The Fate of Active Acne and Acne Scars Following Treatment With Fractional Radiofrequency

December 2019 | Volume 18 | Issue 12 | Original Article | 1268 | Copyright © December 2019

Bruce E. Katz MD

JUVA Skin & Laser Center, New York, NY

Abstract
INTRODUCTION: Acne vulgaris (AV) is a common skin disorder that may result in long-lasting acne scars. Techniques such as delivering fractional radiofrequency (RF) energy through miniature pins or needles have been utilized to manage active acne and acne scars. Skin restoration through dermal remodeling, neo-collagenesis, neo-elastogenesis, and epidermal re-newal are typical results of such treatments.

METHODS: 15 subjects suffering from acne received 3 sessions of facial treatments, 3-4 weeks apart, using a fractional RF device with 24 pins tip of 2500μm in length. The treatment's safety and efficacy were evaluated up to 6 months after the last treatment.

RESULTS: Facial photos and classifications of active acne, acne scars, and overall skin appearance demonstrated improve-ments in follow-up visits compared to baseline. No significant or unexpected adverse events were detected.

CONCLUSION: The current study supports the safety and efficacy of the fractional RF treatment modality for acne condition.

J Drugs Dermatol. 2019;18(12):1268-1272.

INTRODUCTION

Acne vulgaris (AV), one of the most common skin disorders is a prevalent condition mostly affecting adolescents and young adults.1 For some patients, acne continues to be a problem beyond adolescence, persisting well into adulthood.2 Studies on the psychosocial impact of acne have documented dissatisfaction with appearance, embarrassment, self-consciousness, and lack of self-confidence.3 Furthermore, acne is associated with feelings of anxiety, depression, anger, less satisfaction with the body, lower self-esteem, and social dysfunction.4 For many patients, acne may lead to permanent scarring and disfigurement, further aggravating the existing psychosocial aspects of this condition.5,6 It is therefore crucial to effectively treat AV in order to avoid scarring. The pathogenesis of acne relates to increased sebum production in the setting of aberrant follicular keratinization, propionibacterium acnes proliferation and significant perifollicular inflam-mation.7 This process leads to a local tissue damage, resulting in activation of a wound healing cascade. Imbalance in col-lagen deposition and matrix degradation may result in permanent scarring.8

Various therapeutic measures such as chemical peeling, dermabrasion, and fillers have been performed to improve acne scarring, but with sub-optimal outcomes. Various lasers, each with variable reports of success and advantages, as well as limitations, were also adapted to overcome acne effects.9

The potential of ablative lasers such as Er:YAG or CO2 lasers in producing significant improvement was promising; how-ever, these technologies were found to be associated with long recovery times and side effects such as post-inflammatory hyperpigmentation and scarring.10 More recently, newer methods have been developed to minimize adverse effects by treat-ing the skin fractionally, leaving healthy areas to promote and improve the healing process. Ablative fractional resurfacing, using the CO2 fractional laser system has demonstrated significant beneficial effects on atrophic acne scars and minor side effects comparing to non-fractional CO2 laser.11 Newer techniques such as delivering fractional radiofrequency (RF) energy through miniature pins or needles have been clinically proven effective for skin rejuvenation with high margins of safe-ty.12-15 Improvement of skin conditions such as wrinkles, lax skin, and acne scars following fractional RF treatments is achieved through dermal remodeling, neo-collagenesis, and neo-elastogenesis with controlled epidermal renewal.15

The current study was focused on evaluating a fractional RF device for simultaneous treatment of acne scars and active acne and for overall skin appearance improvement.

METHODS

A prospective, open label, single center clinical study was conducted in our clinic, following IRB approval. The study was intended to evaluate the safety and efficacy of a fractional RF applicator (Fractora, InMode Ltd., Israel) for the treatment of active acne and acne scarring.

Fifteen subjects, 13 females and 2 males, average age 27.9 years (range 13-53 years), with Fitzpatrick skin types II-VI, hav-ing active acne lesions and acne scars were recruited. Subjects signed informed consent forms prior to enrolment in the study.