Multiple therapies involving ablative and nonablative techniques have been developed for rejuvenation of photodamaged skin. Monopolar radiofrequency (RF) is emerging as a gentler, nonablative skin-tightening device that delivers uniform heat to the dermis at a controlled depth. We evaluated the clinical effects and objectively quantified the histologic changes of the nonablative RF device in the treatment of photoaging. Six individuals of Fitzpatrick skin type III to IV and Glogau class I to II wrinkles were subjected to 3 months of treatment (6 sessions at 2-week intervals). Standard photographs and skin biopsy specimens were obtained at baseline, and at 3 and 6 months after the start of treatment. We performed quantitative evaluation of total elastin, collagen types I and III, and newly synthesized collagen using computerized histometric and immunohistochemical techniques. Blinded photographs were independently scored for wrinkle improvement. RF produced noticeable clinical results, with high satisfaction and corresponding facial skin improvement. Compared with the baseline, there was a statistically significant increase in the mean of collagen types I and III, and newly synthesized collagen, while the mean of total elastin was significantly decreased, at the end of treatment and 3 months posttreatment. A limitation of this study is the small number of patients, yet the results show a significant improvement. Although the results may not be as impressive as those obtained by ablative treatments, RF is a promising treatment option for photoaging with fewer side effects and downtime.
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