Bipolar Fractional Radiofrequency

Compare To Other Treatments

Compared to many other scar revision treatments, bipolar fractional radiofrequency poses a low risk of side effects. The charts below show the chances of developing various side effects from bipolar fractional radiofrequency treatment.1-8

Certain/Likely Side Effects (% = Incidence)

SHORT TERM Pain*up to 100%
SHORT TERM Transient redness (erythema)**up to 100%
SHORT TERM Swelling immediately after procedure (edema)†up to 100%
SHORT TERM Crustingup to 100%
SHORT TERM Scaling (peeling)up to 100%
SHORT TERM Burning sensationup to 61%
SHORT TERM Skin drynessup to 25%

*Pain: Skin needling causes temporary pain or a burning sensation.

**Erythema: Mild skin redness after skin needling is normal and usually disappears after 2-3 days.3,4

†Edema: Swelling after bipolar fractional radiofrequency is normal and should disappear after 2-3 days at most.3,4

Possible/Rare Side Effects

LONG TERM or SHORT TERM Skin darkening (post-inflammatory hyperpigmentation)*up to 13%
SHORT TERM Folliculitis (infection of hair follicle)up to 9%

*Post-inflammatory hyperpigmentation (skin darkening): Cases of post-inflammatory hyperpigmentation were reported in 3 studies. These cases persisted from several weeks to 6 months (in 2 Asian patients) after the treatment.2,4,5

Studies:

Five studies have looked at the side effects of fractional bipolar radiofrequency.

  • Study 1:

    • Authors: Nitayavardhana et al.2
    • Total # of patients: 23
    • # of female patients: 14
    • # of male patients: 9
    • Age of patients: Average: 30.6
    • Duration of treatment and follow-up: 3 sessions, follow-up at 1, 3, and 6 months
    • Side effects:
      • Pain: 100%
      • Erythema (redness): 100%
      • Crusting: 100%
      • Edema (swelling): 82.6%
      • Burning sensation: 60.8%
      • Post-inflammatory hyperpigmentation (skin darkening): 13%
  • Study 2:

    • Authors: Eubanks et al.3
    • Total # of patients: 25
    • # of female patients: 21
    • # of male patients: 4
    • Age of patients: 26-71
    • Duration of treatment and follow-up: 3 sessions, follow-up at 6 and 12 weeks
    • Side effects:
      • Mild-to-moderate pain: 87.9%
  • Study 3:

    • Authors: Rongsaard and Rummaneethorn4
    • Total # of patients: 20
    • # of female patients: 8
    • # of male patients: 12
    • Age of patients: 18-55
    • Duration of treatment and follow-up: 3 sessions, follow-up at 4 weeks
    • Side effects:
      • Pain: (not reported)
      • Erythema (redness): (not reported)
      • Dryness: (not reported)
      • Crusting: (not reported)
      • Post-inflammatory hyperpigmentation (skin darkening): (not reported)
  • Study 4:

    • Authors: Kaminaka et al.5
    • Total # of patients: 8
    • # of female patients: 6
    • # of male patients: 2
    • Age of patients: 19-44
    • Duration of treatment and follow-up: 5 sessions, follow-up at 1 year
    • Side effects:
      • Pain: 100%
      • Erythema (redness): 100%
      • Edema (swelling): 100%
      • Scaling: 100%
      • Skin dryness: 25%
  • Study 5:

    • Authors: Qin et al.6
    • Total # of patients: 26
    • # of female patients: 16
    • # of male patients: 10
    • Age of patients: Average: 22.6
    • Duration of treatment and follow-up: 4 sessions, follow-up at 4 and 12 weeks
    • Side effects:
      • Pain: 100%
      • Erythema (redness): 100%
      • Edema (swelling): 100%
      • Folliculitis (infection of hair follicle): 8.7%
      • Post-inflammatory hyperpigmentation (skin darkening): 4.4%

Study 1: In a study published in 2020 in the Journal of Cosmetic Dermatology, Nitayavardhana and colleagues performed bipolar fractional radiofrequency on 25 patients. Two subjects were withdrawn from the study as they could not attend the follow-up visits. All patients received 3 sessions at intervals of 1 month and were followed up at 1, 3, and 6 months after treatment. Researchers reported that all patients experienced pain, erythema (redness), and crusting immediately after the treatment which lasted up to 7 days. Three patients developed post-inflammatory hyperpigmentation (PIH) or skin darkening. In two of these three patients, PIH lasted for 6 months, while in one patient it spontaneously disappeared before the 3-month follow-up.2

Study 2: In a study published in 2021 in the Lasers of Surgery and Medicine, Eubank and colleagues treated 25 patients with acne scars with a bipolar fractional radiofrequency device. All patients received 3 sessions of treatment at 1-month intervals and were followed up at 6 and 12 weeks. Bipolar fractional radiofrequency treatment induced only mild-to-moderate pain in 87.9% of patients.3

Study 3: In a study published in 2014 in the journal Dermatologic Surgery, Roongsard and Rummaneethorn treated 20 patients with atrophic scars with a bipolar fractional radiofrequency microneedling device. Patients received 3 sessions of treatment at 1-month intervals. The researchers followed up with the patients 4 weeks after the last treatment session. The researchers did not report the actual percentage of adverse events, but they measured the time needed for the recovery. Redness and crusting disappeared in 3 days, while pain and dryness lasted for up to 7 days.4

Study 4: In a study published in 2016 in the Photomedicine and Laser Surgery, Kaminaka and colleagues treated 9 patients with atrophic scars with a bipolar fractional radiofrequency device. Patients received 5 sessions of treatment at 1-month intervals and were followed up for a year. They reported transitory pain, redness, swelling, and scaling, while 25% of patients also experienced skin dryness after the procedure.5

Study 5: In a study published in 2015 in the Journal of Cosmetic and Laser Therapy, Qin and colleagues treated 26 patients with atrophic scars with bipolar fractional radiofrequency microneedling device. Patients received 4 sessions of treatment at 1-month intervals. The researchers followed up with the patients for a year after the last treatment session. Pain and redness lasted for 24 hours. Two patients developed folliculitis, an infection in the hair follicle after first two treatment sessions, but these lesions were mostly mild and resolved in 2 or 3 days without any interventions.6

References
  1. Forbat, E., & Al-Niaimi, F. Fractional radiofrequency treatment in acne scars: Systematic review of current evidence. Journal of Cosmetic and Laser Therapy, 18(8), 442-447 (2016).
  2. Nitayavardhana, S., Wanitphakdeedecha, R., Ng, J. N. C., Eimpunth, S., & Manuskiatti, W. The efficacy and safety of fractional radiofrequency nanoneedle system in the treatment of atrophic acne scars in Asians. Journal of cosmetic dermatology, 19(7), 1636-1641 (2020).
  3. Eubanks, S. W., & Solomon, J. A. Safety and efficacy of fractional radiofrequency for the treatment and reduction of acne scarring: a prospective study. Lasers in Surgery and Medicine, 54(1), 74-81 (2022).
  4. Rongsaard, N., & Rummaneethorn, P. Comparison of a fractional bipolar radiofrequency device and a fractional erbium-doped glass 1,550-nm device for the treatment of atrophic acne scars: a randomized split-face clinical study. Dermatologic surgery, 40(1), 14-21 (2014).
  5. Kaminaka, C., Furukawa, F., & Yamamoto, Y. Long-term clinical and histological effects of a bipolar fractional radiofrequency system in the treatment of facial atrophic acne scars and acne vulgaris in Japanese patients: a series of eight cases. Photomedicine and laser surgery, 34(12), 657-660 (2016).
  6. Qin, X., Li, H., Jian, X., & Yu, B. Evaluation of the efficacy and safety of fractional bipolar radiofrequency with high-energy strategy for treatment of acne scars in Chinese. Journal of cosmetic and laser therapy, 17(5), 237-245 (2015).

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