Microneedling radiofrequency with sublative radiofrequency versus microneedling radiofrequency with subcision: A randomized controlled study for scar resurfacing, skin rejuvenation and anti-aging

Objectives: Microneedling radiofrequency (RF) is an established tool in scar revision and collagen boosting. The combination of this modality with subcision or sublative RF can help enhance the results or reduce the number of sessions. This study was undertaken to evaluate and compare the efficacy and safety of microneedling RF combined with sublative RF versus microneedling RF combined with subcision for scar resurfacing, skin rejuvenation, and anti-aging. Materials and Methods: Prospective, single-center randomized controlled study. Forty patients (8 males and 32 females), aged 21–59 years with concerns of scars and/or signs of aging were enrolled and randomly received either of the 2 treatments: Microneedling RF combined with sublative RF or microneedling RF combined with subcision using 18G needle. Baseline photographs were taken and scar and aging scores were calculated (on the worst side) using Goodman and Barron’s scar scale and Global drooping and wrinkles classification and scoring system for assessing facial age, respectively. Final scar score, aging score, and patient satisfaction score were assessed at the end of treatment. Results: Most patients required 1–2 sessions (Mean 1.55 ± 0.60) in microneedling RF with the sublative RF group and 2–3 sessions (Mean 2.55 ± 0.51) in microneedling RF with the subcision group and this difference was statistically very significant (P = 0.0001). While both treatment groups noted an overall decrease in scar scores from baseline, microneedling RF with subcision had superior results which were statistically significant (P = 0.034). Both groups reported overall improvement in aging score, which was better and faster in microneedling RF with the sublative RF group but the difference was statistically not significant. Conclusion: Microneedling RF is an effective modality for scars and aging. It can be combined with subcision when scars are deep and tethered. Sublative RF is a newer technology that helps in the improvement of skin laxity and sagging by repositioning fat planes. Combination with sublative RF can be done when there is more skin drooping and wrinkles.