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Background and aims: After the inflammatory stage of severe acne vulgaris, atrophic scarring may occur this is problematic to both the patient and surgeon. A variety of treatment techniques including ablative and nonablative lasers have been used, however results have been inconsistent with both over- and under-treatment. Fractional radiofrequency (RF) has recently attracted attention in this field. The present study evaluated changes in the dermal morphology and ultrastructure one month post-fractional RF treatment.
Patients and methods: The study subjects were 4 females and 2 males (Fitzpatrick skin type IV, mean age 39.3 yr) with moderate to severe acne scarring. They were treated with a single session of fractional RF (peak energy level of 25 J). Biopsies were obtained before, immediately after and 1 month after treatment, and examined under both light and transmission electron microscopy.
Results: Before treatment, the dermis in all patients demonstrated dense connective tissue with hyperplasia of elastic fibers with sporadic depositions of elastin. Histological and ultrastructural evaluation at one month after fractional RF treatment revealed remodeling of the dermis, accompanied by elastic fiber remodeling, to give a more normallooking morphology.
Conclusions: Fractional-type RF therapy is promising, not only as a means of treating acne as reported previously, but also in the treatment of acne scars through remodeling of the dermis to replace acne scar-associated morphological and ultrastructural irregularities with a more normal architecture.