Background: Monopolar radiofrequency (MRF) is widely used for non-invasive facial rejuvenation. Objective: In this study, we compared the clinical efficacy and patient-reported procedural pain of a novel MRF system with continuous water cooling (RF-CWC) versus conventional MRF with cryogen spray cooling (RF-CSC) in 22 Asian women. Methods: In this prospective, randomized, split-face, single-blind trial, 22 participants received a single session of both RF-CWC and RF-CSC. Clinical outcomes—including changes in pore size, elasticity, skin density, fine lines, and lifting—were assessed over 8 weeks using quantitative measurements and investigator-assessed global improvement scores. Procedural pain was also recorded. To support the clinical findings, an ex vivo model was used to evaluate collagen and elastin fiber density, collagen I and III concentrations, and dermal temperature profiles. Results: RF-CWC demonstrated clinical efficacy comparable to that of RF-CSC in terms of lifting, skin volume, and wrinkle reduction, while significantly reducing procedural pain. Ex vivo analysis confirmed enhanced collagen remodeling and efficient dermal heating with RF-CWC. Conclusion RF-CWC offers a clinically effective and better-tolerated alternative to traditional cryogen-cooled MRF for facial rejuvenation.

Background: Nonablative fractional lasers (NAFLs) have been used since the early 2000s for the treatment of facial dermatological conditions. A new-generation 1,550 nm NAFL has recently become commercially available with a novel handpiece and beam technology. The present retrospective study was designed to assess the safety and efficacy of this system in facial dermatological treatment. Methods: Twenty-one informed and consenting subjects were retrospectively selected for the Institutional Review Board (IRB)-approved study from patients attending the Lutronic in-house clinic for facial dermatological treatments, comprising 15 males and 6 females, average age 39.65 years (range 18-75 years). Fitzpatrick skin types I (1), III (9), and IV (11). The study was approved by the IRB of the Lutronic in-house clinic. Subjects received three treatment sessions with the NAFL system at 4-6-week intervals. Digital clinical photography was obtained at baseline and 12 weeks after final treatment. Two independent dermatologists correctly identified baseline and follow-up images and scored improvement using five-point Global Assessment Improvement Scale (GAIS). Patient satisfaction was scored on 11-point visual analogue scale. Any unexpected adverse events during or after treatment were noted. Results: All patients completed the study and follow-up. Baseline and follow-up images were correctly identified by independent investigators, and the average GAIS score was 3.05 (2-4). Patients were ‘satisfied’ to ‘extremely satisfied’ with treatment, satisfaction scores ranging from 7 to 9, with a patient satisfaction index of 79%. Conclusion The new-generation NAFL proved safe and effective for facial a variety of dermatological conditions, with no adverse events.

Background: Monopolar radiofrequency (RF) has been extensively used as a valuable modality for noninvasive skin tightening and rejuvenation but is associated with side effects such as pain. In addition, the results have also been inconsistent. The present study sought to assess the safety and efficacy of a new-generation dualfrequency monopolar RF system for the treatment of facial laxity with fine lines and wrinkles. Methods: Twenty female subjects aged 28-63 years with Fitzpatrick skin types III and IV and mild-to-moderate skin aging underwent a single treatment with the monopolar RF system at dual frequencies of 6.78 and 2.0 MHz. Pain during treatment was scored on a visual analogue scale (VAS). The final assessment was performed 12 weeks after treatment. Two independent, blinded investigators identified correct post-treatment photographs and scored improvement using a Global Aesthetic Improvement Scale (GAIS). Patients assessed satisfaction subjectively on a VAS. The occurrence of unexpected adverse events during treatment or follow-up was investigated. Results: All 20 patients completed the treatment, follow-up, and final assessment. Independent investigators successfully identified post-treatment images in 80% of cases, and their GAIS score averaged 2.75 out of 4. All patients scored at least 7 out of 10 for satisfaction, and pain was scored as mild to moderate. No adverse events were recorded. Conclusion The good GAIS scores by independent clinicians, high patient satisfaction levels, and mild-tomoderate pain scores indicated the dual-frequency monopolar RF system was effective in treating aging facial skin, while safety was supported by the lack of unexpected adverse events.

Oral tranexamic acid (TXA) is a proven first-line approach for the treatment of recalcitrant melasma. A novel multi-pulse width 1,064 nm Q-switched Nd:YAG (Q-NDY) laser coupled with the micropulse mode (L-NDY, Genesis technique) has shown promise in pigment removal. In this study five female patients were randomly assigned to receive the combination treatment of Q-NDY + L-NDY + TXA (8 sessions, 3 subjects, Group A) or Q-NDY + L-NDY only (10 sessions, 2 subjects, Group B). At the final assessment, both groups showed extremely significant clearance of pigment as observed through the melasma area and severity index scores, although Group A was better than Group B. The combination of TXA, Q-NDY, and L-NDY for pigment removal and restoration of dermal health is a promising minimally invasive approach for melasma treatment. The good results in the laser-only group holds equal promise for those patients unable to take oral TXA.

A new 1,064 nm Q-Nd:YAG system developed by the author offers a quadruple-pulse (Q4) mode as a 1,064 nm laser toning method for epidermal pigmented lesions (EPLs) traditionally treated using the 532 nm wavelength. EPLs in seven Korean subjects were treated with the Q-Nd:YAG in Q4 mode with a zoom handpiece using a 2 mm spot, 26-40 J/cm 2 fluence at 10 Hz. The endpoint was a grayish color change or frosting. Two-four sessions were given, two-three weeks apart, with a follow-up of three-four weeks after the final session. A Global Aesthetic Improvement Scale (GAIS) and patient satisfaction were scored, and the pain was assessed on a visual analogue scale. The target lesions cleared well in all subjects with high GAIS scores and patient satisfaction. No adverse events were noted; the downtime was short, and the pain was reasonable. The author’s Q4 toning approach proved safe and effective for EPLs.