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MAKING WAVES 24 MAY/JUNE 2016 | Med Esthetics bipolar RF and fractional microneedle RF devices offered the best results in the resolution of acne scars, improving cosmetic appearance by 25% to 75% in an average of three to four treatments. "We use fractional microneedle RF devices for acne scars more than anything else and are getting 30% to 70% improvement after three sessions," says Dr. Ross. "Results are better than what we see with nonablative lasers with little or no downtime, and most importantly there is minimal risk of PIH, even among patients with darker skin. Patients with lighter skin who can afford 7 to 10 days of recovery and are willing to accept slightly higher risks can get better results with an ablative laser, but we've found it is valuable to be able to say, 'Here's an alternative, a less invasive needle device that can accomplish some of the same things with little downtime and little PIH risk.'" Dr. Sadick also prefers RF for acne scar treatments. "We fi nd fractional RF is defi nitely better than lasers for treating acne scars in darker skin types," he says. Research from Japan (C. Kaminaka, et al, J Dermatol, June 2015) showed good results in 23 patients with atrophic acne scars and mild to severe acne on both cheeks after fi ve fractional RF treatments (eMatrix). Mild scars showed marked improvement and even moderate scars were signifi cantly improved in 57% of treated areas with minimal side effects. In an Israeli study of 20 patients with depressed acne scars treated with a non-insulated fractional RF treatment system (Intensif, EndyMed), 95% showed some improvement with 55% reporting good to excellent improvement. The only reported side effect was redness that subsided in a day or two. The study was published in June 2014 in the online Journal of Cosmetics, Dermatological Sciences and Applications. COST-EFFECTIVE EQUIPMENT The good news is that fractional RF devices tend to be cheaper than lasers in general because production costs are lower and they do not require expensive, complicated optics. They are also fast. Trained practitioners can perform a full face and neck treatment in less than 15 minutes. The ability to vary energy delivery, pulse duration, depth of needle penetration and number of passes enables physicians to customize treatments for individual patients. Those shopping for a device will want to compare maximum power levels, pulse times, cost of consumables and, for microneedle devices, the type of needles and range of needle depth. "The evenness and uniformity of the energy delivery along the treatment area is important as well as visual/auditory feedback to let the user know when target temperature has © GETTY IMAGES "RF energy is 'colorblind' and can safely treat skin of all colors, regardless of the amount of pigment or water in the epidermis."