Pulsed Wave Mode of Fractional Radiofrequency Microneedling as a New Advance in the Treatment of Inflammatory Acne Vulgaris

Inflammatory acne vulgaris (IAV) is a common skin condition characterized by the presence of reddish, inflamed, and painful lesions on the skin. IAV can drastically affect individuals, specifically their self-esteem, psychological health, and quality of their life in general. Despite new advances in the field, traditional treatment modalities withstand many challenges. Hence, in the current study, we sought to assess the efficacy and safety of a new pulsed wave mode of the fractional microneedling radiofrequency device in the treatment of IAV. This advanced technique employs insulated microneedles to administer energy to the deep dermis without causing damage to the epidermis. Eighty patients (40 males, 40 females, age 21 +/- 3, Fitzpatrick skin type III and IV), with acne severity ranging from moderate to severe, were employed in this trial. They were randomly assigned into two groups, 40 patients each. The treated group (A) underwent four sessions of fractionated microneedle RF, 1.5-month apart, whereas group B was designated as the control group that received placebo treatment. Six months following the last session, the degree of improvement assessed by the quantity of IAV lesions and the overall skin appearance in terms of facial pores, sebum excretion, scar, skin tone, and texture. The RF-treated group showed significant improvement compared to the control group after the follow-up period (p-value = 0.0071). Regarding safety, very mild adverse effects were reported, such as discomfort during the session, pinpoint hemorrhage, and erythema, with no major side effects such as burns, scarring, hyperpigmentation, or hypopigmentation were reported. Thus, our data suggest a potential role of the fractional microneedling radiofrequency device in IAV treatment that is both effective and safe.