Medical Lasers; Engineering, Basic Research, and Clinical Application  
Laser-assisted Delivery of a Combined Antioxidant Formulation Enhances the Clinical Efficacy of Fractional Microneedle Radiofrequency Treatment: A Pilot Study
Jihee Kim1,2,3, Soo Min Kim1, Bok Ki Jung4, Sang Ho Oh1, Young-Koo Kim5, Ju Hee Lee1,2
1Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
2Scar Laser and Plastic Surgery Center, Yonsei Cancer Hospital, Seoul, Korea
3Department of Dermatology, Yongin Severance Hospital, Yongin, Korea
4Department of Plastic and Reconstructive Surgery, Yongin Severance Hospital, Yongin, Korea
5Yonsei Star Skin and Laser Clinic, Seoul, Korea
Correspondence to: Ju Hee Lee
Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea Tel.: +82-2-2228-2080
Fax: +82-2-393-6947
Received: May 25, 2021; Accepted: June 7, 2021; Published online: July 29, 2021.
© Korean Society for Laser Medicine and Surgery. All rights reserved.

Background and Objectives
Fractional microneedle radiofrequency systems are popular options to increase elasticity in aging skin. Laser-assisted drug delivery is a promising method for the epidermal injection of topically applied drugs and cosmetic ingredients. This study assesses the safety and efficacy of topical delivery of L-ascorbic acid, vitamin E, and ferulic acid after fractional microneedle radiofrequency treatment for reducing photodamage.
Materials and Methods
In this prospective, single-center, split-face, controlled pilot study, six women (mean age, 48.0 years; range, 35-57 years; Fitzpatrick skin types III and IV) exhibiting mild to moderate photodamage, underwent a single session of fractional microneedle radiofrequency treatment. The patients were instructed to apply the antioxidant formulation to only one side of the face. Patients were evaluated 3 days, 7 days, and 4 weeks thereafter, using three-dimensional imaging and ultrasound. Ex vivo , the full-thickness human skin was used for molecular and histological evaluation. Statistical analysis was achieved by applying t-tests, Mann-Whitney U tests, and one-way analyses of variance.
Compared to the untreated side, the antioxidant-treated side exhibited a significant increase in dermal thickness (10.32% vs. 17.54%, p < 0.05), but not in skin elasticity (4.76% vs. 4.69%, p > 0.05). The difference in erythema between the sides was statistically not significant (p > 0.05). In the ex vivo model, expression of FGF2 in the skin was significantly increased after application of the antioxidant formulation, as compared to results obtained subsequent to fractional microneedle radiofrequency treatment only (p < 0.01).
This study demonstrates that for the treatment of photodamaged skin, laser-assisted delivery of the antioxidant formulation is a safe and effective adjuvant modality following fractional microneedle radiofrequency.
Keywords: Energy-based device; Fractional microneedle radiofrequency; Laserassisted drug delivery; Skin aging; Antioxidant

This Article

Funding Information
  • Korea Mental Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea
  • Yonsei University Faculty Research

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