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Evaluation of pulsed light and radiofrequency combined for the treatment of acne vulgaris with histologic analysis of facial skin biopsies

Background. Light and radiofrequency (RF) devices have recently been used to treat acne in selected patients. Objective. To investigate the safety and efficacy of a combination of pulsed light and RF energy for the treatment of acne. Materials and methods. Thirty‐two patients with moderate acne were treated twice weekly for four weeks with the Aurora AC® (Syneron Medical Ltd, Yokneam, Israel), a combination of pulsed light and RF energy. Twenty‐five patients completed the study. In four patients, the number of hair follicles showing perifolliculitis, the diameters of hair follicles, the diameters of sebaceous glands, and expressions of heat shock protein 70 and procollagen‐1 were evaluated before and after treatment. Results. The mean lesion count was reduced by 47% (p<0.05) after eight treatments. Adverse effects—erythema, tingling, and burning—were mild and temporary. The percentage of follicles with perifolliculitis decreased from 58% to 33%, sebaceous gland areas decreased from 0.092 mm2 to 0.07 mm2, and heat shock protein 70 and procollagen‐1 expressions did not change. Conclusion. The combination of optical and RF energies may be an alternative nonablative modality for the treatment of moderate acne. Clinical improvement may be partly due to reductions in both perifollicular inflammation and sebaceous gland areas.