Cameli et al. (2014)1010. Cameli N, Mariano M, Serio M, Ardigò M. Preliminary comparison of fractional laser with fractional laser plus radiofrequency for the treatment of acne scars and photoaging. Dermatol Surg. 2014;40(5):553-61. doi: 10.1111/dsu.12470. https://doi.org/10.1111/dsu.12470...
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Fractional carbon dioxide laser (CO2 FS) |
Bipolar radiofrequency (BR): 500MHz; 30mJ per microterm zone; 500lm spacing; 20W for two seconds |
One week and three months after treatment |
To compare the results obtained with the use of CO2 FS with those obtained with the use of CO2 FS associated with radiofrequency (RF) for the treatment of acne scars. |
The combination of CO2 FS and RF showed high efficacy, producing better results with fewer sessions, lower risks, and fewer side effects. |
18 |
Cannarozzo et al. (2014) (1111. Cannarozzo G, Sannino M, Tamburi F, Chiricozzi A, Saraceno R, Morini C, et al. Deep pulse fractional CO2 laser combined with a radiofrequency system: results of a case series. Photomed Laser Surg. 2014;32(7):409-12. doi: 10.1089/pho.2014.3733. https://doi.org/10.1089/pho.2014.3733...
|
CO2 FS |
BR: 12W; 700lm spacing; 1.2ms time; 30W for three seconds |
Three treatment sessions with an interval of two months |
To evaluate the safety and efficacy of radio frequency associated with CO2 FS technology for the treatment of acne scars. |
All patients had good results in terms of improvement of skin texture, with mild and transient side effects. |
19 |
Chae et al. (2015) (1212. Chae WS, Seong JY, Jung HN, Kong SH, Kim MH, Suh HS, et al. Comparative study on efficacy and safety of 1550 nm Er:Glass fractional laser and fractional radiofrequency microneedle device for facial atrophic acne scar. J Cosmet Dermatol. 2015;14(2):100-6. doi: 10.1111/jocd.12139. https://doi.org/10.1111/jocd.12139...
|
Fractional 1,550nm laser (erbium glass - Er:Glass) |
40-60W; 0.1ms driving time; continuous wave mode |
Twenty weeks from treatment (four-week interval during the 12-week treatment period and an eight-week interval after the final session) |
To evaluate the clinical efficacy and safety of fractional laser Er:Glass and fractional microneedling radiofrequency (FMR). |
Both treatments are safe and effective methods for treating acne scars. However, the laser was more effective for acne scars without showing significant side effects. But FMR showed to be a relatively good option for pain-sensitive patients, and treatment has a shorter downtime. |
24 |
*not bipolar |
Zhang et al. (2013) (1313. Zhang Z, Fei Y, Chen X, Lu W, Chen J. Comparison of a fractional microplasma radio frequency technology and carbon dioxide fractional laser for the treatment of atrophic acne scars: a randomized split-face clinical study. Dermatol Surg. 2013;39(4):559-66. doi: 10.1111/dsu.12103. https://doi.org/10.1111/dsu.12103...
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CO2 FS |
Fractional microplasma RF |
Three treatment sessions at intervals of 6 to 12 (8 average) weeks and one follow-up visit after six months |
To compare the fractional microplasma RF technology with the CO2 FS system in the treatment of atrophic acne scars. |
No statistically significant difference between the two therapies was found. Twelve individuals (36.4%) presented post-inflammatory symptoms of hyperpigmentation after 30 of 99 treatment sessions (30.3%) in the CO2 FS group, which was not observed with the use of microplasma RF. |
24 |
*not bipolar |
Kaminaka, Furukawa and Yamamoto (2016) (1414. Kaminaka C, Furukawa F, Yamamoto Y. Long-term clinical and histological effects of a bipolar fractional radiofrequency system in the treatment of facial atrophic acne scars and acne vulgaris in Japanese patients: a series of eight cases. Photomed Laser Surg. 2016;34(12):657-60. doi: 10.1089/pho.2016.4116. https://doi.org/10.1089/pho.2016.4116...
|
Fractional laser |
Coverage rate: 10%; peak energy: 62mJ/pin; two passes |
Five treatment sessions at an interval of one month and follow-up for at least one year after the end of the treatment |
To examine the usefulness and safety of BR in the treatment for atrophic acne and acne vulgaris scars in Japanese patients. |
The importance of the physical therapist acting interdisciplinary with other professionals, primary care. |
19 |
Kaminaka et al. (2014) (1515. Kaminaka C, Uede M, Nakamura Y, Furukawa F, Yamamoto Y. Histological studies of facial acne and atrophic acne scars treated with a bipolar fractional radiofrequency system. J Dermatol. 2014;41(5):435-8. doi: 10.1111/1346-8138.12483. https://doi.org/10.1111/1346-8138.12483...
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- |
Fractional BR. Coverage rate: 10%; peak energy: 25J |
One session and 30 minutes later for histological evaluation |
To histologically analyze the treatment performed with a bipolar radiofrequency system, taking into consideration the number of passes. |
By increasing the number of passages, better results were observed in the treatment of deep acne atrophic scars. Moreover, although the most ablative mode was selected, the treatment did not produce serious adverse effects. |
14 |
Kim et al. (2014) (1616. Kim ST, Lee KH, Sim HJ, Suh KS, Jang MS. Treatment of acne vulgaris with fractional radiofrequency microneedling. J Dermatol. 2014;41(7):586-91. doi: 10.1111/1346-8138.12471. https://doi.org/10.1111/1346-8138.12471...
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- |
1MHz, 1.5mm depth, 10mm point size, level 3 (12.5W power, 80ms RF display time) |
Three procedures with one-month intervals, with follow-up performed each month, from before treatment to three months after the last procedure |
To investigate the safety and efficacy of FMR in the treatment of acne vulgaris. |
The number of acne lesions (inflammatory and non-inflammatory) were reduced. Sebum excretion and subjective satisfaction were more favorable at all times compared to baseline values (P<0.05). Inflammatory lesions showed better results than non-inflammatory lesions (P<0.05). Adverse effects, such as occasional bleeding, pain, and erythema, were noted, but they were transient and mild enough not to have to stop the treatment. |
21 |
*not bipolar |
Kim et al. (2014) (1717. Kim JE, Lee HW, Kim JK, Moon SH, Ko JY, Lee MW, et al. Objective evaluation of the clinical efficacy of fractional radiofrequency treatment for acne scars and enlarged pores in Asian skin. Dermatol Surg. 2014;40(9):988-95. doi: 10.1097/01.DSS.0000452625.01889.c3. https://doi.org/10.1097/01.DSS.000045262...
|
Ablative fractional lasers |
BR: 50 to 62mJ per pin, can be supplied with 5% to 7% ablation coverage, 16% to 22% coagulation coverage, and 27% to 35% heating coverage |
Four treatment sessions at three-week intervals |
To evaluate the efficacy of a new fractional device based on BR to treat acne scars and dilated pores in Asians, with objective measurements and histological evaluations. |
The patients showed clinical improvement. Patients’ self-assessments corresponded with physicians’ evaluations. Histological analyses showed significant improvements in elasticity and melanin/erythema index, along with increases in procollagen levels types I and III, as well as elastin levels. There were no cases of hyperpigmentation, and adverse events were only mild. |
22 |
Kwon et al. (2017) (1818. Kwon HH, Park HY, Choi SC, Bae Y, Kang C, Jung JY, et al. Combined fractional treatment of acne scars involving non-ablative 1,550-nm erbium-glass laser and micro-needling radiofrequency: a 16-week prospective, randomized split-face study. Acta Derm Venereol. 2017;97(8):947-51. doi: 10.2340/00015555-2701. https://doi.org/10.2340/00015555-2701...
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Nonablative fractional laser |
Micro-needle penetration depth of 1.5 to 2.5mm, intensity from 20 to 50 and duration from 50 to 100ms, with two or three passes in FMR device and 25 to 35J/cm2 at level 6 and with four passes of fractional 1,550nm laser (erbium glass) |
Three consecutive sessions at four-week intervals, with a follow-up visit eight weeks after the end of treatment |
Compare the clinical course of the treatment of acne between non-ablative 1,450nm laser diode (LD) and FMR. |
The subjective evaluations of patients regarding the improvement of seborrhea were similar between the two devices, while those of acne, skin texture, and acne scars were more satisfactory with the use of MRF. For the safety profile, no significant difference was observed between the two regimens, while mild post-inflammatory hyperpigmentation was observed only on the LD side. |
23 |
Lan et al. (2018) (1919. Lan T, Xiao Y, Tang L, Hamblin MR, Yin R. Treatment of atrophic acne scarring with fractional micro-plasma radio-frequency in Chinese patients: a prospective study. Lasers Surg Med. 2018;50(8):844-50. doi: 10.1002/lsm.22825. https://doi.org/10.1002/lsm.22825...
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- |
Microplasma radiofrequency |
Three sessions at two-month intervals. Patients were seen one week after each treatment and one, three, and six months after the end of treatment |
To evaluate the clinical effectiveness and safety of microplasma RF for the treatment of facial acne scars in Chinese patients. |
There was a significant improvement in acne scars after three treatments. Mean score of the ECCA classification scale was reduced from 107.21 to 42.27 (P<0.05). Hyperpigmentation, hypopigmentation, infections, and worsening of scars were not observed. All patients were “very satisfied” or “satisfied” with the treatment results. |
23 |
*not bipolar |
Lee et al. (2013) (2020. Lee KR, Lee EG, Lee HJ, Yoon MS. Assessment of treatment efficacy and sebosuppressive effect of fractional radiofrequency microneedle on acne vulgaris. Lasers Surg Med. 2013;45(10):639-47. doi: 10.1002/lsm.22200. https://doi.org/10.1002/lsm.22200...
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- |
1MHz. Power: 50W; levels 1-20 with multiple exposure times: 10-1,000ms |
Two sessions, initial evaluation of the study and two, four, and eight weeks after treatment |
To evaluate the efficacy of the FMR device for acne vulgaris in Asians and its effect on sebum production. |
After a single FMR treatment, the casual sebum level and sebum secretion rate showed 30-60% and 70-80% reduction, respectively (P<0.01), and remained below the basal level until the eighth week. Physician’s overall improvement scores for acne severity and acne lesion count also showed improvement with maximum effectiveness by week two, but returned to baseline in most patients by week eight. |
21 |
Min et al. (2015) (2121. Min S, Park SY, Yoon JY, Suh DH. Comparison of fractional microneedling radiofrequency and bipolar radiofrequency on acne and acne scar and investigation of mechanism: comparative randomized controlled clinical trial. Arch Dermatol Res. 2015;307(10):897-904. doi: 10.1007/s00403-015-1601-z. https://doi.org/10.1007/s00403-015-1601-...
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- |
BR: 100Hz; 100mJ/cm2
|
Three treatment sessions with an interval of two months |
To compare the efficacy and safety of FMR with RB in the treatment of acne scars. |
FMR showed superior efficacy in acne and acne scar compared to RB. Increased expression of TGFb and collagen I and decreased expression of NF-kB suggest that IL-8 is involved in the improvement of acne scarring and acne lesion by FMR. |
22 |
Park et al. (2016) (2222. Park JY, Lee EG, Yoon MS, Lee HJ. The efficacy and safety of combined microneedle fractional radiofrequency and sublative fractional radiofrequency for acne scars in Asian skin. J Cosmet Dermatol. 2016;15(2):102-7. doi: 10.1111/jocd.12195. https://doi.org/10.1111/jocd.12195...
|
- |
FMR: 1.5mm needle depth; level 7; 50ms exposure time superficial fractional radio frequency (SFR): level 16-17; 70-80ms exposure |
Three consecutive treatment sessions for four weeks over 12 weeks |
To evaluate the efficacy and safety of FMR in the treatment of acne scars on Asian skin. |
All 20 participants were evaluated by physicians for clinical improvement of grade 2 or more. Subjects’ scores also showed a good agreement indicated by the 0.695 kappa index. |
24 |
Pudukadan (2017) (2323. Pudukadan D. Treatment of acne scars on darker skin types using a noninsulated smooth motion, electronically controlled radiofrequency microneedles treatment system. Dermatol Surg. 2017;43(Suppl 1):S64-9. doi: 10.1097/DSS.0000000000000894. https://doi.org/10.1097/DSS.000000000000...
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- |
Micro-needling RF: power 15 to 25W (mean 20.19±2.22); pulse duration 110 to 140ms; and 2-3mm needle depth (mean: 2.47±0.20 |
Three sessions at monthly intervals and two other follow-up visits were held one and three months after the sessions |
Evaluation of the efficacy and safety of the non-isolated, electronically controlled radiofrequency microneedling system on acne scars in patients with dark skin. |
Improvement of at least one degree of acne scar was observed in 11 of 19 patients (57.9%) after one month and in 9 of 9 patients (100%) after three months. |
19 |
Qin et al. (2015) (2424. Qin X, Li H, Jian X, Yu B. Evaluation of the efficacy and safety of fractional bipolar radiofrequency with high-energy strategy for treatment of acne scars in Chinese. J Cosmet Laser Ther. 2015;17(5):237-45. doi: 10.3109/14764172.2015.1007070. https://doi.org/10.3109/14764172.2015.10...
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- |
Fractional BR. Energy: 85 to 95mj/pin; two or three passes were performed with a maximum of 5-10% overlap |
Four sessions at one-month intervals and follow-up visits of 4 and 12 weeks after the end of treatment |
To evaluate the efficacy and safety of FMR in the treatment of acne scars on Asian skin, with high energy strategy. |
Patients’ overall improvement and satisfaction assessment increased at the 12th week compared to baseline. Side effects were limited to transient pain, erythema, dryness, and low risk of hyperpigmentation. |
22 |
Rongsaard and Rummaneethorn (2014) (2525. Rongsaard N, Rummaneethorn P. Comparison of a fractional bipolar radiofrequency device and a fractional erbium-doped glass 1,550-nm device for the treatment of atrophic acne scars: a randomized split-face clinical study. Dermatol Surg. 2014;40(1):14-21. doi: 10.1111/dsu.12372. https://doi.org/10.1111/dsu.12372...
|
Fractional 1,550nm laser (erbium glass - Er:Glass) |
Fractional BR: 53-59mJ/pin for two passes |
Three treatment sessions were performed at four-week intervals. Follow-up four weeks after the end of treatment |
To compare the clinical effectiveness and side effects of fractional BR with 1,550nm erbium glass laser in the treatment of atrophic acne scars. |
The side effects of both devices were pain, transient facial erythema, and crust formation. The pain score was higher in laser treatment, but the duration of skin flaking was shorter. One case had post-inflammatory hyperpigmentation on the laser treated side only. Fractional BR and laser have similar efficacy for the treatment of atrophic acne scars. |
20 |
Trelles e Martínez-Carpio (2014) (2626. Trelles MA, Martínez-Carpio PA. Attenuation of acne scars using high power fractional ablative unipolar radiofrequency and ultrasound for transepidermal delivery of bioactive compounds through microchannels. Lasers Surg Med. 2014;46(2):152-9. doi: 10.1002/lsm.22224. https://doi.org/10.1002/lsm.22224...
|
Ablative fractional laser |
Fractional ablative microplasma RF: 27.5kHz, with variables from 10 to 100Hz |
Four treatment sessions at three-week intervals Follow-up two and six months after the final session |
To determine the efficacy and safety of high-potency unipolar radiofrequency in the treatment of acne scars over a short-term period of two months and a long-term period of six months. |
The bimodal procedure is safe and effective in reducing acne scars. Significant improvement was observed in the scars, both on the face (P<0.0001) and on the back and shoulders (P<0.0001). |
22 |
Verner et al. (2015) (2727. Verner I. Clinical evaluation of the efficacy and safety of fractional bipolar radiofrequency for the treatment of moderate to severe acne scars. Dermatol Ther. 2016;29(1):24-7. doi: 10.1111/dth.12275. https://doi.org/10.1111/dth.12275...
|
- |
Fractional RB: one low energy pass (15-20mJ/pin) over the whole face, as well as with two or three high energy passes at scar level (50-80mJ/pin) |
Three to five treatment sessions at one-month intervals. Patients were followed up at each session and three months after the end of treatment |
To evaluate the efficacy, safety, and tolerability of BR and the eTwoTM system (Syneron Candela Ltd., Yokneam, Israel) for the treatment of acne scars |
All patients showed improvement after the second session and very good improvement (of at least one scale) after five sessions. |
16 |