SAN DIEGO – Correct affected person choice and setting reasonable expectations are the keys to enhancing outcomes with fractional radiofrequency (RF) microneedling gadgets, in accordance with Catherine M. DiGiorgio, MD.
Most core fractional RF microneedling indications – zits scars, rhytides, pores and skin tightening – require a number of remedies, DiGiorgio, a laser and beauty dermatologist who practices in Boston, mentioned on the annual Masters of Aesthetics Symposium. “That is an necessary expectation to set to your sufferers,” she mentioned. “You additionally need to choose depth and density parameters based mostly on pathophysiology of the situation being handled, and mixture remedies at all times present the perfect outcomes. So, whether or not you are treating somebody for zits scars or rhytides, you need to deal with them for his or her erythema or their dermatoheliosis. The identical goes for pores and skin tightening procedures.”
Many nonpolar and bipolar gadgets can be found to be used, most of which function adjustable depths and energies. Ideas might be insulated or noninsulated. Usually, the insulated suggestions are safer for darker pores and skin sorts as a result of the vitality isn’t delivered to the dermis. Nonetheless, the Sylfirm X system from Benev has a noninsulated tip however is secure for all pores and skin sorts as a result of the vitality is delivered from the tip of a conically formed needle and strikes proximally however by no means reaches the dermis, mentioned DiGiorgio. Steady wave mode is used for tightening and wrinkles whereas pulsed mode is used for pigment and vascular lesions.
Remedy with most fractional RF microneedling gadgets is painful so topical anesthesia is required. DiGiorgio sometimes makes use of topical 23% lidocaine and seven% tetracaine. The downtime varies relying on which system is getting used. For anesthesia previous to aggressive fractional microneedle RF remedies comparable to with the Profound RF for pores and skin tightening, DiGiorgio sometimes makes use of a Mesoram needle with a cocktail of 30 ccs of two% lidocaine with epinephrine, 15 ccs of bicarbonate, and 5 ccs of saline. “Extra aggressive RF procedures can lead to bruising for 7 to eight days,” she mentioned. “It may be lined with make-up. Sporting masks throughout the COVID-19 pandemic have additionally helped sufferers cowl the bruising.”
In her scientific expertise, the perfect affected person for pores and skin tightening with fractional RF microneedling has gentle to average pores and skin laxity that doesn’t require surgical intervention. “Nonsurgical remedies present nonsurgical outcomes,” she mentioned. “If a affected person is available in holding their pores and skin again and there’s a lot of laxity, this isn’t going to be the suitable remedy for that individual.”
DiGiorgio presents fractional RF microneedling within the context of a full-face rejuvenation. She begins by addressing quantity loss and dynamic rhytides with injectables previous to pores and skin tightening gadgets comparable to fractional RF microneedling or ultrasound-based tightening gadgets comparable to Sofwave or Ulthera (additionally known as Ultherapy). “You possibly can add an ablative fractional to focus on deeper rhytides or pigment-targeting laser to handle their dermatoheliosis, which can improve their outcomes,” she mentioned. “Lastly, you may comply with up with a thread carry two weeks after the microneedle RF to attain better pores and skin tightening. If the thread carry is carried out earlier than the microneedle RF, you need to wait about 2 months as a result of the microneedle RF can harm the thread.”
Regardless of the restricted efficacy for tissue tightening with fractional RF microneedling, “it is a good various to lasers, particularly for darker pores and skin sorts,” she mentioned. “Mixture remedies will at all times improve your outcomes.”
DiGiorgio disclosed that she is a member of the advisory board for Quthero. She can be a advisor for Revelle and has obtained gear from Acclaro.
This text initially appeared on MDedge.com, a part of the Medscape Skilled Community.