medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-358medsovet-8545Research ArticleКОСМЕТОЛОГИЯCOSMETOLOGYКомбинированная терапия атрофических рубцов радиоволновым методом воздействия и филлерами на основе гиалуроновой кислоты с предварительной субцизиейCombined treatment of atrophic scars using radiofrequency microneedling and hyaluronic acid fillers with subcisionhttps://orcid.org/0000-0002-1021-4606АкопянИ. Х.AkopyanI. Kh.

Акопян Инесса Хачатуровна, соискатель кафедры дерматовенерологии и косметологии

125371, Москва, Волоколамское шоссе, д. 91

Inessa Kh. Akopyan, Applicant of the Department of Dermatovenereology and Cosmetology

9, Volokolamskoye Shosse, Moscow, 12537

ines-akopyan@yandex.ruhttps://orcid.org/0000-0003-4330-2570МураковС. В.MurakovS. V.

Мураков Станислав Вячеславович, д.м.н., доцент, доцент кафедры дерматовенерологии и косметологии, Академия постдипломного образования Федерального научно-клинического центра специализированных видов медицинской помощи и медицинских технологий; медицинский директор, заведующий косметологическим центром, врач-косметолог, Лотос 288

125371, Москва, Волоколамское шоссе, д. 91,

119313, Москва, ул. Гарибальди, д. 6, корп. 1

Stanislav V. Murakov, Dr. Sci. (Med.), Associate Professor of the Department of Dermatovenereology and Cosmetology, Academy of Postgraduate Education of the Federal Clinical Research Centre for Specialized Medical Care and Medical Technologies; Medical Director, Head of the Cosmetology Center, Cosmetologist, Lotos 288

9, Volokolamskoye Shosse, Moscow, 125371,

6, Bldg. 1, Garibaldi St., Moscow, 119313

Stanislav@doctor.comГрачеваС. Г.GrachevaS. G.

Грачева Сусанна Генриховна, врач-дерматовенеролог, врач-косметолог, руководитель, Клиника скульптуры лица; врач-косметолог, Планета красоты

196066, Санкт-Петербург, Московский проспект, д. 183–185А,

125009, Москва, пер. Б. Кисловский, д. 9

Susanna G. Gracheva, Dermatovenereologist, Cosmetologist, Head, Klinika Skulptury Litsa; Cosmetologist, Planeta Krasoty

183–185A, Moskovskiy Ave., St Petersburg, 196066,

9, Bolshoy Kislovskiy Lane, Moscow, 125009

Susanna.grachev@gmail.comhttps://orcid.org/0000-0003-0545-4709БондаренкоИ. Н.BondarenkoG. N.

Бондаренко Игорь Николаевич, д.м.н., заведующий отделением косметологии

350063, Краснодар, ул. Пушкина, д. 51

Igor N. Bondarenko, Dr. Sci. (Med.), Head of the Cosmetology Department, 

51, Pushkin St., Krasnodar, 350063

 

docbin81@gmail.comhttps://orcid.org/0009-0009-1098-3171ТимофеевА. В.TimofeyevA. V.

Тимофеев Алексей Владимирович, врач-косметолог

119313, Москва, ул. Гарибальди, д. 6, корп. 1

Aleksey V. Timofeyev, Cosmetologist

6, Bldg. 1, Garibaldi St., Moscow, 119313

dr.alextimofeev@mail.ruhttps://orcid.org/0000-0002-3485-4050ВасильевС. В.VasilyevS. V.

Васильев Сергей Васильевич, д.т.н., профессор, биостатистик

109147, Москва, ул. Таганская, д. 3, эт. 5, п. 1

Sergey V. Vasilyev, Dr. Sci. (Eng.), Professor, Biostatistician

3, Fl. 5, Suite 1, Taganskaya St., Moscow, 109147

vasilievsenator@gmail.comАкадемия постдипломного образования Федерального научно-клинического центра специализированных видов медицинской помощи и медицинских технологийРоссияAcademy of Postgraduate Education of the Federal Clinical Research Centre for Specialized Medical Care and Medical TechnologiesRussian FederationАкадемия постдипломного образования Федерального научно-клинического центра специализированных видов медицинской помощи и медицинских технологий; Лотос 288РоссияAcademy of Postgraduate Education of the Federal Clinical Research Centre for Specialized Medical Care and Medical Technologies; Lotos 288Russian FederationКлиника скульптуры лица; Планета красотыРоссияKlinika Skulptury Litsa; Planeta KrasotyRussian FederationГородская поликлиника №7 г. КраснодараРоссияCity Polyclinic No. 7 of KrasnodarRussian FederationЛотос 288РоссияLotos 288Russian FederationЭЮЦ КлиникРоссияEYuTs KlinikRussian Federation202415092024014164176Copyright © Акопян И.Х., Мураков С.В., Грачева С.Г., Бондаренко И.Н., Тимофеев А.В., Васильев С.В., 20242024Акопян И.Х., Мураков С.В., Грачева С.Г., Бондаренко И.Н., Тимофеев А.В., Васильев С.В.Akopyan I.K., Murakov S.V., Gracheva S.G., Bondarenko G.N., Timofeyev A.V., Vasilyev S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8545Введение

Введение. Атрофические рубцы могут являться причиной психоэмоциональных расстройств и снижения качества жизни пациентов. Несмотря на большую актуальность вопроса коррекции атрофических рубцов, существующие методы лечения не всегда обеспечивают их полное устранение.

Цель

Цель. Оценить эффективность и безопасность комбинированной терапии атрофических рубцов с применением игольчатого радиоволнового метода воздействия (RF), субцизии и филлеров на основе гиалуроновой кислоты.

Материалы и методы

Материалы и методы. Включенных в исследование 10 пациенток в возрасте 28–44 лет с клиническим диагнозом атрофических рубцов рандомизировали в 2 группы с проведением RF в виде монотерапии (группа 1) и применением комбинации RF, субцизии и введением филлера на основе гиалуроновой кислоты (группа 2). Клиническую эффективность оценивали с помощью шкалы выраженности рубцов Goodman и Baron и шкалы общего эстетического улучшения (GAIS). Для определения динамики изменения толщины дермы выполнялось ультразвуковое исследование. Измерение объема углублений и текстуры кожи (3D-диагностика кожи лица) осуществляли с помощью аппарата Antera 3D®. Оценку безопасности процедур выполняли путем регистрации нежелательных явлений.

Результаты

Результаты. По большинству показателей эффективности комбинированный метод обладал преимуществом по сравнению с монотерапией. В группе 2 статистически значимое снижение выраженности рубцов по шкале Goodman и Baron было отмечено у 100% пациентов (р = 0,026). 3D-диагностика кожи лица показала в группе 2 более выраженное улучшение текстуры кожи по сравнению с группой 1. Значимая динамика (р = 0,027) в изменении показателей по шкале Face-Q наблюдалась только в группе, получавшей комбинированное лечение. Ультразвуковая картина в динамике подтверждала восстановление толщины дермы на фоне лечения. Серьезных нежелательных явлений зарегистрировано не было. Ожидаемые местные нежелательные явления (болезненность, эритема, отек и кровоизлияния) были выражены в незначительной или легкой степени и самопроизвольно разрешались в течение 1–7 дней.

Заключение

Заключение. Представленный метод, основанный на проведении курса процедур RF с последующей субцизией и введением гиалуроновой кислоты, подтвердил свою эффективность у пациентов с атрофическими рубцами.

Introduction

Introduction. Atrophic scars may be associated with significant psychological stress and a substantial negative impact on quality of life. Despite the great relevance of the atrophic scars therapy, existing treatment methods do not always provide their complete elimination.

Aim

Aim. To study the efficacy of combined therapy of atrophic scars with radiofrequency microneedling (RF-MN), subcision and hyaluronic acid filler injection.

Materials and methods

Materials and methods. Ten female patients aged 28–44 years with a clinical diagnosis of atrophic scars were randomly assigned to two groups. Group 1 received RF-MN alone, while Group 2 received a combination treatment comprising RF-MN, subcision, and hyaluronic acid injections. Clinical effectiveness was assessed using the Goodman-Baron scar rating scale and the Global Aesthetic Improvement Scale (GAIS). Ultrasound was used to determine the changes in dermal thickness. The volume of depressions and skin texture were measured using the Antera 3D®. The safety of the treatment was evaluated by recording adverse events.

Results

Results. The combined method demonstrated superior efficacy compared to RF-MN alone in the majority of efficacy parameters. In Group 2, a statistically significant reduction in Goodman-Baron scale was observed in 100% of patients (p = 0.026). 3D measurements of the face demonstrated a more pronounced improvement in skin texture in Group 2 relative to Group 1. Statistically significant changes (p = 0.027) in the Face-Q scale were exclusively observed in the group that received the combined treatment. Ultrasonic imaging demonstrated a restoration of dermal thickness following treatment. No serious adverse events were observed. Expected local adverse events (pain, erythema, swelling, and bruising) were mild and resolved spontaneously within 1–7 days.

Conclusion

Conclusion. The combined treatment with RF-MN followed by subcision and hyaluronic acid filler injections demonstrated its efficacy in patients with atrophic scars.

атрофические рубцыигольчатый радиоволновой метод воздействиясубцизиягиалуроновая кислотадермальные филлерыкомбинированное применениеультразвуковое исследование3D-диагностикаatrophic scarsradiofrequency microneedlingsubcisionhyaluronic aciddermal fillerscombination treatmentultrasound3D measurementReferencesБелоусов АЕ. Очерки пластической хирургии. Т. 1. Рубцы и их коррекция. СПб.: КОМАНДОР-SPB; 2005. 128 с.Белоусов АЕ. Очерки пластической хирургии. Т. 1. Рубцы и их коррекция. СПб.: КОМАНДОР-SPB; 2005. 128 с.Байтингер ВФ, Пайтян КГ. Морфофункциональные особенности патологических кожных рубцов: состояние вопроса. Вопросы реконструктивной и пластической хирургии. 2013;(1):28–33. Режим доступа: https://journals.tsu.ru/uploads/import/1151/files/1,_2013_web_30.pdf.Baitinger VF, Paityan KG. Morphologic and functional characteristics of pathologic skin scars: state of the art. Issues of Reconstructive and Plastic Surgery. 2013;(1):28–33. (In Russ.) Available at: https://journals.tsu.ru/uploads/import/1151/files/1,2013_web_30.pdf.Moon J, Yoon JY, Yang JH, Kwon HH, Min S, Suh DH. Atrophic acne scar: a process from altered metabolism of elastic fibres and collagen fibres based on transforming growth factor-β1 signalling. Br J Dermatol. 2019;181(6):1226–1237. https://doi.org/10.1111/bjd.17851.Moon J, Yoon JY, Yang JH, Kwon HH, Min S, Suh DH. Atrophic acne scar: a process from altered metabolism of elastic fibres and collagen fibres based on transforming growth factor-β1 signalling. Br J Dermatol. 2019;181(6):1226–1237. https://doi.org/10.1111/bjd.17851.Parks WC, Wilson CL, López-Boado YS. Matrix metalloproteinases as modulators of inflammation and innate immunity. Nat Rev Immunol. 2004;4(8):617–629. https://doi.org/10.1038/nri1418.Parks WC, Wilson CL, López-Boado YS. Matrix metalloproteinases as modulators of inflammation and innate immunity. Nat Rev Immunol. 2004;4(8):617–629. https://doi.org/10.1038/nri1418.Darby IA, Laverdet B, Bonté F, Desmoulière A. Fibroblasts and myofibroblasts in wound healing. Clin Cosmet Investig Dermatol. 2014;7:301–311. https://doi.org/10.2147/CCID.S50046.Darby IA, Laverdet B, Bonté F, Desmoulière A. Fibroblasts and myofibroblasts in wound healing. Clin Cosmet Investig Dermatol. 2014;7:301–311. https://doi.org/10.2147/CCID.S50046.Wilkinson HN, Hardman MJ. Wound healing: cellular mechanisms and pathological outcomes. Open Biol. 2020;10(9):200223. https://doi.org/10.1098/rsob.200223.Wilkinson HN, Hardman MJ. Wound healing: cellular mechanisms and pathological outcomes. Open Biol. 2020;10(9):200223. https://doi.org/10.1098/rsob.200223.Kim GH, Lee WJ, Jung JM, Won CH, Chang SE, Lee MW, Moon IJ. Morphological characteristics of facial scars: A retrospective analysis according to scar location, onset, age, and cause. Int Wound J. 2024;21(4):e14453. https://doi.org/10.1111/iwj.14453.Kim GH, Lee WJ, Jung JM, Won CH, Chang SE, Lee MW, Moon IJ. Morphological characteristics of facial scars: A retrospective analysis according to scar location, onset, age, and cause. Int Wound J. 2024;21(4):e14453. https://doi.org/10.1111/iwj.14453.Abdel Hay R, Shalaby K, Zaher H, Hafez V, Chi CC, Dimitri S et al. Interventions for acne scars. Cochrane Database Syst Rev. 2016;4(4):CD011946. https://doi.org/10.1002/14651858.CD011946.pub2.Abdel Hay R, Shalaby K, Zaher H, Hafez V, Chi CC, Dimitri S et al. Interventions for acne scars. Cochrane Database Syst Rev. 2016;4(4):CD011946. https://doi.org/10.1002/14651858.CD011946.pub2.Zaleski-Larsen LA, Fabi SG, McGraw T, Taylor M. Acne Scar Treatment: A Multimodality Approach Tailored to Scar Type. Dermatol Surg. 2016; 42(2 Suppl.):S139–S149. https://doi.org/10.1097/DSS.0000000000000746.Zaleski-Larsen LA, Fabi SG, McGraw T, Taylor M. Acne Scar Treatment: A Multimodality Approach Tailored to Scar Type. Dermatol Surg. 2016; 42(2 Suppl.):S139–S149. https://doi.org/10.1097/DSS.0000000000000746.Alam M, Han S, Pongprutthipan M, Disphanurat W, Kakar R, Nodzenski M et al. Efficacy of a needling device for the treatment of acne scars: a randomized clinical trial. JAMA Dermatol. 2014;150(8):844–849. https://doi.org/10.1001/jamadermatol.2013.8687.Alam M, Han S, Pongprutthipan M, Disphanurat W, Kakar R, Nodzenski M et al. Efficacy of a needling device for the treatment of acne scars: a randomized clinical trial. JAMA Dermatol. 2014;150(8):844–849. https://doi.org/10.1001/jamadermatol.2013.8687.Fife D. Practical evaluation and management of atrophic acne scars: tips for the general dermatologist. J Clin Aesthet Dermatol. 2011;4(8):50–57. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168245/.Fife D. Practical evaluation and management of atrophic acne scars: tips for the general dermatologist. J Clin Aesthet Dermatol. 2011;4(8):50–57. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168245/.Vempati A, Zhou C, Tam C, Khong J, Rubanowitz A, Tam K et al. Subcision for Atrophic Acne Scarring: A Comprehensive Review of Surgical Instruments and Combinatorial Treatments. Clin Cosmet Investig Dermatol. 2023;16:125–134. https://doi.org/10.2147/CCID.S397888.Vempati A, Zhou C, Tam C, Khong J, Rubanowitz A, Tam K et al. Subcision for Atrophic Acne Scarring: A Comprehensive Review of Surgical Instruments and Combinatorial Treatments. Clin Cosmet Investig Dermatol. 2023;16:125–134. https://doi.org/10.2147/CCID.S397888.Ивановская ЕВ, Ан ОИ, Мартьянов АА, Ивановская ЮА, Газитаева ЗИ, Свешникова АН. Теоретическое исследование фармакодинамики поперечно-сшитого продукта высокомолекулярной гиалуроновой кислоты в межклеточном матриксе. Экспериментальная и клиническая фармакология. 2023;86(11S):64. https://doi.org/10.30906/ekf-2023-86s-64a.Ivanovskaya EV, An OI, Martyanov AA, Ivanovskaya YuA, Gazitaeva ZI, Sveshnikova AN. Theoretical study of the pharmacodynamics of a crosslinked product of high molecular weight hyaluronic acid in the intercellular matrix. Eksperimentalnaya i Klinicheskaya Farmakologiya. 2023;86(11S):64. (In Russ.) https://doi.org/10.30906/ekf-2023-86s-64a.Болдова АЕ, Ивановская ЕВ, Сидорина АН, Ан ОИ, Мартьянов АА, Ивановская ЮА и др. Фагоцитоз поперечно-сшитых продуктов высокомолекулярной гиалуроновой кислоты клетками человека. В: XXIV съезд физиологического общества им. И.П. Павлова: сборник тезисов съезда. Санкт-Петербург, 11–15 сентября 2023 г. СПб.: ВВМ; 2023. С. 105–106. Режим доступа: https://rusphysiol2023.iephb.ru/wp-content/uploads/2023/11/sbornik-xxiv-sezda.pdf.Болдова АЕ, Ивановская ЕВ, Сидорина АН, Ан ОИ, Мартьянов АА, Ивановская ЮА и др. Фагоцитоз поперечно-сшитых продуктов высокомолекулярной гиалуроновой кислоты клетками человека. В: XXIV съезд физиологического общества им. И.П. Павлова: сборник тезисов съезда. Санкт-Петербург, 11–15 сентября 2023 г. СПб.: ВВМ; 2023.  С. 105–106. Режим доступа: https://rusphysiol2023.iephb.ru/wp-content/uploads/2023/11/sbornik-xxiv-sezda.pdf.Almukhadeb E, Binkhonain F, Alkahtani A, Alhunaif S, Altukhaim F, Alekrish K. Dermal Fillers in the Treatment of Acne Scars: A Review. Ann Dermatol. 2023;35(6):400–407. https://doi.org/10.5021/ad.22.230.Almukhadeb E, Binkhonain F, Alkahtani A, Alhunaif S, Altukhaim F, Alekrish K. Dermal Fillers in the Treatment of Acne Scars: A Review. Ann Dermatol. 2023;35(6):400–407. https://doi.org/10.5021/ad.22.230.Owczarczyk-Saczonek A, Zdanowska N, Wygonowska E, Placek W. The Immunogenicity of Hyaluronic Fillers and Its Consequences. Clin Cosmet Investig Dermatol. 2021;14:921–934. https://doi.org/10.2147/CCID.S316352.Owczarczyk-Saczonek A, Zdanowska N, Wygonowska E, Placek W. The Immunogenicity of Hyaluronic Fillers and Its Consequences. Clin Cosmet Investig Dermatol. 2021;14:921–934. https://doi.org/10.2147/CCID.S316352.Turlier V, Delalleau A, Casas C, Rouquier A, Bianchi P, Alvarez S et al. Association between collagen production and mechanical stretching in dermal extracellular matrix: in vivo effect of cross-linked hyaluronic acid filler. A randomised, placebo-controlled study. J Dermatol Sci. 2013;69(3):187–194. https://doi.org/10.1016/j.jdermsci.2012.12.006.Turlier V, Delalleau A, Casas C, Rouquier A, Bianchi P, Alvarez S et al. Association between collagen production and mechanical stretching in dermal extracellular matrix: in vivo effect of cross-linked hyaluronic acid filler. A randomised, placebo-controlled study. J Dermatol Sci. 2013;69(3):187–194. https://doi.org/10.1016/j.jdermsci.2012.12.006.Levy LL, Zeichner JA. Management of acne scarring, part II: a comparative review of non-laser-based, minimally invasive approaches. Am J Clin Dermatol. 2012;13(5):331–340. https://doi.org/10.2165/11631410-000000000-00000.Levy LL, Zeichner JA. Management of acne scarring, part II: a comparative review of non-laser-based, minimally invasive approaches. Am J Clin Dermatol. 2012;13(5):331–340. https://doi.org/10.2165/11631410-000000000-00000.Капулер ОМ, Разумовская ЕА, Мураков СВ, Главнова АМ. Ультразвуковые особенности тканевой интеграции и деградации под воздействием гиалуронидазы филлеров на основе гиалуроновой кислоты. Клиническая дерматология и венерология. 2024;23(3):322–331. https://doi.org/10.17116/klinderma202423031322.Kapuler OM, Razumovskaya EA, Murakov SV, Glavnova AM. Ultrasound characteristics of hyaluronic acid fillers tissue integration and hyaluronidase-mediated degradation. Russian Journal of Clinical Dermatology and Venereology. 2024;23(3):322–331. (In Russ.) https://doi.org/10.17116/klinderma202423031322.Tahiliani S, Mysore V, Ganjoo A, Udare S, Rajendran SC, Reddy R et al. Practical Aspects of Acne Scar Management: ASAP 2024. Cureus. 2024;16(3):e55897. https://doi.org/10.7759/cureus.55897.Tahiliani S, Mysore V, Ganjoo A, Udare S, Rajendran SC, Reddy R et al. Practical Aspects of Acne Scar Management: ASAP 2024. Cureus. 2024;16(3):e55897. https://doi.org/10.7759/cureus.55897.Круглова ЛС, Колчева ПА, Корчажкина НБ. Обзор современных методов коррекции рубцов постакне. Вестник новых медицинских технологий. 2018;25(4):155–163. https://doi.org/10.24411/1609-2163-2018-16316.Kruglova LS, Kolcheva PA, Korchazhkina NB. About modern methods of acnescars correction. Journal of New Medical Technologies. 2018;25(4):155–163. (In Russ.) https://doi.org/10.24411/1609-2163-2018-16316.Connolly D, Vu HL, Mariwalla K, Saedi N. Acne Scarring-Pathogenesis, Evaluation, and Treatment Options. J Clin Aesthet Dermatol. 2017;10(9):12–23. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749614/.Connolly D, Vu HL, Mariwalla K, Saedi N. Acne Scarring-Pathogenesis, Evaluation, and Treatment Options. J Clin Aesthet Dermatol. 2017;10(9):12–23. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749614/.Стенько АГ, Талыбова АМ, Коваленко АА, Стрекозова АЕ. Вопросы эффективной терапии рубцовых деформаций. Медицинский алфавит. 2019;2(26): 62–66. https://doi.org/10.33667/2078-5631-2019-2-26(401)-62-66.Stenko AG, Talybova AM, Kovalenko AA, Strekozova AE. Effective therapy for cicatricial deformities. Medical Alphabet. 2019;2(26):62–66. (In Russ.) https://doi.org/10.33667/2078-5631-2019-2-26(401)-62-66.Perry DM, McGrouther DA, Bayat A. Current tools for noninvasive objective assessment of skin scars. Plast Reconstr Surg. 2010;126(3):912–923. https://doi.org/10.1097/PRS.0b013e3181e6046b.Perry DM, McGrouther DA, Bayat A. Current tools for noninvasive objective assessment of skin scars. Plast Reconstr Surg. 2010;126(3):912–923. https://doi.org/10.1097/PRS.0b013e3181e6046b.Dill-Müller D, Maschke J. Ultrasonography in dermatology. J Dtsch Dermatol Ges. 2007;5(8):689–707. https://doi.org/10.1111/j.1610-0387.2007.06453.x.Dill-Müller D, Maschke J. Ultrasonography in dermatology. J Dtsch Dermatol Ges. 2007;5(8):689–707. https://doi.org/10.1111/j.1610-0387.2007.06453.x.Бондаренко ИН. Новые возможности применения ультразвукового исследования в эстетической медицине: систематический обзор. Кубанский научный медицинский вестник. 2021;28(6):73–89. https://doi.org/10.25207/1608-6228-2021-28-6-73-89.Bondarenko IN. New outreach of ultrasound in aesthetic medicine: a systematic review. Kuban Scientific Medical Bulletin. 2021;28(6):73–89. (In Russ.) https://doi.org/10.25207/1608-6228-2021-28-6-73-89.Бондаренко ИН. Ультразвуковая характеристика кожи, мягких тканей лица, шеи, кистей рук у женщин разных возрастных групп: нерандомизированное обсервационное кросс-секционное исследование. Кубанский научный медицинский вестник. 2021;28(3):16–28. https://doi.org/10.25207/1608-6228-2021-28-3-16-28.Bondarenko IN. Ultrasonic diagnosis of skin, facial, neck and hand soft tissue in women of different age: a non-randomised observational cross-sectional study. Kuban Scientific Medical Bulletin. 2021;28(3):16–28. (In Russ.) https://doi.org/10.25207/1608-6228-2021-28-3-16-28.Artzi O, Cohen S, Koren A, Niv R, Friedman O. Dual-plane hyaluronic acid treatment for atrophic acne scars. J Cosmet Dermatol. 2020;19(1):69–74. https://doi.org/10.1111/jocd.12991.Artzi O, Cohen S, Koren A, Niv R, Friedman O. Dual-plane hyaluronic acid treatment for atrophic acne scars. J Cosmet Dermatol. 2020;19(1):69–74. https://doi.org/10.1111/jocd.12991.Dierickx C, Larsson MK, Blomster S. Effectiveness and Safety of Acne Scar Treatment With Nonanimal Stabilized Hyaluronic Acid Gel. Dermatol Surg. 2018;44(1 Suppl.):S10–S18. https://doi.org/10.1097/DSS.0000000000001689.Dierickx C, Larsson MK, Blomster S. Effectiveness and Safety of Acne Scar Treatment With Nonanimal Stabilized Hyaluronic Acid Gel. Dermatol Surg. 2018;44(1 Suppl.):S10–S18. https://doi.org/10.1097/DSS.0000000000001689.Hasson A, Romero WA. Treatment of facial atrophic scars with Esthélis, a hyaluronic acid filler with polydense cohesive matrix (CPM). J Drugs Dermatol. 2010;9(12):1507–1509. Available at: https://pubmed.ncbi.nlm.nih.gov/21120258/.Hasson A, Romero WA. Treatment of facial atrophic scars with Esthélis, a hyaluronic acid filler with polydense cohesive matrix (CPM). J Drugs Dermatol. 2010;9(12):1507–1509. Available at: https://pubmed.ncbi.nlm.nih.gov/21120258/.Siperstein R, Nestor E, Meran S, Grunebaum L. A split-face, blind, randomized placebo-controlled clinical trial investigating the efficacy and safety of hyaluronic acid filler for the correction of atrophic facial scars. J Cosmet Dermatol. 2022;21(9):3768–3778. https://doi.org/10.1111/jocd.15153.Siperstein R, Nestor E, Meran S, Grunebaum L. A split-face, blind, randomized placebo-controlled clinical trial investigating the efficacy and safety of hyaluronic acid filler for the correction of atrophic facial scars. J Cosmet Dermatol. 2022;21(9):3768–3778. https://doi.org/10.1111/jocd.15153.Clementoni MT, Azzopardi E. Specific Attention Areas in Scar Management: Management of Atrophic Scars. In: Téot L, Mustoe TA, Middelkoop E, Gauglitz GG (eds.). Textbook on Scar Management: State of the Art Management and Emerging Technologies. Cham (CH): Springer; 2020, pp. 353–362. https://doi.org/10.1007/978-3-030-44766-3_41.Clementoni MT, Azzopardi E. Specific Attention Areas in Scar Management: Management of Atrophic Scars. In: Téot L, Mustoe TA, Middelkoop E, Gauglitz GG (eds.). Textbook on Scar Management: State of the Art Management and Emerging Technologies. Cham (CH): Springer; 2020, pp. 353–362. https://doi.org/10.1007/978-3-030-44766-3_41.Ebrahim HM, Nassar A, ElKashishy K, Artima AYM, Morsi HM. A combined approach of subcision with either cross-linked hyaluronic acid or threads in the treatment of atrophic acne scars. J Cosmet Dermatol. 2022;21(8):3334–3342. https://doi.org/10.1111/jocd.14675.Ebrahim HM, Nassar A, ElKashishy K, Artima AYM, Morsi HM. A combined approach of subcision with either cross-linked hyaluronic acid or threads in the treatment of atrophic acne scars. J Cosmet Dermatol. 2022;21(8):3334–3342. https://doi.org/10.1111/jocd.14675.Dastgheib M, Heidari S, Azizipour A, Kavyani M, Lajevardi V, Ehsani AH et al. Investigating the impact of added Profhilo mesogel to subcision versus subcision monotherapy in treating acne scars; a single-blinded, splitface randomized trial. J Cosmet Dermatol. 2024;23(6):1992–2000. https://doi.org/10.1111/jocd.16258.Dastgheib M, Heidari S, Azizipour A, Kavyani M, Lajevardi V, Ehsani AH et al. Investigating the impact of added Profhilo mesogel to subcision versus subcision monotherapy in treating acne scars; a single-blinded, splitface randomized trial. J Cosmet Dermatol. 2024;23(6):1992–2000. https://doi.org/10.1111/jocd.16258.Mohammed GF, Al-Dhubaibi MS. Triple steps acne scar revision technique: A new combination therapeutic modality for atrophic acne scars. J Cosmet Dermatol. 2022;21(10):4659–4668. https://doi.org/10.1111/jocd.14944.Mohammed GF, Al-Dhubaibi MS. Triple steps acne scar revision technique: A new combination therapeutic modality for atrophic acne scars. J Cosmet Dermatol. 2022;21(10):4659–4668. https://doi.org/10.1111/jocd.14944.Choi SY, Lee YH, Kim H, Koh HJ, Park SY, Park WS et al. A combination trial of intradermal radiofrequency and hyaluronic acid filler for the treatment of nasolabial fold wrinkles: a pilot study. J Cosmet Laser Ther. 2014;16(1):37–42. https://doi.org/10.3109/14764172.2013.854636.Choi SY, Lee YH, Kim H, Koh HJ, Park SY, Park WS et al. A combination trial of intradermal radiofrequency and hyaluronic acid filler for the treatment of nasolabial fold wrinkles: a pilot study. J Cosmet Laser Ther. 2014;16(1):37–42. https://doi.org/10.3109/14764172.2013.854636.Kim H, Park KY, Choi SY, Koh HJ, Park SY, Park WS et al. The efficacy, longevity, and safety of combined radiofrequency treatment and hyaluronic Acid filler for skin rejuvenation. Ann Dermatol. 2014;26(4):447–456. https://doi.org/10.5021/ad.2014.26.4.447.Kim H, Park KY, Choi SY, Koh HJ, Park SY, Park WS et al. The efficacy, longevity, and safety of combined radiofrequency treatment and hyaluronic Acid filler for skin rejuvenation. Ann Dermatol. 2014;26(4):447–456. https://doi.org/10.5021/ad.2014.26.4.447.Ko EJ, Choi HG, Kim H, Park WS, Kim BJ, Kim MN. Novel Treatment Using Intradermal Radiofrequency and Hyaluronic Acid Filler to Correct Marionette Lines. Ann Dermatol. 2015;27(3):351–352. https://doi.org/10.5021/ad.2015.27.3.351.Ko EJ, Choi HG, Kim H, Park WS, Kim BJ, Kim MN. Novel Treatment Using Intradermal Radiofrequency and Hyaluronic Acid Filler to Correct Marionette Lines. Ann Dermatol. 2015;27(3):351–352. https://doi.org/10.5021/ad.2015.27.3.351.Lolis MS, Goldberg DJ. Radiofrequency in cosmetic dermatology: a review. Dermatol Surg. 2012;38(11):1765–1776. https://doi.org/10.1111/j.1524-4725.2012.02547.x.Lolis MS, Goldberg DJ. Radiofrequency in cosmetic dermatology: a review. Dermatol Surg. 2012;38(11):1765–1776. https://doi.org/10.1111/j.1524-4725.2012.02547.x.Płatkowska A, Korzekwa S, Łukasik B, Zerbinati N. Combined Bipolar Radiofrequency and Non-Crosslinked Hyaluronic Acid Mesotherapy Protocol to Improve Skin Appearance and Epidermal Barrier Function: A Pilot Study. Pharmaceuticals (Basel). 2023;16(8):1145. https://doi.org/10.3390/ph16081145.Płatkowska A, Korzekwa S, Łukasik B, Zerbinati N. Combined Bipolar Radiofrequency and Non-Crosslinked Hyaluronic Acid Mesotherapy Protocol to Improve Skin Appearance and Epidermal Barrier Function: A Pilot Study. Pharmaceuticals (Basel). 2023;16(8):1145. https://doi.org/10.3390/ph16081145.Гладько ВВ, Измайлова ИВ. Применение сочетанного метода микронидлинга и радиоволновой терапии и дермального импланта на основе гиалуроновой кислоты для лечения атрофических рубцов в области лица в рамках пост-акне синдрома. Вестник Медицинского института непрерывного образования. 2023;3(2):20–23. Режим доступа: https://med.mgupp.ru/wp-content/uploads/2023/06/Вестник_МИНО_2_2023.pdf.Gladko VV, Izmaylova IV. The use of the combined method of microneedling and radiofrequency therapy and dermal fillers for atrophic scars treatment in the facial area in the context of post-acne syndrome. Bulletin of the Medical Institute of Сontinuing Education. 2023;3(2):20–23. (In Russ.) Available at: https://med.mgupp.ru/wp-content/uploads/2023/06/Вестник_МИНО_2_2023.pdf.Талыбова АМ, Стенько АГ, Круглова ЛС. Эффективность комбинированного применения фракционной микроигольчатой RF-терапии и фармафореза гиалуроновой кислоты в лечении пациентов с атрофическими рубцами. Физиотерапия, бальнеология и реабилитация. 2020;19(1):32–39. https://doi.org/10.17816/1681-3456-2020-19-1-5.Talybova AM, Stenko AG, Kruglova LS. The effectiveness of the combined use of fractional microneedle RF-therapy and pharmacophoresis of hyaluronic acid in the treatment of patients with atrophic scars. Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(1):32–39. (In Russ.) https://doi.org/10.17816/1681-3456-2020-19-1-5.Cucu C, Butacu AI, Niculae BD, Tiplica GS. Benefits of fractional radiofrequency treatment in patients with atrophic acne scars – Literature review. J Cosmet Dermatol. 2021;20(2):381–385. https://doi.org/10.1111/jocd.13900.Cucu C, Butacu AI, Niculae BD, Tiplica GS. Benefits of fractional radiofrequency treatment in patients with atrophic acne scars – Literature review. J Cosmet Dermatol. 2021;20(2):381–385. https://doi.org/10.1111/jocd.13900.Bhargava S, Cunha PR, Lee J, Kroumpouzos G. Acne Scarring Management: Systematic Review and Evaluation of the Evidence. Am J Clin Dermatol. 2018;19(4):459–477. https://doi.org/10.1007/s40257-018-0358-5.Bhargava S, Cunha PR, Lee J, Kroumpouzos G. Acne Scarring Management: Systematic Review and Evaluation of the Evidence. Am J Clin Dermatol. 2018;19(4):459–477. https://doi.org/10.1007/s40257-018-0358-5.Boen M, Jacob C. A Review and Update of Treatment Options Using the Acne Scar Classification System. Dermatol Surg. 2019;45(3):411–422. https://doi.org/10.1097/DSS.0000000000001765.Boen M, Jacob C. A Review and Update of Treatment Options Using the Acne Scar Classification System. Dermatol Surg. 2019;45(3):411–422. https://doi.org/10.1097/DSS.0000000000001765.Kravvas G, Al-Niaimi F. A systematic review of treatments for acne scarring. Part 1: Non-energy-based techniques. Scars Burn Heal. 2017;3:1–17. https://doi.org/10.1177/2059513117695312.Kravvas G, Al-Niaimi F. A systematic review of treatments for acne scarring. Part 1: Non-energy-based techniques. Scars Burn Heal. 2017;3:1–17. https://doi.org/10.1177/2059513117695312.Min S, Park SY, Yoon JY, Suh DH. Comparison of fractional microneedling radiofrequency and bipolar radiofrequency on acne and acne scar and investigation of mechanism: comparative randomized controlled clinical trial. Arch Dermatol Res. 2015;307(10):897–904. https://doi.org/10.1007/s00403-015-1601-z.Min S, Park SY, Yoon JY, Suh DH. Comparison of fractional microneedling radiofrequency and bipolar radiofrequency on acne and acne scar and investigation of mechanism: comparative randomized controlled clinical trial. Arch Dermatol Res. 2015;307(10):897–904. https://doi.org/10.1007/s00403-015-1601-z.Huang L, Liu Y, Fang W, Liu L, Sun Q, Lin X et al. Efficiency and safety of microneedling fractional radiofrequency in the treatment of Chinese atrophic acne scars: A retrospective study of 3 consecutive treatments with 1-month intervals. J Cosmet Dermatol. 2023;22(2):497–504. https://doi.org/10.1111/jocd.15454.Huang L, Liu Y, Fang W, Liu L, Sun Q, Lin X et al. Efficiency and safety of microneedling fractional radiofrequency in the treatment of Chinese atrophic acne scars: A retrospective study of 3 consecutive treatments with 1-month intervals. J Cosmet Dermatol. 2023;22(2):497–504. https://doi.org/10.1111/jocd.15454.Kim CNT, Thi LP, Van TN, Minh PPT, Nguyet MV, Thi ML et al. Successful Treatment of Facial Atrophic Acne Scars by Fractional Radiofrequency Microneedle in Vietnamese Patients. Open Access Maced J Med Sci. 2019;7(2):192–194. https://doi.org/10.3889/oamjms.2019.002.Kim CNT, Thi LP, Van TN, Minh PPT, Nguyet MV, Thi ML et al. Successful Treatment of Facial Atrophic Acne Scars by Fractional Radiofrequency Microneedle in Vietnamese Patients. Open Access Maced J Med Sci. 2019;7(2):192–194. https://doi.org/10.3889/oamjms.2019.002.Nitayavardhana S, Wanitphakdeedecha R, Ng JNC, Eimpunth S, Manuskiatti W. The efficacy and safety of fractional radiofrequency nanoneedle system in the treatment of atrophic acne scars in Asians. J Cosmet Dermatol. 2020;19(7):1636–1641. https://doi.org/10.1111/jocd.13484.Nitayavardhana S, Wanitphakdeedecha R, Ng JNC, Eimpunth S, Manuskiatti W. The efficacy and safety of fractional radiofrequency nanoneedle system in the treatment of atrophic acne scars in Asians. J Cosmet Dermatol. 2020;19(7):1636–1641. https://doi.org/10.1111/jocd.13484.Bulbul Baskan E, Akin Belli A. Evaluation of the efficacy of microneedle fractional radiofrequency in Turkish patients with atrophic facial acne scars. J Cosmet Dermatol. 2019;18(5):1317–1321. https://doi.org/10.1111/jocd.12812.Bulbul Baskan E, Akin Belli A. Evaluation of the efficacy of microneedle fractional radiofrequency in Turkish patients with atrophic facial acne scars. J Cosmet Dermatol. 2019;18(5):1317–1321. https://doi.org/10.1111/jocd.12812.Elawar A, Dahan S. Non-insulated Fractional Microneedle Radiofrequency Treatment with Smooth Motor Insertion for Reduction of Depressed Acne Scars, Pore Size, and Skin Texture Improvement: A Preliminary Study. J Clin Aesthet Dermatol. 2018;11(8):41–44. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122511/.Elawar A, Dahan S. Non-insulated Fractional Microneedle Radiofrequency Treatment with Smooth Motor Insertion for Reduction of Depressed Acne Scars, Pore Size, and Skin Texture Improvement: A Preliminary Study. J Clin Aesthet Dermatol. 2018;11(8):41–44. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122511/.Cho SI, Chung BY, Choi MG, Baek JH, Cho HJ, Park CW et al. Evaluation of the clinical efficacy of fractional radiofrequency microneedle treatment in acne scars and large facial pores. Dermatol Surg. 2012;38(7-1): 1017–1024. https://doi.org/10.1111/j.1524-4725.2012.02402.x.Cho SI, Chung BY, Choi MG, Baek JH, Cho HJ, Park CW et al. Evaluation of the clinical efficacy of fractional radiofrequency microneedle treatment in acne scars and large facial pores. Dermatol Surg. 2012;38(7-1): 1017–1024. https://doi.org/10.1111/j.1524-4725.2012.02402.x.Колчева ПС, Талыбова АМ, Стенько АГ. Инновационные методы в лечении пациентов с атрофическими рубцами постакне. Медицинский алфавит. 2020;(6):47–51. https://doi.org/10.33667/2078-5631-2020-6-47-51.Kolcheva PS, Talybova AM, Stenko AG. Innovative methods in treatment of patients with atrophic post-acne scars. Medical Alphabet. 2020;(6):47–51. (In Russ.) https://doi.org/10.33667/2078-5631-2020-6-47-51.Flegontova E, Kreindel M, Vranis NM, Mulholland RS. Correction of age-related changes in the skin at the dermal and subdermal level using radiofrequency macroneedling therapy. J Cosmet Dermatol. 2024;23(7):2401–2410. https://doi.org/10.1111/jocd.16361.Flegontova E, Kreindel M, Vranis NM, Mulholland RS. Correction of age-related changes in the skin at the dermal and subdermal level using radiofrequency macroneedling therapy. J Cosmet Dermatol. 2024;23(7):2401–2410. https://doi.org/10.1111/jocd.16361.

The authors declare that there are no conflicts of interest present.