LAUSR

Dear Editor: Radiofrequency devices (RF) have been used to destroy cancer cell using heat generation by the high frequency current. But they also become known for skin tightening, dermal remodeling, and skin regeneration effect after using on the skin [1]. A 60-year-old man and a 64-year-old woman presented with fine wrinkles on their periorbital and perioral areas (Figs. 1a and 2a). We used the newly developed RF dev ice which name is AGNES (Gowoonsesang Cosmetics.co., Ltd., Seoul, Korea) which can disperse the energy to depth of wrinkles without leaving scars due to insulation of their epidermal point of contact. The anesthetic creams were applied for 30 min on face and we marked along wrinkles on periorbital and perioral areas. Then patients were laid back on the chair, needles were inserted with 3–5-mm intervals on the wrinkles. A high frequency current was applied at 120 msec, an intensity of power level 2 with 1 MHz RF apparatus. Procedure time was about 5–10 min and an ice cooler was needed on the treated lesions. Assessments of clinical improvement were performed at base and after 4 weeks of treatments by one dermatologist. Clinical improvement was also based on the subjective satisfaction of the patients using a visual analogue scale (VAS, 0∼7, 0—not at all satisfied, 7—very satisfied). After 4 weeks, both patients demonstrated a marked reduction in the size and depth of their lesions (Figs. 1b and 2b) and had high satisfaction (VAS score, 5). Other than transient mild erythema and pain, they had no adverse effects such as scarring and hyperpigmentation related to epidermal damage. Of the various devices that have been used to correct wrinkles and laxity, RF is thought to be highly effective and is frequently used in worldwide [2, 3]. Yusuke et al. reported that after monopolar RF treatment for skin rejuvenation, type I and III of collagen significantly increased after irradiation in the dermis (p < .05), and their changes were noticed uniformly in all layers [4]. Commonly used RF devices in cosmetic dermatology are microneedling fractional radiofrequency devices (MFRD). In contrast to MFRD, needle of AGNES has shorter insulated part (<0.5 mm) which make possible to transfer RF energy to more superficial tissue. For example, MFRD is impossible to be used on eyelid skin because of the skin depth is around 1 mm. Also, the shoulders of T-shape AGNES needle can function as a stopper which is essential to transfer energy with even depth regardless of different session or physician. Also, single-needle system make possible to deliver more electrical fluence to tissue than multi-needle system of MFRD. This selective dermal stimulation make neocollagenesis without epidermal damages then further * Beom Joon Kim [email protected]