Combining RF energy with fractional CO2 adds the effect of a temperature increase in the upper layers of the dermis. This temperature increase produces a firming and compacting effect, write Mu et al. A 10-patient study showed more pronounced clinical improvement and faster healing with fewer side effects and pigmentary changes in the combination treatment group. But due to the study’s small size, the authors reserve judgment on this combination.
“The two areas where I see the most promise are fractional CO2 combined with radiofrequency microneedling and with subcision,” Dr. Bhatia says. Like fractional laser therapy, he says, these technologies have demonstrated acne scarring efficacy on their own. Their mechanisms of action also complement that of laser resurfacing.
“Fractional CO2 does a good job from the surface down. Basically you’re drilling little micrometer holes in the scar-type collagen in a pattern, and the depth is based on the energies used,” he says.
This process vaporizes some of the scar tissue while remodeling existing collagen and stimulating new collagen growth around the micro-channels.
“That improves the surface texture, along with more superficial and intermediate remodeling of the actual scars,” says Dr. Bhatia. “In some cases, you can see improvement in pigmentation as well.”
Dr. Bhatia is a Cutera investigator, speaker and consultant and Solta Medical consultant
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