pore tightening and sebum output reduction in Thai patients. METHODS Nineteen patients with enlarged pores underwent two sessions of NMRF treatments at 4-week intervals. The measurements of pore volume, skin texture, average pore size, sebum production, and skin elasticity were quantified using Antera® 3D imaging system, dermoscopic image analysis with ImageJ software, Sebumeter® and Cutometer®. Clinical evaluation by two dermatologists was done using blinded clinical photographs. All objective and subjective assessments were done at the baseline, a month after the first treatment, and during follow-up visits 1, 3, and 6 months after the last treatment. Adverse effects were also recorded during each visit. RESULTS Seventeen out of the 19 subjects completed the study protocol. The mean pore volume significantly reduced by 24% from the baseline at 1 month after the first treatment (p < 0.016). The pore volume continued to decrease by 34% and 38% a month (p < 0.001) and 6 months (p < 0.001) following the final treatment, respectively. Sebum excretion likewise significantly decreased from baseline by 39% (p = 0.002) and 36% (p < 0.001), 3 and 6 months after the second treatment, respectively. Skin texture and elasticity also significantly improved following two NMRF sessions. The objective assessments of the pore appearance corresponded to subjective clinical evaluations. The treatment was well-tolerated without significant side effects, such as dyspigmentation, textural alteration, and scarring. CONCLUSION NMRF appears to be effective and safe for the reduction of pore size and sebum production, with therapeutic outcomes persisting up to 6 months after two treatment sessions.
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Affiliation(s)
- Thanya Techapichetvanich
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supisara Wongdama
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Noldtawat Viriyaskultorn
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jayne Bernadeth Li
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nuttagarn Jantanapornchai
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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4
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Suh DH, Jeong JY, Lee SJ, Song KY, Ryu HJ. Can a radiofrequency device reduce the pore size? Lasers Med Sci 2021; 37:1203-1208. [PMID: 34250567 DOI: 10.1007/s10103-021-03373-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
A facial pore is an empty funnel-shaped structure filled with cornified cylindrical plugs that can be cosmetically bothersome to some patients. In the previous report, the new unipolar radiofrequency (RF) device with a vacuum showed excellent skin tightening and patient satisfaction with improved pores. This study aims to confirm the treatment's efficacy with the new unipolar RF device on facial dilated pores by measuring quantitative sebum production differences and doing a histologic examination of pore size. Twelve patients who visited the dermatologic clinic without other underlying inflammatory facial skin diseases were included, regardless of the patient's age or sex. All patients received five successive treatments at 2-week intervals. We assessed all changes in sebum production levels, melanin index, erythema index before and after treatment, along with overall improvement (reduction of pore size, skin tone, skin texture, and skin laxity). In the five patients who agreed in advance, a biopsy of the pore lesion was taken before and 1 month after the last treatment with hematoxylin and eosin (H&E) staining, Masson's trichrome (M-T) staining, and Victoria blue staining. We observed a significant reduction of sebum production and melanin index after using the new unipolar RF device with a vacuum (sebum production, p = 0.011; MI, p = 0.004). In evaluating patient satisfaction for four categories, the patients showed a moderate to the excellent improvement of more than 50% in their condition except for skin tones. The average pore size decreased by 41.7% in the histological examination, from 64.98 to 37.86 μm. Additionally, we observed an overall decreased sebaceous gland in the dermis and the proliferation of dermal collagen fiber. The number of elastic bundles in the D-E junction was increased after treatment. The nonablative unipolar RF devices with a vacuum can improve dilated pores with a dual mechanism (collagen regeneration and reduction of sebum production), with much less pain than other RF devices.
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Affiliation(s)
- Dong Hye Suh
- Arumdaun Nara Dermatologic Clinic, Seoul, Republic of Korea
| | - Jae Yeong Jeong
- Department of Dermatology, Korea University Ansan Hospital, Korea University, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea
| | - Sang Jun Lee
- Arumdaun Nara Dermatologic Clinic, Seoul, Republic of Korea
| | - Kye Yong Song
- Department of Pathology, Chung-Ang University, Seoul, Republic of Korea
| | - Hwa Jung Ryu
- Department of Dermatology, Korea University Ansan Hospital, Korea University, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea.
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5
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Aesthetic Applications of Radiofrequency: Lymphatic and Perfusion Assessment. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3193. [PMID: 33173697 PMCID: PMC7647541 DOI: 10.1097/gox.0000000000003193] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 08/18/2020] [Indexed: 12/03/2022]
Abstract
Background: The use of radiofrequency in aesthetics has increased in popularity since the early 2000s. To date, there have been limited studies investigating the effect of thermal energy secondary to radiofrequency treatment. The purpose of this study was to evaluate perfusion and lymphatic assessment tools pre and post bipolar and fractional radiofrequency treatment. Methods: A retrospective IRB-approved study was conducted between January 2019 and April 2019. Patients who were independently deemed appropriate candidates for radiofrequency soft tissue remodeling were evaluated. Diagnostic perfusion and lymphatic imaging obtained were reviewed using indocyanine green (SPY, Stryker) and optical coherence tomography (Vivosight OCT). Results: A total of 63 patients were treated during the study period, of which 37 had diagnostic perfusion and lymphatic imaging. Average patient age was 47 (STD 12), 95% (35/37) of patients were women, and no patients were active smokers. In total, 27% (10/37) of patients were post-surgical patients with recurrent laxity, 32% (12/37) did not have enough skin laxity to justify traditional excisions procedures, and 41% (15/37) may have been candidates for excisional procedures but were willing to accept more moderate results to avoid excisions surgery. Indocyanine green perfusion and lymphatic assessment for bipolar and fractional radiofrequency, as well as optical coherence tomography pre and post radiofrequency, did not show compromise from thermal injury. Conclusions: This study supports safety of radiofrequency in terms of preservation of tissue perfusion and lymphatic drainage. This correlated to our low clinical incidence of burns, prolonged swelling, or tissue ischemia.
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Jung YJ, Ro YS, Ryu HJ, Kim JE. Therapeutic effects of a new invasive pulsed-type bipolar radiofrequency for facial erythema associated with acne vulgaris and rosacea. J COSMET LASER THER 2020; 22:205-209. [PMID: 33650938 DOI: 10.1080/14764172.2021.1880599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Facial erythema from rosacea and acne is one of the most common problems encountered in dermatologic clinics. Effective therapeutic interventions for persistent erythema, which can cause patients frustration and psychological distress, are needed. The aim of this study was to evaluate the efficacy and safety of an invasive short pulsed-type bipolar radiofrequency device (IPBRF) for the treatment of intractable facial erythema. Thirty-one patients who had been diagnosed with rosacea or acne vulgaris and combined erythema underwent at least two IPBRF treatment sessions (maximum: 5) at 2-week intervals. Treatment outcomes were evaluated by investigator global assessment (IGA) based on clinical photographs, patient global assessment (PGA) score, and skin biophysical parameters including erythema index (EI), melanin index (MI), and transepidermal water loss (TEWL). Most patients showed significant clinical improvement. IGA scores for erythema, pores and smoothness improved after treatment. PGA also showed a trend toward improvement. Mean EI was significantly improved after the second treatment compared to baseline, which maintained until the study period. MI and TEWL showed a tendency toward improvement. There were no serious adverse events reported during the study. IPBRF led to rapid clinical improvement in facial erythema associated with rosacea and acne vulgaris and could be an effective and safe treatment option.
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Affiliation(s)
- You Jin Jung
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Young Suck Ro
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Hwa Jung Ryu
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
| | - Jeong Eun Kim
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
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7
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Lyons AB, Townsend SM, Turk D, Narla S, Baah N, Hamzavi IH. Laser and Light-Based Treatment Modalities for the Management of Hidradenitis Suppurativa. Am J Clin Dermatol 2020; 21:237-243. [PMID: 31845121 DOI: 10.1007/s40257-019-00491-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Hidradenitis suppurativa is a chronic inflammatory skin disease characterized by inflammatory nodules, abscesses, and sinus tracts in intertriginous areas that has a significant impact on patient quality of life. Treatments range from topical, intralesional, systemic, and surgical. Furthermore, laser and light-based treatment options have become increasingly popular because of the limitations of adverse effects associated with systemic therapy and decreased down-time associated with laser and light therapy. These modalities are thought to work through a variety of mechanisms including decreasing inflammation, destroying hair follicles, targeting sebaceous glands, killing bacteria, and debulking lesions through ablation. This review explores these laser and light-based treatment modalities for the treatment of hidradenitis suppurativa.
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Affiliation(s)
- Alexis B Lyons
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Detroit, MI, 48202, USA
| | | | - Dilara Turk
- Wayne State School of Medicine, Detroit, MI, USA
| | - Shanthi Narla
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Detroit, MI, 48202, USA
| | - Natasha Baah
- Ohio University-Heritage College of Osteopathic Medicine, Dublin, OH, USA
| | - Iltefat H Hamzavi
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Detroit, MI, 48202, USA.
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8
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Zeng R, Liu Y, Zhao W, Yang Y, Wu Q, Li M, Lin T. A split-face comparison of a fractional microneedle radiofrequency device and fractional radiofrequency therapy for moderate-to-severe acne vulgaris. J Cosmet Dermatol 2020; 19:2566-2571. [PMID: 31957952 DOI: 10.1111/jocd.13299] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/11/2019] [Accepted: 01/02/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Radiofrequency equipment, including invasive fractional microneedle radiofrequency (FMR) and noninvasive fractional radiofrequency (FR), has facilitated progress in the field of active acne treatment, but clinical data are limited. This study aimed to compare the efficacy and safety of FMR and FR in the treatment of moderate-to-severe acne vulgaris. METHODS Ten patients with moderate-to-severe acne were enrolled in a 24-week, prospective, single-blind, randomized, comparative clinical trial with a split-face design. Fractional microneedle radiofrequency treatment was provided on one side of the face and FR on the opposite side. Three consecutive treatments were performed at 4-week interval. Objective assessment of efficacy was performed using the Acne Severity Index (ASI), and acne inflammatory lesions and noninflammatory lesions were evaluated. RESULTS After the first treatment, ASI and both inflammatory and noninflammatory lesions of the FMR-treated side were improved to a greater degree than the FR-treated side. Patients' subjective satisfaction was also better regarding the FMR-treated side. After subsequent treatments, efficacy improves for both groups, and no significant differences in the above efficacy parameters between the two groups were observed. Pain scores were significantly higher for the FR-treated side than the FMR-treated side. CONCLUSION Fractional microneedle radiofrequency is faster and more effective than FR for the treatment of moderate and severe acne after only one treatment. However, after several treatment sessions, both FMR and FR proved to be safe and effective for long-term treatment of moderate-to-severe acne. Therefore, invasive radiofrequency, such as FMR, or noninvasive radiofrequency, such as FR, can successfully treat active acne.
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Affiliation(s)
- Rong Zeng
- Cosmetic lasers, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Yuzhen Liu
- Cosmetic lasers, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Wenwen Zhao
- Cosmetic lasers, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Yin Yang
- Cosmetic lasers, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Qiuju Wu
- Cosmetic lasers, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Min Li
- Cosmetic lasers, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Tong Lin
- Cosmetic lasers, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
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9
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Wilden S, Friis M, Tuettenberg A, Staubach-Renz P, Wegner J, Grabbe S, von Stebut E. Combined treatment of hidradenitis suppurativa with intense pulsed light (IPL) and radiofrequency (RF). J DERMATOL TREAT 2019; 32:530-537. [PMID: 31609667 DOI: 10.1080/09546634.2019.1677842] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Hidradenitis suppurativa is a chronic inflammatory disease with high burden. Treatment options are often unsatisfactory. We assessed the effect of a combination therapy of intense pulsed light (IPL) and radiofrequency (RF). METHODS The explorative study included 47 patients and was performed as a prospective, monocentric, randomized, three-arm parallel-group design trial with a prior 12 weeks observation period. Treatment arms were IPL and RF monotherapies or IPL + RF combination therapy. After 12 weeks, all patients received IPL + RF for additional 12 weeks (cross-over). Primary endpoint was the change in active lesion numbers, secondary endpoint the change in Dermatology Quality of Life Index (DLQI). RESULTS After 12 weeks, active lesion counts of the IPL + RF group decreased more than in the IPL group (p = .044); the decrease in DLQI was significantly higher in the IPL + RF and RF groups compared to IPL. Prolonged 24-week treatment with IPL + RF obtained better results as 12 weeks. Overall, disease burden after 24 weeks of treatment compared to disease fluctuation during the observation period was significantly lower (change in active lesions -3.6, p = .001; in DLQI -5.2, p = .003). CONCLUSIONS IPL + RF treatment appears to represent a promising therapeutic option that leads to reduction of disease activity without severe side effects.
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Affiliation(s)
- Sophia Wilden
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Marina Friis
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Andrea Tuettenberg
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Petra Staubach-Renz
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Joanna Wegner
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Esther von Stebut
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany.,Department of Dermatology, Faculty of Medicine, University of Cologne, Cologne, Germany
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10
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Aşiran Serdar Z, Aktaş Karabay E. A case of fractional microneedling radiofrequency induced rosacea. J COSMET LASER THER 2019; 21:349-351. [PMID: 31476963 DOI: 10.1080/14764172.2019.1661487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Fractional microneedling radiofrequency (FMR) has been reported to improve cutaneous wrinkles due to its effects of inducing neoelastogenesis and neocollagenosis. Furthermore, FMR has shown to be effective in acne scars, acne lesions, hyperhidrosis, acne-related postinflammatory erythema and recently in rosacea. FMR treatment has been suggested to improve rosacea by reducing inflammation and abnormal vessel proliferation. Here we present a 61-year-old female who developed rosacea symptoms after the treatment of FMR for cutaneous wrinkles. Since the case shows conflictory findings with the previous data, it was found worthy presentation.
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Affiliation(s)
- Zehra Aşiran Serdar
- Faculty of Medicine, Department of Dermatology and Venereology, Bahçeşehir University , Istanbul , Turkey
| | - Ezgi Aktaş Karabay
- Faculty of Medicine, Department of Dermatology and Venereology, Bahçeşehir University , Istanbul , Turkey
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11
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Kwon HH, Jung JY, Lee WY, Bae Y, Park GH. Combined treatment of recalcitrant papulopustular rosacea involving pulsed dye laser and fractional microneedling radiofrequency with low-dose isotretinoin. J Cosmet Dermatol 2019; 19:105-111. [PMID: 31102325 DOI: 10.1111/jocd.12982] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/11/2019] [Accepted: 04/10/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND While a considerable number of cases with papulopustular rosacea (PPR) are resistant to conventional medications, therapeutic regimens are not currently established. Pulsed dye laser (PDL) and fractional microneedling radiofrequency (FMR) have previously demonstrated satisfactory results for anti-angiogenesis, anti-inflammation, and dermal remodeling. AIMS To evaluate the efficacy and safety of novel combination regimen with low-dose oral isotretinoin, PDL, and FMR in the treatment of recalcitrant PPR. PATIENTS AND METHODS A retrospective study was undertaken for recalcitrant PPR patients to evaluate the clinical course of novel combination regimen. Twenty-five PPR patients who had failed in previous first-line therapies were enrolled. They were treated with three sessions of PDL and FMR consecutively at 4-week intervals, maintaining daily oral administration of 10 mg isotretinoin for 8 weeks. Objective assessments, erythema index measurement, and patients' subjective satisfaction were evaluated at each visit and 16 weeks after the final treatment. RESULTS At the final follow-up visit, the number of papules and pustules decreased by 71%, and erythema index by 54% compared with baseline (P < 0.05 for both). Physician's global assessment based on rosacea severity score and patients' subjective assessments paralleled with these results. No serious side effect was observed during whole study periods. CONCLUSION This novel combination regimen demonstrated satisfactory efficacy with reasonable safety profiles for the treatment of recalcitrant PPR.
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Affiliation(s)
| | | | - Won-Yong Lee
- Seoul Institute of Clinical Dermatology, Seoul, Korea
| | - Youin Bae
- Department of Dermatology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Gyeong-Hun Park
- Department of Dermatology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
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12
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Shin JW, Kwon SH, Choi JY, Na JI, Huh CH, Choi HR, Park KC. Molecular Mechanisms of Dermal Aging and Antiaging Approaches. Int J Mol Sci 2019; 20:ijms20092126. [PMID: 31036793 PMCID: PMC6540032 DOI: 10.3390/ijms20092126] [Citation(s) in RCA: 290] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 04/22/2019] [Accepted: 04/28/2019] [Indexed: 01/08/2023] Open
Abstract
The dermis is primarily composed of the extracellular matrix (ECM) and fibroblasts. During the aging process, the dermis undergoes significant changes. Collagen, which is a major component of ECM, becomes fragmented and coarsely distributed, and its total amount decreases. This is mainly due to increased activity of matrix metalloproteinases, and impaired transforming growth factor-β signaling induced by reactive oxygen species generated during aging. The reduction in the amount of collagen hinders the mechanical interaction between fibroblasts and the ECM, and consequently leads to the deterioration of fibroblast function and further decrease in the amount of dermal collagen. Other ECM components, including elastic fibers, glycosaminglycans (GAGs), and proteoglycans (PGs), also change during aging, ultimately leading to a reduction in the amount of functional components. Elastic fibers decrease in intrinsically aged skin, but accumulate abnormally in photoaged skin. The changes in the levels of GAGs and PGs are highly diverse, and previous studies have reported conflicting results. A reduction in the levels of functional dermal components results in the emergence of clinical aging features, such as wrinkles and reduced elasticity. Various antiaging approaches, including topicals, energy-based procedures, and dermal fillers, can restore the molecular features of dermal aging with clinical efficacy. This review summarizes the current understanding of skin aging at the molecular level, and associated treatments, to put some of the new antiaging technology that has emerged in this rapidly expanding field into molecular context.
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Affiliation(s)
- Jung-Won Shin
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Soon-Hyo Kwon
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Ji-Young Choi
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
- Department of Dermatology, Seoul National University College of Medicine, Seoul 03080, Korea.
| | - Jung-Im Na
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Chang-Hun Huh
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Hye-Ryung Choi
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Kyung-Chan Park
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
- Department of Dermatology, Seoul National University College of Medicine, Seoul 03080, Korea.
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Pestoni Porvén C, Vieira dos Santos V, del Pozo Losada J. Fractional carbon dioxide (CO2) laser combined with topical tretinoin for the treatment of different forms of cystic acne. J COSMET LASER THER 2017; 19:465-468. [DOI: 10.1080/14764172.2017.1349323] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Simmons BJ, Griffith RD, Falto-Aizpurua LA, Nouri K. Use of radiofrequency in cosmetic dermatology: focus on nonablative treatment of acne scars. Clin Cosmet Investig Dermatol 2014; 7:335-9. [PMID: 25540589 PMCID: PMC4270307 DOI: 10.2147/ccid.s74411] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Acne is a common affliction among many teens and some adults that usually resolves over time. However, the severe sequela of acne scarring can lead to long-term psychological and psychiatric problems. There exists a multitude of modalities to treat acne scars such as more invasive surgical techniques, subcision, chemical peels, ablative lasers, fractional lasers, etc. A more recent technique for the treatment of acne scars is nonablative radiofrequency (RF) that works by passing a current through the dermis at a preset depth to produce small thermal wounds in the dermis which, in turn, stimulates dermal remodeling to produce new collagen and soften scar defects. This review article demonstrates that out of all RF modalities, microneedle bipolar RF and fractional bipolar RF treatments offers the best results for acne scarring. An improvement of 25%–75% can be expected after three to four treatment sessions using one to two passes per session. Treatment results are optimal approximately 3 months after final treatment. Common side effects can include transient pain, erythema, and scabbing. Further studies are needed to determine what RF treatment modalities work best for specific scar subtypes, so that further optimization of RF treatments for acne scars can be determined.
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Affiliation(s)
- Brian J Simmons
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Robert D Griffith
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Leyre A Falto-Aizpurua
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami, Miami, FL, USA
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Kim ST, Lee KH, Sim HJ, Suh KS, Jang MS. Treatment of acne vulgaris with fractional radiofrequency microneedling. J Dermatol 2014; 41:586-91. [DOI: 10.1111/1346-8138.12471] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Accepted: 02/18/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Sang Tae Kim
- Department of Dermatology; Kosin University College of Medicine; Busan South Korea
| | - Kang Hoon Lee
- Department of Dermatology; Kosin University College of Medicine; Busan South Korea
| | - Hyung Jun Sim
- Department of Dermatology; Kosin University College of Medicine; Busan South Korea
| | - Kee Suck Suh
- Department of Dermatology; Kosin University College of Medicine; Busan South Korea
| | - Min Soo Jang
- Department of Dermatology; Kosin University College of Medicine; Busan South Korea
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Abstract
Acne vulgaris is a prevalent and non-discriminatory condition affecting individuals of all races and ethnicities. As people with skin of color make up a rapidly expanding segment of the US population, dermatologic care must evolve accordingly to address their distinct concerns. Patients with skin of color with acne can be particularly challenging, given their potential for cosmetically disturbing complications, including post-inflammatory hyperpigmentation and keloid development. A variety of treatments have been shown to be effective in preventing or treating these complications. Topical retinoids are considered first-line therapy for acne in patients of color; topical alternatives include azelaic acid, dapsone, and antimicrobials. Hydroquinone may be used in combating post-inflammatory hyperpigmentation, specifically. For more severe acne, oral agents, including oral antibiotics or isotretinoin, may be used. Most recently, various lasers and phototherapies have been suggested for their safety and efficacy in patients with skin of color with acne. Ultimately, recognizing the clinical and histologic differences, as well as the variations in treatment regimens for darker skin types will allow for better care and patient satisfaction.
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Affiliation(s)
- Natalie C Yin
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, 33136, USA,
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KIM JK, ROH MR, PARK GH, KIM YJ, JEON IK, CHANG SE. Fractionated microneedle radiofrequency for the treatment of periorbital wrinkles. J Dermatol 2012; 40:172-6. [DOI: 10.1111/1346-8138.12046] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 10/21/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Jae Kyung KIM
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul; Korea
| | - Mi Ryung ROH
- Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute; Yonsei University College of Medicine; Seoul; Korea
| | - Gyeong-hun PARK
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul; Korea
| | | | - In Kyung JEON
- Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute; Yonsei University College of Medicine; Seoul; Korea
| | - Sung Eun CHANG
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul; Korea
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Aziz-Jalali MH, Tabaie SM, Djavid GE. Comparison of Red and Infrared Low-level Laser Therapy in the Treatment of Acne Vulgaris. Indian J Dermatol 2012; 57:128-30. [PMID: 22615511 PMCID: PMC3352636 DOI: 10.4103/0019-5154.94283] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND/PURPOSE Acne vulgaris is a very prevalent skin disorder and remains a main problem in practice. Recently, phototherapy with various light spectrums for acne has been used. There are some evidences that low-level laser therapy (LLLT) has beneficial effect in the treatment of acne lesions. In this study, two different wavelengths of LLLT (630 and 890 nm) were evaluated in treatment of acne vulgaris. MATERIALS AND METHODS This study was a single-blind randomized clinical trial. Patients with mild to moderate acne vulgaris and age above 18 years and included were treated with red LLLT (630 nm) and infrared LLLT (890 nm) on the right and left sides of the face respectively, twice in a week for 12 sessions, and clinically assessed at baseline and weeks 2, 4, 6, and 8. RESULTS Twenty-eight patients were participated in this study. Ten weeks after treatment acne lesion were significantly decreased in the side treated by 630 nm LLLT (27.7±12.7 to 6.3±1.9) (P<0.001), but this decrease was not significant in the site treated by 890 nm LLLT (26.9±12.4 to 22.2±8.5) (P>0.05). CONCLUSION Red wavelength is safe and effective to be used to treat acne vulgaris by LLLT compared to infrared wavelength.
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Affiliation(s)
- Mir Hadi Aziz-Jalali
- Department of Dermatology, Hazrat-e Rasool University Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Lee JW, Kim BJ, Kim MN, Ahn GY, Aso H. Selective sebaceous gland electrothermolysis as a treatment for acne: a prospective pilot study. Int J Dermatol 2012; 51:339-44. [DOI: 10.1111/j.1365-4632.2011.05255.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Traditional medical treatments for acne vulgaris include a variety of topical and oral medications. The combination of poor compliance, lack of durable remission, and potential side effects are common drawbacks to these treatments. The use of lasers and light devices has increased dramatically in recent years due to the overall ease of treatment, predictable clinical efficacy, and minimal adverse effects. A variety of light and laser devices has been used for the treatment of acne, including the potassium titanyl phosphate (KTP) laser, the 585- and 595-nm pulsed dye lasers, the 1450-nm diode laser, radiofrequency devices, intense pulsed light sources, low-intensity light treatment, and photodynamic therapy using 5-aminolevulinic acid and indocyanine green. These devices are thought to target underlying pathogenic factors such as Propionibacterium acnes colonization, increased sebaceous gland activity, and the cutaneous inflammatory response. Lasers in particular also have a central role in the management of acne scarring, which tends to be refractory to medical therapies. Fractional photothermolysis, the 1450-nm diode laser, and pulsed dye lasers have been used in the nonablative treatment of acne scars with significant success. In this article, we review the current status of light- and laser-based treatment of acne and related conditions and briefly review the use of lasers for the treatment of acne scarring.
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Abstract
Radio frequency (RF) is electromagnetic radiation in the frequency range of 3-300GHz. The primary effects of RF energy on living tissue are considered to be thermal. The goal of the new devices based on these frequency ranges is to heat specific layers of the skin. The directed use of RF can induce dermal heating and cause collagen degeneration. Wound healing mechanisms promote the remodeling of collagen and wound contraction, which ultimately clinically enhances the appearance of mild to moderate skin laxity. Preliminary studies have reported efficacy in the treatment of laxity that involves the periorbital area and jowls. Because RF energy is not dependent on specific chromophore interaction, epidermal melanin is not at risk of destruction and treatment of all skin types is possible. As such, radiofrequency-based systems have been used successfully for nonablative skin rejuvenation, atrophic scar revision and treatment of unwanted hair, vascular lesions and inflammatory acne. The use of RF is becoming more popular, although a misunderstanding exists regarding the mechanisms and limitations of its actions. This concise review serves as an introduction and guide to many aspects of RF in the non ablative rejuvenation of skin.
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Affiliation(s)
- Mohamed Lotfy Elsaie
- MBAFellow of Dermatology and Cutaneous Surgery, University Miami School of Medicine, USA
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el-Domyati M, el-Ammawi TS, Medhat W, Moawad O, Brennan D, Mahoney MG, Uitto J. Radiofrequency facial rejuvenation: evidence-based effect. J Am Acad Dermatol 2011; 64:524-35. [PMID: 21315951 DOI: 10.1016/j.jaad.2010.06.045] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 05/12/2010] [Accepted: 06/08/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND Multiple therapies involving ablative and nonablative techniques have been developed for rejuvenation of photodamaged skin. Monopolar radiofrequency (RF) is emerging as a gentler, nonablative skin-tightening device that delivers uniform heat to the dermis at a controlled depth. OBJECTIVE We evaluated the clinical effects and objectively quantified the histologic changes of the nonablative RF device in the treatment of photoaging. METHODS Six individuals of Fitzpatrick skin type III to IV and Glogau class I to II wrinkles were subjected to 3 months of treatment (6 sessions at 2-week intervals). Standard photographs and skin biopsy specimens were obtained at baseline, and at 3 and 6 months after the start of treatment. We performed quantitative evaluation of total elastin, collagen types I and III, and newly synthesized collagen using computerized histometric and immunohistochemical techniques. Blinded photographs were independently scored for wrinkle improvement. RESULTS RF produced noticeable clinical results, with high satisfaction and corresponding facial skin improvement. Compared with the baseline, there was a statistically significant increase in the mean of collagen types I and III, and newly synthesized collagen, while the mean of total elastin was significantly decreased, at the end of treatment and 3 months posttreatment. LIMITATIONS A limitation of this study is the small number of patients, yet the results show a significant improvement. CONCLUSIONS Although the results may not be as impressive as those obtained by ablative treatments, RF is a promising treatment option for photoaging with fewer side effects and downtime.
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Badgwell Doherty C, Doherty SD, Rosen T. Thermotherapy in dermatologic infections. J Am Acad Dermatol 2010; 62:909-27; quiz 928. [PMID: 20466169 DOI: 10.1016/j.jaad.2009.09.055] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Revised: 08/30/2009] [Accepted: 09/20/2009] [Indexed: 10/19/2022]
Abstract
The use of local induced hyperthermia or thermotherapy for dermatologic infections has not been fully explored in the more recent medical literature. Herein, we discuss the rationale behind the use of thermotherapy and review reported clinical experience with its use in the management of cutaneous infections.
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Abstract
Lasers frequently are used by dermatologists for their multiple aesthetic applications, but they also can be used to treat a variety of medical dermatology conditions. Conditions such as acne vulgaris, psoriasis, and vitiligo can all be successfully treated with laser, thereby providing the patient with additional therapeutic options. Lasers have also been used for years to improve the appearance of scars. The newer fractionated lasers have been especially effective in enhancing the clinical outcomes of scar revision.
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Acne scarring: A review and current treatment modalities. J Am Acad Dermatol 2008; 59:659-76. [DOI: 10.1016/j.jaad.2008.05.029] [Citation(s) in RCA: 162] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2008] [Revised: 05/28/2008] [Accepted: 05/31/2008] [Indexed: 11/23/2022]
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Philipp CM, Scharschmidt D, Berlien HP. Laser treatment of scars and keloids – How we do it. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.mla.2008.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
BACKGROUND Simple procedural treatments such as comedone extraction and intralesional steroids have been utilized for many years as adjunctive therapy for acne. In the past 5 years, new technologies and procedures have become available that present new options for the treatment of acne. OBJECTIVES The objective was to review, summarize, and evaluate the key studies of procedural therapies for the treatment of acne as well as place them in perspective with current clinical practice. METHODS Studies selected for evaluation had at least 10 patients and clear statements of purpose, acne severity, patient selection, follow-up evaluations, previous and concurrent medications, treatment parameters, methods for evaluating results, and adverse effects. All studies were complete and published (in English) in peer-reviewed journals. RESULTS AND CONCLUSIONS Earlier procedural therapies were adjunctive to medical therapy, such as intralesional steroids, chemical peels, and microdermabrasion. Newer methods include radiofrequency, light or laser, and photodynamic therapy that represent treatment alternatives for systemic medications. Still early in their development, these new procedures provide an important, novel set of options for the treatment of acne. The most developed and studied therapies are blue or blue/red light combinations, 1,450-nm diode laser, and photodynamic therapy with 5-aminolevulinic acid or indocyanine green. Review of the literature of more up-to-date physical procedures provides a starting point for physicians seeking to treat their acne patients safely and effectively with these new methods.
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Kobayashi T, Tamada S. Selective electrothermolysis of the sebaceous glands: treatment of facial seborrhea. Dermatol Surg 2007; 33:169-77. [PMID: 17300602 DOI: 10.1111/j.1524-4725.2006.33035.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND There are few publications on facial seborrhea treatment. A focused therapy is needed. OBJECTIVE Our aim was to evaluate the efficacy of electrothermolysis of the sebaceous glands. METHODS In the preliminary studies, histologic changes in the cheek skin by electrothermolysis were examined by light microscopy. In the clinical studies, 15 adult women subjects with facial seborrhea were treated four times by the same procedure. A 1.50-mm-long needle with a 0.45-mm base insulation was inserted into pores in the forehead and cheeks, and a high-frequency electrical current was applied for 0.25 to 0.50 seconds with an output of 40 W. Each treatment took 60 to 90 minutes. The subjects returned for 6-months follow-up after their fourth treatment. RESULTS Histology 1 and 6 months later showed fewer sebaceous glands and the development of fibrosis. All 12 subjects who completed the 6-month follow-up gave a subjective assessment of continuous reduction of facial seborrhea. On a scale of 0.0 to 3.0, the mean improvement score was 1.67+/-0.75. The mean reduction rate of skin surface lipids was 31.5% by sebumeter (p< .01). CONCLUSIONS Even though this is a pilot, uncontrolled clinical assessment study, electrothermolysis of sebaceous glands may be an effective and safe approach for facial seborrhea treatment.
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Ruiz-Esparza J. Nonablative radiofrequency for facial and neck rejuvenation. A faster, safer, and less painful procedure based on concentrating the heat in key areas: the ThermaLift concept. J Cosmet Dermatol 2007; 5:68-75. [PMID: 17173575 DOI: 10.1111/j.1473-2165.2006.00226.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Nonablative radiofrequency was the first method of noninvasive tissue contraction. It is a safe and effective method, although the results are modest when compared with plastic surgery. Patients like the fact that it requires no down time, it is performed with topical anesthesia, and it can be combined with numerous other modalities of skin rejuvenation. Technique and results are discussed.
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Gold MH. Acne and PDT: new techniques with lasers and light sources. Lasers Med Sci 2007; 22:67-72. [PMID: 17225060 DOI: 10.1007/s10103-006-0420-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2006] [Accepted: 06/12/2006] [Indexed: 10/23/2022]
Abstract
Acne vulgaris is one of the most common dermatologic disorders encountered in everyday practice. Treatment options for this often psychologically scarring disease are numerous and, for many individuals, provide relief from the disorder. However, factors such as antibiotic resistance and slow onset of action from many topical therapies have led researchers to seek out alternative therapies, especially for those suffering from moderate to severe inflammatory acne vulgaris. Lasers and light sources are finding increased usage in the treatment of inflammatory acne vulgaris. Light sources including blue lights and intense pulsed lights are becoming regular additions to routine medical management to enhance the therapeutic response. Finally, photodynamic therapy may change many of the acne vulgaris paradigms, as its place is being defined in the treatment of moderate to severe inflammatory acne vulgaris. More and more clinical trials are showing the effectiveness of 5-aminolevulinic acid and photodynamic therapy in the treatment of moderate to severe inflammatory acne vulgaris.
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Affiliation(s)
- Michael H Gold
- Gold Skin Care Center, 2000 Richard Jones Road, Suite 220, Nashville, TN 37215, USA.
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Abstract
In recent years, a number of studies have evaluated the treatment of acne using electromagnetic waves, such as lasers, photodynamic therapy, visible light or radio waves. While the efficacy of laser treatment is still uncertain, photodynamic therapy shows promising results, but with marked side-effects, as destruction of sebaceous glands. Treatment with blue light (405-420 nm wavelength) also appears effective and can be regarded as an treatment option for inflammatory acne.
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Affiliation(s)
- C Borelli
- Klinik für Dermatologie und Allergologie der Ludwig-Maximilians-Universität München.
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Abstract
Light-based treatments for acne are becoming increasingly commonplace in dermatology. This article reviews various light approaches in acne therapy. Methods are discussed from an anatomical and a functional perspective. The emphasis is on the practicality of treatment as well as the pros and cons of various devices. Also, a review of the recent literature is presented. The article is intended to give the reader a panoramic view of this still-young and developing area. Most likely, light-based acne treatment will receive more popularity as dermatologists learn how to integrate this type of therapy within the context of more established drug agents.
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Affiliation(s)
- E Victor Ross
- Dermatology Department, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, USA.
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Abstract
Acne vulgaris remains an emotionally and debilitating dermatologic disease, and is conventionally treated with a variety of oral and topical therapies with a number of significant side effects. An evolving understanding of laser-tissue interactions involving Propionibacterium acnes-produced porphyrins, and the development of infrared nonablative lasers to target sebaceous glands, has lead to the development of an escalating number of laser, light and radiofrequency devices for acne. Used as monotherapy or in combination, these devices are showing promise as a method to clear acne in a convenient, non-invasive manner, though there remains a clear need for long-term data and randomized, blinded studies.
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Affiliation(s)
- Julie C Harper
- Department of Dermatology, University of Alabama, Birmingham, AL 35294, USA.
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