Efficiency and safety of microneedling fractional radiofrequency in the treatment of Chinese atrophic acne scars: A retrospective study of 3 consecutive treatments with 1‐month intervals

Abstract

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Efficacy and safety of fractional microneedle radiofrequency for atrophic acne scars: A real‐world clinical study of 126 patients

“…Previous studies have also found that the effect of FMR on rolling-type scars is pronounced in the early stage (first three sessions), but limited later. 14 We also observed that in patients with skin laxity, more than three treatment sessions did not improve the outcome significantly, which is consistent with observations in previous studies on skin tightening treatments. These may be explained by the fact that with the aging of the skin, the collagen regenerative capacity declines and becomes gradually less responsive to FMR.…”

“…Afterward, additional treatments, such as subcutaneous dissection and fillers, may be necessary for further improvement. Previous studies have also found that the effect of FMR on rolling‐type scars is pronounced in the early stage (first three sessions), but limited later 14 . We also observed that in patients with skin laxity, more than three treatment sessions did not improve the outcome significantly, which is consistent with observations in previous studies on skin tightening treatments.…”

“…(3) skin type (Fitzpatrick classification); (4) course of atrophic acne scars (years); (5) scar type (ice-pick, rolling, or boxcar); (6) mean between-session interval (months); (7) total number of treatment sessions; (8) presence of enlarged facial pores; (9) rating of enlarged facial pores based on the standard developed by Chinese scholars 16 (Grade 3 or above indicated enlarged pores, while Grade 1, 2, or 3 no enlarged pores) (Supporting Information: Table S1); (10) type of treatment tips (insulated or noninsulated); (11) energy, pulse width, and needle length used for each treatment session (pulse width was grouped into three categories: 200, 300, and 400-500 ms); (12) post-FMR treatments (immediate application of recombinant human basic fibroblast growth factor gel or AQ Skin Solutions ® Recevery Serum); (13) presence of active acne; (14) presence of facial laxity (before the initial treatment, facial laxity was assessed using the laxity evaluation criterion from the Alexiades Comprehensive Grading Scale [ACGS]), 17 with a score greater than or equal to 3 points indicating the presence of facial laxity (Supporting Information: Table S2); (15) ECCA scores 18 (Supporting Information: Table S3) before treatment and 3 months after the last treatment, and improvement based on ECCA scores (ECCA improvement rate = [ pretreatment ECCA score − ECCA score 3 months after the last treatment]/pretreatment ECCA score × 100%, and improvement rates were divided into no [0%], mild [1%-25%], moderate [26%-50%], significant [51%-75%], and excellent [76%-100%]); (16) scars in three sub-items of VAS (visual analogue scale), color, and distortion, rated according to the modified Manchester Scar Scale (mMSS) 19 (Supporting Information: Table S4); (17) scar improvement based on the Global Aesthetic Improvement Scale (GAIS) evaluated by two independent physicians not associated with the study (score criteria: 0: no change, 1: minimal improvement, 2: good improvement, 3: significant improvement, 4: optimal improvement); (18) patient satisfaction score (selfassessment) (1: dissatisfied, 2: mild satisfied, 3: satisfied, 4: very satisfied); (19) facial laxity improvement based on the GAIS evaluated by two independent physicians not associated with the study (score criteria: 0: no change, 1: minimal improvement, 2: good improvement, 3: significant improvement, 4: optimal improvement); (20) adverse reactions, including postoperative erythema, pain intensity score (VAS score), persistent erythema (lasting for more than 1 month), persistent pigmentation (lasting for more than 1 month), acneiform eruption, and so forth.…”

“…However, FMR manifests a higher safety, a quicker recovery, and fewer adverse effects 13 . A clinical study has clarified the efficacy of FMR in Chinese patients with atrophic acne scars, with the most obvious improvement, highest satisfaction, and least adverse reactions observed in boxcar scars 14 …”

“…13 A clinical study has clarified the efficacy of FMR in Chinese patients with atrophic acne scars, with the most obvious improvement, highest satisfaction, and least adverse reactions observed in boxcar scars. 14 Several prospective studies on FMR have been conducted under ideal conditions, in which intervention methods were fixed, inclusion and exclusion criteria strictly set, the numbers of FMR treatment sessions generally less than four sessions, and the sample size less than 50 cases. Moreover, there is a lack of exploration for factors influencing treatment efficacy and adverse reactions, as well as long-term treatment outcomes.…”