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[5 min read] Providing radiofrequency in primary care
Due to the minimal risk of complications, short recovery time, relatively low cost, and effectiveness, minimally invasive and non-invasive cosmetic interventions are gaining popularity in recent years.
The scalpel-free aesthetic medicine is establishing its place at the primary care level. Doctors now have a chance to make an additional profit while improving their patient’s self-esteem and quality of life with cosmetic procedures such as:
- Botulinum toxin injections
- Dermal fillers
- Thread lifts, and
- Radiofrequency (RF)
For further information on this topic, you may be interested to learn more about the HealthCert Professional Diploma program in Aesthetic Medicine.
The latter is probably the best non-surgical way of reaching deep into the skin to improve the common signs of ageing.
Radiofrequency is an invaluable part of treatment for both intrinsic ageing (deep wrinkles and skin laxity) and photoaging (UV damage). The technology causes targeted thermal damage in deep skin layers to stimulate tissue regeneration (neocollagenesis).
RF therapy has many advantages over popular light-based treatments that work similarly.
For example, IPL and laser devices have difficulties penetrating the epidermis. The reason is the absorption of light energy by the melanin in the skin and hemoglobin in the blood. That makes treating fair hair and dark skin nearly impossible and dangerous.
Radiofrequency does not have such limitations. Its efficacy and safety depend only on the electrical properties of the skin, not on pigment levels. Therefore, procedures such as epilation, skin tightening, cellulite reduction, acne treatment, removal of pigmented and vascular lesions, and fine wrinkles reduction are safe with RF technology on the skin of any colour.
There are different types of RF technologies. However, not all of them are suitable for the primary care setting.
Types of RF technologies
In the narrowest sense, we can separate RF technologies into two main types. These are:
- Non-Ablative Radiofrequency (NARF)
- Ablative Radiofrequency (Electrosurgery)
According to the method by which the electrical current flows through the skin, we can classify NARF devices into:
- Monopolar RF
- Bipolar RF
- Tripolar RF, and
- Fractional Radiofrequency
Fractional radiofrequency or RF microneedling is a popular skin-tightening treatment. It uses bipolar RF energy to deliver thermal energy to the reticular dermis without causing damage to the more superficial skin layers.
All NARF systems require multiple sessions to produce non-surgical body contouring and rejuvenating outcomes on the skin. However, they do not have a resurfacing effect.
Cellulite treatment is another promising application of RF technology. So far, the results look encouraging.
Ablative radiofrequency uses high-frequency AC at various voltages to generate heat in the skin. It is an invasive treatment used to achieve ablation, deep ablation, or cutting. Ablative RF has many medical uses ranging from electrocoagulation to removal of abnormal skin growths.
The use of ablative RF in primary care is rare.
Who can perform radiofrequency?
The use of radiofrequency devices requires special training. Also, all RF treatments call for medical supervision. Therefore, a primary care physician with certified qualifications for radiofrequency therapy is a perfect fit.
There are also potential legal limitations to the use of ablative RF devices. Such treatments carry a higher risk of complications, such as burns, pigmentation, or scarring. So, they might be beyond primary care scope of practice in some countries.
– Dr Rosmy De Barros
Read another article like this one: Biostimulator fillers in primary care
References:
- Bonjorno AR, Gomes TB, Pereira MC, et al. Radiofrequency therapy in esthetic dermatology: A review of clinical evidence. J Cosmet Dermatol. 2020;19(2):278-281. doi:10.1111/jocd.13206
- Gentile RD, Kinney BM, Sadick NS. Radiofrequency Technology in Face and Neck Rejuvenation. Facial Plast Surg Clin North Am. 2018;26(2):123-134. doi:10.1016/j.fsc.2017.12.003
- Araújo AR, Soares VP, Silva FS, Moreira Tda S. Radiofrequency for the treatment of skin laxity: mith or truth. An Bras Dermatol. 2015 Sep-Oct;90(5):707-21. doi: 10.1590/abd1806-4841.20153605. PMID: 26560216; PMCID: PMC4631236.
- Kleidona IA, Karypidis D, Lowe N, Myers S, Ghanem A. Fractional radiofrequency in the treatment of skin aging: an evidence-based treatment protocol. J Cosmet Laser Ther. 2020;22(1):9-25. doi:10.1080/14764172.2019.1674448
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Re comparison of laser and RF.
Laser devices and IPL used for ablative and non ablative treatments targeting the dermis for remodelling are not necessarily limited by skin colour as their chromophore is water, not melanin and haemoglobin. In treatments such as 1064nm bulk heating where 1064nm has a low affinity to melanin and haemoglobin, the pulse duration is too long to affect melanosomes and effects on microvasculature are due to tissue heating rather than laser interaction. In treatments such as CO2 ablative laser, the wavelength has no affinity to melanin or haemoglobin. Like lasers and light based devices, RF is used in a wide range of different technologies. They are often more affordable and do not require extensive safety considerations required with most lasers. However many RF devices do also have limitations when treating higher Fitzpatrick skin types and incidence of PIH, hypopigmentation and over treating is similar to lasers causing the same type of tissue injury or stimulation.