The use of fractional bipolar gold needle radiofrequency for acne scar in the cosmetology unit at Akdeniz University Faculty of Medicine Hospital: 18-months retrospective study

Acne scars are color and shape disorders caused by abnormal healing of acne vulgaris in the inflammatory process. Due to the complex and heterogeneous clinical nature of scars and variable individual characteristics of patients, there is no specific treatment algorithm and guidelines. Each treatment method is preferred individually according to the patient with a different clinical response and side effect profile. In recent years, radiofrequency therapy has been preferred as an alternative microinvasive treatment method to traditional treatments due to its effectiveness and low risk of side effects. We conducted this study to evaluate the effectiveness in acne scar; patient satisfaction, additional cosmetic benefits and observed side effects of fractional bipolar microneedle radiofrequency therapy, which has been used in the world for the last 10 years as a new treatment method. In the study, 30 patients who received at least 3 sessions fractional bipolar gold needle radiofrequency (FBAR) treatment for facial acne scar in Akdeniz University, Faculty of Medicine, Cosmetology Unit between January 2019 and June 2020 were retrospectively evaluated. Demographic information of the patients, characteristics of the cosmetic treatments and photographs of patients were obtained from patient file records and follow-up forms of cosmetology unit. The photographs of the patients were evaluated by two dermatologists. Acne scar scores were measured by using the Goodman and Baron qualitative acne scar score and the Echelle d'evaluation Clinique des Cicatrices d'acne (ECCA) score. 5 point scale was used by physician and patient to measure treatment responses in acne scar, brightness, tightness, enlarged pores and wrinkle. The pain level of the patients was measured using the visual analog scale; the severity of erythema and edema was evaluated using the 5-point scale. Goodman score, whole facial ECCA score, "boxcar" and "ice pick" scar ECCA scores and malar region ECCA score were statistically significantly decreased in patients who received only FBAR treatment. In the 5-point scale evaluations according to the physician and the patient, the response to the treatment was obtained in acne scar, brightness, tightness, enlarged pores and wrinkle. According to both the physician and the patient, the highest treatment response 116 scores were obtained in acne scars and the lowest response scores were obtained in wrinkles. As the initial acne scar severity of the patients increased, it was observed that the treatment responses of acne scar, brightness and tightness increased according to the physician. Treatment satisfaction in women and patients with "rolling" scars tends to be lower. Combining FBAR therapy with other treatments improves treatment effectiveness. Topical anesthesia is usually sufficient to prevent pain associated with the FBAR therapy. Posttreatment erythema and edema were determined to be mild and short-term. Postinflammatory hyperpigmentation, hypopigmentation and infection were not observed in any of the patients. With these results, fractional bipolar microneedle radiofrequency therapy can be considered as a effective treatment method in acne scars and provides additional cosmetic benefits. It is also suitable to combinate with other treatments; side effects are mild and temporary.