Clinical Evaluation of Hyperpigmentation Through Monopolar / Bipolar Radiofrequency and Fractional Microneedle Rf in Fitzpatrick Iii–V

Abstract

This study evaluated the comparative benefit and safety of monopolar radiofrequency (RF), bipolar RF and fractional microneedling radiofrequency (FMR) in post inflammatory hyper pigmentation (PIH) in subjects of Fitzpatrick skin types III-V. This was a prospective comparative quasi-experimental study conducted at various dermatology or aesthetic centers in Pakistan over a period of 4 months. 77 subjects (25 to 60 years) were distributed in three different treatment groups and the three executed 4 treatment sessions at two-to-three-week intervals. Clinical outcomes were wrinkles, skin laxity, reduction of PIH, patient satisfaction, pain scores, erythema, edema, and adverse effects. One-way ANOVA, Chi-square, Tukey post hoc tests, and Pearson correlation were performed in SPSS 26.0 for statistical analyses. The results showed highly significant difference between the treatment modalities (p < 0.001). Compared to the other groups, FMR group gave the best results for wrinkle reduction (45.6% ± 7.4) and skin laxity (42.8% ± 6.9) and 69.2% fulfilled higher than 50% boost in PIH seriousness within the FMR group. Moderate clinical efficacy, with increased tolerability, was noted with bipolar RF and comparatively decreased efficacy, with minimal downtime, was noted with monopolar RF. Somewhat higher pain scores did not affect patient satisfaction, which was highest in the FMR group. The most common complication was transient erythema and edema but there was no long-term PIH or severe complication noted. The outcomes suggest that FMR offers the best modality for patients of darker skin types for hyperpigmentation, skin texture and skin laxity, while bipolar RF offers a favorable compromise in terms of treatment efficacy and tolerability. All three RF-based modalities were safe and clinically useful for Fitzpatrick skin types III-V, and if performed appropriately as an isolated treatment.