A New Approach with Combined Microneedle and Sublative Fractional Radiofrequency for Photoaging Management: A Clinical, Histometric, and Immunohistochemical Study.

BACKGROUND: Fractional radiofrequency (FRF) has been reported to be effective in improving wrinkles. A combination of microneedle and sublative fractional radiofrequency (SFRF) may have the potential synergy to improve photoaged skin. OBJECTIVES: To evaluate the efficacy and safety of combined microneedle and SFRF in photoaging management. METHODS: This prospective study included 12 subjects with moderate photoaging (skin phototype III-IV). The subjects received three consecutive combined microneedle and sublative FRF at 1-month intervals. Punch biopsies were obtained before and after three months of treatment. Routine H&E, Masson-trichrome, Orcein staining, histometric measurements, as well as Collagen type I and Elastin immunohistochemical staining were performed. RESULTS: Significant improvement was noticed regarding skin tightening and texture (p < 0.05), rhytides, and volunteers' satisfaction (p < 0.001). Collagen fibers appeared better organized, with a significant increase in collagen type I (p = 0.001). Meanwhile, normal-appearing elastic fibers were restored, and a significant reduction in abnormal elastin was achieved (p = 0.0005). CONCLUSION: Combined microneedle and sublative FRF may provide a new therapeutic approach for photoaged skin. LEVEL OF EVIDENCE II: For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .