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DERMAL
Radio Frequency for Skin Rejuvenation:
An Oldie, But A Goodie! By Nancy Abdou
Skin ageing is inescapable, due to both intrinsic and extrinsic factors which lead to a reduction in collagen, degradation by metalloproteases (MMPs) activity and lowered function of epidermal keratinocytes, resulting in wrinkling and skin laxity. This leads us to an increase in demand for results driven skin rejuvenation – without surgery or extended periods of downtime! Radio Frequency (RF) has not let us down, stepping up to the challenge that we are currently facing (excuse the pun!). Utilising controlled thermal trauma, RF is able to overcome this ageing dilemma by inducing neocollagenesis, and contracting lax skin – and quite well too, on all Fitzpatrick skin types, since RF is colour blind! RF energy is a current that can be delivered through various tissue types (ie, skin, fat, and muscle) to generate thermal energy, that has been used in many medical fields including; cardiology, urology & oncology, just to name a few. Initially used in the 1920s as an electrocautery tool, the use of RF to contract collagen isn’t a new concept. For example, orthopaedic surgeons have used RF to contract areas such 26
Beauty Biz Year 14 Issue 3
as shoulder ligaments, responsible for instability, for over a decade. Over the last 15 years RF has seen an increase in its diversity, being used in aesthetic surgery. In 2002, the FDA approved the first mono-polar RF device for facial wrinkle reduction and since then other RF devices have evolved such as bipolar, multipolar, and fractional, with even more safety features. Unlike lasers, RF does not target specific chromophores by selective photo-thermolysis. Instead, RF generates heat as a result of different tissue resistance or impedance to the current. This means that heat is produced when the tissues’ inherent resistance, converts the electrical current to thermal energy. 3 mechanisms of action take place when RF
energy is applied to the skin: 1. Splitting of hydrogen bonds in the collagen triple helix causes shortening and thickening of collagen fibrils. 2. Initiation of a wound healing response, triggering angiogenesis, collagenesis, and elastin reorganisation, along with fibroblast stimulation to produce collagen over the following 3-6 months and 3. An increase in angiogenesis, lymphatic flow, increased oxygen supply and greater toxin clearance. Clinical studies show that skin surface temperatures ranging from 39°C to 42°C (subdermally temperatures from 65°C to 68°C) need to be reached for optimal contraction. However, if temperatures exceed a critical heat threshold, there is potential for collagen ablation and full-thickness injury, along with lipolysis (fat
