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      Evaluation of Microneedling Fractional Radiofrequency Device for Treatment of Acne Scars

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          Abstract

          Background:

          Various treatment modalities including non-invasive methods such as chemical peels, topical retinoids, microdermabrasion, minimally invasive techniques such as microneedling, fractional lasers, microneedling radiofrequency devices and invasive procedures such as acne scar surgeries and ablative lasers are used for acne scars, each with its own unique advantages and disadvantages. This study is a retrospective assessment of efficacy and safety of microneedling fractional radiofrequency in the treatment of acne scars.

          Methods:

          Thirty one patients of skin types III-V with moderate and severe facial acne scarring received four sequential fractional radiofrequency treatments over a period of 6 months with an interval of 6 weeks between each session. Goodman & Baron's acne scar grading system was used for assessment by a side by side comparison of preoperative and post- operative photographs taken at their first visit and at the end of 3 months after the last session.

          Results:

          Estimation of improvement with Goodman and Baron's Global Acne Scarring System showed that by qualitative assessment of 31 patients with grade 3 and grade 4 acne scars, 80.64% showed improvement by 2 grades and 19.35% showed improvement by 1 grade. Quantitative assessment showed that 58% of the patients had moderate, 29% had minimal, 9% had good and 3% showed very good improvement. Adverse effects were limited to transient pain, erythema, edema and hyperpigmentation.

          Conclusion:

          Microneedling fractional radiofrequency is efficacious for the treatment of moderate and severe acne scars.

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          Most cited references23

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          Acne scarring: a classification system and review of treatment options.

          Acne is a common condition experienced by up to 80% of people between 11 and 30 years of age and by up to 5% of older adults. In some patients, the severe inflammatory response to Propionibacterium acnes results in permanent, disfiguring scars. Over the past several decades, numerous descriptive terms and surgical techniques have been used to diagnose the types, and improve the appearance, of scarring in those persons with acne. We propose a descriptive, simple, universally applicable acne scar classification system that includes 3 scar types: icepick, rolling, and boxcar. We also have developed an effective treatment algorithm for reconstructing and improving the appearance of acne scars including punch excision, punch elevation, subcutaneous incision (Subcision), and laser skin resurfacing. This new classification system for acne scars enables the physician to more precisely identify scar subtypes. Once the scar type has been defined, appropriate and effective treatment protocols can be developed.
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            Postacne scarring: a qualitative global scarring grading system.

            There is no global qualitative grading system for assessing the disease load and global severity of disease in a patient with postacne scarring. The purpose of this article is to provide a simple qualitative grading system that would allow better communication between practitioners of a patient's global disease severity and the most appropriate corresponding therapy for that degree of acne scarring. Four grades of postacne scarring are described, and appropriate therapeutic interventions are presented for each. Grade assignment is made by lesion morphologies and disease load as indicated by patient perception of severity (i.e., whether or not an individual can easily disguise his or her disease at social distances). A simple qualitative global acne scarring grading system is presented. The determination of disease load in terms of patient perception of severity is intrinsically imperfect due to varying subjectivity among individuals. A global acne scarring grading system is presented that is simple to use and may optimize therapeutic intervention. This system would also allow investigators, educators, and proceduralists to compare their cases more accurately and to have a more objective discussion of the efficacy of operative interventions or therapies.
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              Subcutaneous incisionless (subcision) surgery for the correction of depressed scars and wrinkles.

              A new method of subcuticular underming for the treatment of depressed cutaneous scars and wrinkles is introduced. To define the newly coined term "Subcision" and to describe this minor surgical procedure for treating depressed scars and wrinkles. A tri-beveled hypodermic needle is inserted through a puncture in the skin surface (hence, "incisionless" surgery), and its sharp edges are maneuvered under the defect to make subcuticular cuts or "-cisions." The depression is lifted by the releasing action of the procedure, as well as from connective tissue that forms in the course of normal wound healing. This technique is useful in treating a variety of cutaneous depressions, including scars and wrinkles.
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                Author and article information

                Journal
                J Cutan Aesthet Surg
                J Cutan Aesthet Surg
                JCAS
                Journal of Cutaneous and Aesthetic Surgery
                Medknow Publications & Media Pvt Ltd (India )
                0974-2077
                0974-5157
                Apr-Jun 2014
                : 7
                : 2
                : 93-97
                Affiliations
                [1]Department of Dermatology, CUTIS Academy of Cutaneous Sciences, Bengaluru, Karnataka, India
                Author notes
                Address for correspondence: Dr. B S Chandrashekar, CUTIS Academy of Cutaneous Sciences, 5/1, 4 th main, MRCR Layout, Vijayanagar, Bangalore - 560 040, Karnataka, India. E-mail: cutisclinic@ 123456gmail.com
                Article
                JCAS-7-93
                10.4103/0974-2077.138328
                4134659
                25136209
                5de895b7-cc05-40ad-af42-5ea4b974bcc7
                Copyright: © Journal of Cutaneous and Aesthetic Surgery

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Original Article

                Surgery
                acne scars,microneedling fractional radiofrequency,treatment for acne scars
                Surgery
                acne scars, microneedling fractional radiofrequency, treatment for acne scars

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