Combined radiofrequency and isotretinoin treatment recommended for acne scarring
Acne scarring can be a key concern for people who suffer from hormonal acne.
Not only can inflammatory acne impact a person’s self-esteem and confidence, but equally can acne scarring.
Acne scarring can naturally look different on everyone’s skin type. Scarring can appear pitted, raised or discoloured.
Traditionally, dermatologists have only been able to treat scarring more than 6 months after stopping isotretinoin treatments.
Old beliefs suggested that combining treatments can do more harm than good.
However, new research shows this is no longer the case.
What is acne scarring?
Acne scars result from acne inflammation
Some acne blemishes are small and heal quickly. However, some blemishes can damage the tissue under the skin. This can lead to permanent changes and indentations in the skin, known as acne scarring.
Scarring happens when the skin’s collagen fibres get hurt while healing. This is especially true when there is severe inflammation and damage to the tissue below.
Collagen fibres in your skin help to strengthen and support it. They also play an important role in skin repair and hydration.
There are two types of acne scars:
- Atrophic scars: These are sunken scars that occur when there is a net loss of skin collagen during healing.
- Hypertrophic scars: These are raised scars when the body produces too much collagen during the healing process.
The Traditional Approach: Why the Wait?
Oral isotretinoin is a very effective treatment for severe acne. It works by reducing oil production, preventing clogged pores, and calming inflammation.
For many years, dermatologists have told patients to wait at least 6 months after stopping isotretinoin. This is important before getting treatments for acne scars.
Experts made this recommendation because combining treatments might slow down wound healing or raise the risk of side effects.
While this cautious approach was well-intentioned, it often left patients frustrated while waiting months or years for their acne to clear.
For many, this meant living with the physical and emotional toll of acne scars for far longer than necessary.
A Research Breakthrough
A new study in the Lasers in Surgery and Medicine Journal has found something important. Patients can now treat both acne and scarring at the same time. They can do this by using fractional radiofrequency (FRF).
This study was one of the first to challenge the common belief. Many thought it was impossible to treat scarring while patients took oral isotretinoin (ITN).
What the Study Involved
FRF is a minimally invasive treatment that uses controlled heat energy to stimulate collagen production and remodel scar tissue.
By creating tiny micro-injuries in the skin, FRF encourages the body’s natural healing process, leading to smoother, more even skin texture.
The study involved 38 patients aged in their mid-20s over a 10-month period with moderate- to-severe acne scarring.
Patients were divided into three groups to test treatments:
- Oral isotretinoin patients being treated for acne scaring using FRF at the same time
- Delaying the FRF treatment for 6 months until after ITN is stopped
- Only treating with ITN
The Results
Patients who took ITN and were treated for FRF at the same time had better scarring improvement compared to all other patient groups.
They also had greater reductions in scar volume and scar appearance, indicating they were happier with their results and so improved their quality of life.
However, these patients experienced more redness and discomfort than patients who delayed FRF treatment.
That said, there were no serious side effects in treating with FRF while taking ITN simultaneously.
The Benefits of Combined Treatments
The study attributed these results to the collagen-boosting effect of FRF technology combined with ITN’s anti-inflammatory qualities.
Combining treatments is now proven safe and effective.
Patients can now breathe a sigh of relief with quicker treatment options with manageable side effects now available.
The Reality for Acne Scarring Treatments
The study highlighted how there is a need for better scar treatments for people who suffer from hormonal acne.
Dermatologists are now recommending patients simultaneously treat their acne and acne scarring with ITN and FRF.
With further research, reducing acne scars will soon be a part of treatment plans for acne inflammation and blemishes.
Practical Advice for Patients
If you’re currently taking oral isotretinoin or considering it for severe acne, here are some key points to keep in mind:
- Discuss Your Goals: Be open with your dermatologist about your desire to address both active acne and scarring. They can help you weigh the benefits and risks of combined treatment.
- Understand the Process: FRF treatments typically involve multiple sessions spaced several weeks apart. While the procedure is minimally invasive, you may experience redness, swelling, and discomfort during the healing process.
- Follow Aftercare Instructions: Proper aftercare is crucial to ensure optimal results and minimise side effects. Your dermatologist will provide specific instructions on how to care for your skin post-treatment.
- Be Patient: While combined treatment can speed up the overall process, it still takes time to see significant improvements. Stick to your treatment plan and attend all follow-up appointments.
- Consider the Cost: FRF treatments can be expensive, and they may not be covered by insurance. Discuss the financial aspects with your dermatologist to ensure the treatment fits within your budget.
Dermatologist’s View
Dr Philip Tong is an expert dermatologist and Co-Chair of the All About Acne board.
He has always believed that modern radiofrequency treatments for acne scars are an effective way to treat acne.
Dr Tong encourages fellow dermatologists to support their patients with simultaneous treatment to best reduce acne inflammation and scarring.
By challenging outdated protocols and embracing innovative combinations, dermatologists can provide their patients with safer, faster, and more effective care.
Conclusion
By combining treatments, patients can see improvements in their scars without waiting months or even years.
This new treatment protocol will empower people living with scarring to feel more confident and live life to the fullest in their own skin.
If you are considering treatment for acne or acne scars, don’t hesitate to discuss this new approach with your dermatologist.
Reference: Gallo E, Katz U, Artzi O. Fractional Radiofrequency and Oral Isotretinoin—A Prospective Randomized Controlled Split-Face Trial Comparing Concurrent Versus Delayed Fractional Radiofrequency Treatment for Acne Scars. Lasers in Surgery and Medicine. 2024; 56:574-580. Doi:10.1002/lsm.23811
