An Innovative Approach of Treating Acne Scars Using Bipolar Rotational Stamping and Monopolar Criss-cross Technique with Insulated Microneedling Radiofrequency in Asians

INTRODUCTION: Microneedling radiofrequency (MNRF) using insulated microneedles offers a great advantage to overcome the limitations of fractional lasers such as achieving greater depth, long downtime, and high risk of postinflammatory hyperpigmentation (PIH). AIMS: The aim of this study was to assess the efficacy and safety of a novel multiple depth bipolar rotational stamping and monopolar criss-cross method (Wosyet vital technique) with MNRF using insulated needles for the improvement of facial acne scars in Asians. MATERIALS AND METHODS: Thirty-two patients (20 females, 12 males, average age 30.3 years) with facial atrophic acne scars were treated with insulated MNRF by applying Wosyet vital technique. Most of the patients started noticing improvement in 4–6 weeks after the first session. All patients underwent four sessions at 1-month interval. Outcome assessments included subjective and physician evaluation of acne scars, pores, smoothness, tightness, and overall appearance. Objective assessment was determined by Goodman and Baron’s quantitative and qualitative analysis of the acne scars. RESULTS: All subjects noticed at least 30%–90% (mean––62.50%) improvement in acne scars, whereas unbiased physicians graded 40%–80% (mean––58.44%) at a 6-month follow-up visit. The mean Goodman and Baron’s score decreased significantly from pre- to posttreatment. All patients reported 30%–90% (mean––61.88%) improvement in facial contour and skin tightening. Many patients observe improvement in the open pores as well. CONCLUSION: The possible explanation of improvement in the global appearance of skin and acne scars is the application of both monopolar and bipolar RF in the dermis through insulated microneedles. We did not find PIH after this technique in Asian patients despite of more aggressive treatment parameters and several treatment sessions. STATISTICAL ANALYSIS USED: The results were analyzed using chi-square test, Wilcoxon sign rank test, Pearson’s correlation test, Spearman’s correlation test, and paired t test.