Microneedle fractional radiofrequency for atrophic acne scars: In vivo evaluation of results by 3D analysis and reflectance confocal microscopy

The efficacy of microneedle fractional radiofrequency (MFR) for the treatment of atrophic acne scars has been recently described, but accurate in vivo microscopic documentation of the processes occurring has never been reported. The aim of this study is to describe in vivo morphological atrophic acne scars' variations after treatment with MFR by means reflectance confocal microscopy (RCM) and three-dimensional (3D) imaging. A total of 11 patients requiring treatment for atrophic facial acne scars were treated with four monthly sessions of MFR. 3D imaging and RCM were assessed at baseline and 1 month after last session. Clinical improvement, according to Global Assessment Improvement Scale, and patients' satisfaction were evaluated. Clinical improvement was observed in all the treated patients, although better results were obtained for boxcar scars (p = 0.043). 3D imaging revealed a significant improvement in terms of mean scars' depth (p < 0.001). Otherwise, RCM highlighted collagen remodeling with restoration of a reticular structure. Our study confirms the efficacy and safety of MFR in acne scars' treatment and provides the microscopic description of the results using RCM.