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Radiofrequency and Radiofrequency Microneedling in Skin of Color: A Review of Usage, Safety, and Efficacy. Dermatol Surg 2023; 49:489-493. [PMID: 36826381 DOI: 10.1097/dss.0000000000003733] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND Radiofrequency (RF) and radiofrequency microneedling (RFM) for rhytides, scarring, and skin rejuvenation are believed to have a lower risk of postprocedural dyspigmentation in darker skin types. OBJECTIVE To explore the safety and efficacy of RF and RFM in Fitzpatrick skin Types III to VI. METHODS AND MATERIALS A systematic review of PubMed/MEDLINE databases from 2000 to 2021 using combinations of the terms radiofrequency, microneedling, skin of color, and Fitzpatrick was performed. Exclusion criteria included non-Fitzpatrick skin Types III-VI patient population, nonprimary articles, nonskin radiofrequency, and nonhuman studies. RESULTS Thirty-five articles addressing the use of RF or RFM in skin of color were identified-22 for skin rejuvenation, 7 for acne scars, 4 for nonacne scars, 1 for hyperpigmentation, and 1 for acne treatment. Seven studies noted transient postinflammatory hyperpigmentation, 1 observed mild prolonged hyperpigmentation, and only 1 study reported permanent scarring. CONCLUSION Radiofrequency and RFM seem to have a low risk of scarring or hyperpigmentation in skin of color. This review demonstrates that these procedures have been successfully used primarily for rhytides, acne scarring, and skin rejuvenation. However, a large proportion of the studies lack strong quality evidence.
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Wang X, Zhang Z, Shang Y, Chen X, Xu H, Yuan C. Will repeated Intense Pulsed Light (IPL) treatment sessions affect facial skin sensitivity? Results of a twelve-Month, prospective, randomized split-face study. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2022; 38:382-390. [PMID: 34989016 DOI: 10.1111/phpp.12765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/12/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite the widespread use of intense pulsed light (IPL) technology in cosmetic dermatology, the effects of its repeated use on facial skin sensitivity in healthy individuals remains unknown. METHODS Seventeen healthy female volunteers were included in the study. We measured objective biophysical parameters of the skin, including transepidermal water loss (TEWL), skin glossiness, thickness and density of the epidermis and dermis, sensory nerve current perception threshold (CPT), and regional blood flow before and after treatment at different time points. RESULTS Sixteen volunteers completed a follow-up of 12 months. The treated side of the face showed a decreased TEWL on D1 and D3, which reverted to normal on D7. Epidermal thickness increased and skin glossiness decreased on the treated side on D1, but returned to normal on D3. We found no statistically significant differences in CPT values or in regional blood flow volume and velocity, with the exception of D1, which exhibited a higher regional blood flow volume on the treated side. CONCLUSION Repeated IPL treatments had no effects on facial skin barrier function, skin nerve sensitivity, or local microcirculation among healthy individuals. IPL is a safe skin care procedure that does not affect skin sensitivity.
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Affiliation(s)
- Xue Wang
- Department of Dermatology, Shanghai Ninth People's Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhen Zhang
- Department of Dermatology, Shanghai Ninth People's Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ying Shang
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiangdong Chen
- Department of Dermatology, Shanghai Ninth People's Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hui Xu
- Department of Dermatology, Shanghai Ninth People's Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chao Yuan
- Department of Skin & Cosmetic Research, Shanghai Skin Disease Hospital, Shanghai, China
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Austin GK, Struble SL, Quatela VC. Evaluating the effectiveness and safety of radiofrequency for face and neck rejuvenation: A systematic review. Lasers Surg Med 2021; 54:27-45. [PMID: 34923652 DOI: 10.1002/lsm.23506] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/04/2021] [Accepted: 11/25/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Radiofrequency technology has emerged as a treatment for aesthetic rejuvenation. OBJECTIVE To examine radiofrequency for facial and neck rejuvenation, clinical studies were assessed on effectiveness and safety of radiofrequency for acne, acne scars, and facial aging by subjective and objective measures. METHODS A systematic literature review was performed. Eligibility criteria included articles in English, primary literature, clinical or ex vivo studies, use of radiofrequency, and face or neck treatment. Ablative techniques, home-use devices, combined modalities, and studies unrelated to rejuvenation were excluded. All studies were appraised for quality and biases. RESULTS We identified 121 articles. Radiofrequency effectively treated acne by reducing sebum levels and lesion count and improving acne scars. Radiofrequency demonstrated a volumetric reduction in facial fat, and improved skin laxity, elasticity, and global skin aesthetic. Patient satisfaction was higher for those desiring modest rejuvenation. There were histological changes consistent with repair response, neocollagenesis, and neoelastinogenesis. Radiofrequency was safe apart from one patient who developed a neck fistula. CONCLUSION Most studies demonstrated radiofrequency treatment of acne, scars, or facial rhytids had positive subjective improvement ratings. Objective studies demonstrated reduction of acne, decreased scarring, lifting effect, improvement in elasticity and collagen, volumetric fat changes, and wrinkle reduction.
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Affiliation(s)
- Grace K Austin
- Quatela Center for Plastic Surgery, Rochester, New York, USA.,Grace Kim Austin, MD, Inc, Glendale, California, USA.,Department of Surgery, Facey Medical Group, Valencia, California, USA
| | - Sarah L Struble
- School of Medicine, California University of Science and Medicine, Colton, California, USA
| | - Vito C Quatela
- Quatela Center for Plastic Surgery, Rochester, New York, USA
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Hympanova L, Mackova K, El-Domyati M, Vodegel E, Roovers JP, Bosteels J, Krofta L, Deprest J. Effects of non-ablative Er:YAG laser on the skin and the vaginal wall: systematic review of the clinical and experimental literature. Int Urogynecol J 2020; 31:2473-2484. [PMID: 32780174 DOI: 10.1007/s00192-020-04452-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Er:YAG laser is frequently used in dermatology and gynecology. Clinical studies document high satisfaction rates; however, hard data on the effects at the structural and molecular levels are limited. The aim of this systematic review was to summarize current knowledge about the objective effects of non-ablative Er:YAG laser on the skin and vaginal wall. METHODS We searched MEDLINE, Embase, Cochrane, and the Web of Science. Studies investigating objectively measured effects of non-ablative Er:YAG laser on the skin or vaginal wall were included. Studies of any design were included. Owing to the lack of methodological uniformity, no meta-analysis could be performed and therefore results are presented as a narrative review. RESULTS We identified in vitro or ex vivo studies on human cells or tissues, studies in rats, and clinical studies. Most studies were on the skin (n = 11); the rest were on the vagina (n = 4). The quality of studies is limited and the settings of the laser were very diverse. Although the methods used were not comparable, there were demonstrable effects in all studies. Immediately after application the increase in superficial temperature, partial preservation of epithelium and subepithelial extracellular matrix coagulation were documented. Later, an increase in epithelial thickness, inflammatory response, fibroblast proliferation, an increase in the amount of collagen, and vascularization were described. CONCLUSIONS Er:YAG laser energy may induce changes in the deeper skin or vaginal wall, without causing unwanted epithelial ablation. Laser energy initiates a process of cell activation, production of extracellular matrix, and tissue remodeling.
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Affiliation(s)
- Lucie Hympanova
- Centre for Surgical Technologies, Group Biomedical Sciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.,Department of Development and Regeneration, Woman and Child, Group Biomedical Sciences, KU Leuven, Leuven, Belgium.,Institute for the Care of Mother and Child, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Katerina Mackova
- Centre for Surgical Technologies, Group Biomedical Sciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.,Department of Development and Regeneration, Woman and Child, Group Biomedical Sciences, KU Leuven, Leuven, Belgium.,Institute for the Care of Mother and Child, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Moetaz El-Domyati
- Department of Dermatology and Venereology, Minia University, Al-Minya, Egypt
| | - Eva Vodegel
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands
| | - Jan-Paul Roovers
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands
| | - Jan Bosteels
- Department of Development and Regeneration, Woman and Child, Group Biomedical Sciences, KU Leuven, Leuven, Belgium.,CEBAM, The Centre for Evidence-based Medicine, Cochrane Belgium, KU Leuven-University of Leuven, Leuven, Belgium
| | - Ladislav Krofta
- Institute for the Care of Mother and Child, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jan Deprest
- Centre for Surgical Technologies, Group Biomedical Sciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium. .,Department of Development and Regeneration, Woman and Child, Group Biomedical Sciences, KU Leuven, Leuven, Belgium. .,Pelvic Floor Unit, University Hospitals KU Leuven, Leuven, Belgium.
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Effects of 1,540-nm Fractional Nonablative Erbium and 2,940-nm Fractional Ablative Erbium on p53 Epidermal Expression After 3 months: A Split-Face Interventional Study. Dermatol Surg 2018; 44:1109-1114. [PMID: 29664771 DOI: 10.1097/dss.0000000000001527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Expression of p53 by keratinocytes may be important in the pathogenesis of skin cancer induced by ultraviolet light. OBJECTIVE We used side-by-side nonablative and ablative erbium fractional laser resurfacing to assess the effects on expression of p53 by facial keratinocytes. METHODS Ten female patients (age range, 50-63 years) with Fitzpatrick skin Types I-IV and clinical signs of photoaging underwent erbium fractional laser resurfacing (nonablative, 1,540-nm; ablative, 2,940-nm) on opposite sides of the face. Skin biopsies were obtained before treatment and 3 months after treatment for comparison with control biopsies of face and inner arm, quantifying p53 in immunostained tissue sections. RESULTS Only ablative (2,940-nm) treatments produced a statistically significant reduction in p53 scoring after 3 months. The histologic appearance of skin after ablative resurfacing more closely resembled inner arm skin (rather than facial skin) of control subjects. CONCLUSION Epidermal repopulation with p53-negative keratinocytes through ablative erbium fractional laser resurfacing may diminish the risk of eventual malignancy in photoaged skin.
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Paasch U, Schwandt A, Seeber N, Kautz G, Grunewald S, Haedersdal M. New lasers and light sources - old and new risks? J Dtsch Dermatol Ges 2017; 15:487-496. [DOI: 10.1111/ddg.13238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 12/29/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Uwe Paasch
- Department of Dermatology, Venereology and Allergology; University Hospital Leipzig and Medical Faculty; University of Leipzig; Germany
| | - Antje Schwandt
- Laser Medicine Center Rhein-Ruhr; Porschekanzel 3-5 45127 Essen Germany
| | | | - Gerd Kautz
- Dermatology Practice Peter/Seeber/Altheide; Wandsbeker Marktstr. 48-50 22041 Hamburg-Wandsbek Germany
| | - Sonja Grunewald
- Department of Dermatology, Venereology and Allergology; University Hospital Leipzig and Medical Faculty; University of Leipzig; Germany
| | - Merete Haedersdal
- Department of Dermatology, Bispebjerg Hospital; University of Copenhagen; Denmark
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7
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Paasch U, Schwandt A, Seeber N, Kautz G, Grunewald S, Haedersdal M. Neue Laser und Strahlquellen - alte und neue Risiken? J Dtsch Dermatol Ges 2017; 15:487-497. [DOI: 10.1111/ddg.13238_g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 12/29/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Uwe Paasch
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie; Universitätsklinikum Leipzig AöR und Medizinische Fakultät der Universität Leipzig; Deutschland
| | - Antje Schwandt
- Laser Medizin Zentrum Rhein-Ruhr; Porschekanzel 3-5 45127 Essen Deutschland
| | | | - Gerd Kautz
- Hautarztpraxis Peter/Seeber/Altheide; Wandsbeker Marktstr. 48-50 22041 Hamburg-Wandsbek Deutschland
| | - Sonja Grunewald
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie; Universitätsklinikum Leipzig AöR und Medizinische Fakultät der Universität Leipzig; Deutschland
| | - Merete Haedersdal
- Dermatologische Abteilung, Bispebjerg Hospital; Universität Kopenhagen; Dänemark
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8
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Hair follicle changes following intense pulsed light axillary hair reduction: histometrical, histological and immunohistochemical evaluation. Arch Dermatol Res 2017; 309:191-202. [DOI: 10.1007/s00403-017-1714-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 12/24/2016] [Accepted: 01/06/2017] [Indexed: 10/20/2022]
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9
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Li D, Lin SB, Cheng B. Intense Pulsed Light: From the Past to the Future. Photomed Laser Surg 2016; 34:435-447. [DOI: 10.1089/pho.2016.4139] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Dan Li
- Joint Shantou International Eye Center of Shantou University and Chinese University of Hong Kong, Shantou, China
- Southern Medical University, Guangzhou, China
| | - Shi-Bin Lin
- Joint Shantou International Eye Center of Shantou University and Chinese University of Hong Kong, Shantou, China
| | - Biao Cheng
- Southern Medical University, Guangzhou, China
- Department of Plastic Surgery, General Hospital of Guangzhou Military Command of PLA, Guangzhou, China
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10
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Thaysen-Petersen D, Erlendsson AM, Nash JF, Beerwerth F, Philipsen PA, Wulf HC, Paasch U, Haedersdal M. Side effects from intense pulsed light: Importance of skin pigmentation, fluence level and ultraviolet radiation-A randomized controlled trial. Lasers Surg Med 2016; 49:88-96. [PMID: 27474536 DOI: 10.1002/lsm.22566] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND OBJECTIVE Intense pulsed light (IPL) is a mainstream treatment for hair removal. Side effects after IPL are known, but risk factors remain to be investigated. The objective of this study was to assess the contribution of skin pigmentation, fluence level, and ultraviolet radiation (UVR) on IPL-induced side effects. METHODS The study was a blinded, randomized intra-individual controlled trial including 16 healthy subjects with Fitzpatrick Skin Types (FST) II-V. Three test areas were each divided into four sites, randomized to a single IPL exposure of 22, 34, 46 J/cm2 or triple stacking of 46 J/cm2 . Areas were subsequently randomized to no UVR or single solar-simulated UVR exposure of 3 Standard Erythema Dose at 30 minutes or 24 hours after IPL. Each area had a corresponding control, resulting in 15 treatment sites. Follow-up visits were scheduled up to 4 weeks after IPL. Outcome measures were: (i) blinded clinical skin reactions; (ii) objectively measured erythema and pigmentation; (iii) pain measured by visual analog scale (VAS); (iv) histology (H&E, Fontana-Masson); and (v) mRNA-expression of p53. RESULTS Fifteen subjects with FST II-IV completed the protocol. IPL induced a wide range of skin reactions, including erythema (87% of subjects), purpura (27%), blisters (20%), edema (13%), crusting (13%), hyper- (60%), and hypopigmentation (20%). Darker skin pigmentation and increasing IPL fluence were determinants for IPL-induced side effects (P ≤ 0.002), while a single exposure of UVR did not exacerbate side effects (P ≥ 0.180). Clinical findings were confirmed objectively by reflectance spectrometry and qualitatively by histological changes in skin architecture, inflammatory infiltration, and pigmentation. Marker of cellular DNA damage, that is, p53, did not increase after IPL (P ≥ 0.24). CONCLUSIONS Skin pigmentation and IPL fluence are major determinants of side effects after IPL exposure, while a single exposure to three SED of UVR at 30 minutes or 24 hours after IPL, does not amplify such side effects. Lasers Surg. Med. 49:88-96, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Daniel Thaysen-Petersen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400, Copenhagen, Nordvest, Denmark
| | - Andres M Erlendsson
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400, Copenhagen, Nordvest, Denmark
| | - J F Nash
- The Procter & Gamble Company, Cincinnati, Ohio, 45202
| | | | - Peter A Philipsen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400, Copenhagen, Nordvest, Denmark
| | - Hans C Wulf
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400, Copenhagen, Nordvest, Denmark
| | - Uwe Paasch
- Department of Dermatology, Venereology and Allergology, University of Leipzig, Leipzig, Germany
| | - Merete Haedersdal
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400, Copenhagen, Nordvest, Denmark
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Kim JE, Song D, Kim J, Choi J, Kim JR, Yoon HS, Bae JS, Han M, Lee S, Hong JS, Song D, Kim SJ, Son MJ, Choi SW, Chung JH, Kim TA, Lee KW. Oral Supplementation with Cocoa Extract Reduces UVB-Induced Wrinkles in Hairless Mouse Skin. J Invest Dermatol 2016; 136:1012-1021. [DOI: 10.1016/j.jid.2015.11.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 11/26/2015] [Accepted: 11/30/2015] [Indexed: 11/30/2022]
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12
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Liu Y, Ma JY, Luo SJ, Sun CW, Shao LL, Liu QZ. Semaphoring mAb: a new guide in RIT in inhibiting the proliferation of human skin carcinoma. Asian Pac J Cancer Prev 2015; 16:941-5. [PMID: 25735386 DOI: 10.7314/apjcp.2015.16.3.941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Semaphoring is a transmembrane receptor which participates in many cytokine-mediated signal pathways that are closely related to the angiogenesis, occurrence and development of carcinoma. The present study was designed to access the effect of mono-antibody (mAb) guided radioimmunotherapy (RIT) on skin carcinoma and investigate the potential mechanisms. Semaphoring mAb was acquired from mice (Balb/c), purified with rProtein A column; purity, concentration and activity were tested with SDS-PAGE and indirect ELISA; specificity and expression on the cutanuem carcinoma line and tissue were tested by Western blotting; morphology change was assessed by microscopy. MTT assay and colony inhibition tests were carried out to test the influence on the proliferation of tumor cells; Western blotting was also carried out for expression of apoptosis-associated (caspase-3, Bax, Bcl-2) and proliferation-related (PI3K, p-Akt, Akt, p-ERK1/2, ERK1/2) proteins and analyse the change in signal pathways (PI3K/Akt and MEK/ERK). The purity of purified semaphorin mAb was 96.5% and the titer is about 1?106. Western blotting showed semaphoring mAb to have specifically binding stripes with semaphoring b1b2 protein, B16F10, and A431 cells at 39KDa, 100KDa and 130KDa, respectively. Positive expression was detected both in cutanuem carcinoma line and tissue and it mostly located in cell membranes. MMT assay revealed dose-relate and time-relate inhibitory effect of semaphorin mAb on A431 and B16F10. Colony inhibition tests also showed dose-relate inhibitory effects. Western blotting demonstrated the expression of apoptosis and proliferation-related protein and changes in signal pathway. In conclusion, we demonstrated that semaphorin is highly expressed on the tumor cell-surfaces and RIT with semaphorin mAb has effect in inhibiting proliferation and accelerating apoptosis of tumor cells.
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Affiliation(s)
- Yuan Liu
- Department of Dermatovenereology, Tianjin Medical University General Hospital, Tianjin, China E-mail :
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