Meta-analysis of fractional radiofrequency treatment for acne and/or acne scars.

Background: Fractional radiofrequency (FRF) is increasingly used for acne scars. The common coexistence of acne scars and active acne is a challenge in the timely management of acne scarring.

Objective: We conducted a systematic review and meta-analysis to compare the efficacy and safety of FRF treatment with the lasers for acne and/or acne scars.

Methods: A systematic search was performed on PubMed, Embase, Ovid, Cochrane Library, and Web of Science. Compared with the lasers, a meta-analysis was conducted to assess the clinical improvement and adverse events after FRF treatment.

Results: Eight randomized controlled trials were included. FRF group was more effective than the laser group in patient-evaluated acne improvement (RR = 1.35, 95% CI: 1.01 ∼ 1.80). Regardless of observer assessment or patient evaluation, the FRF group was as effective as the laser group in treating atrophic acne scars (RR = 0.92, 95% CI: 0.78 ∼ 1.08; RR =1.15, 95% CI: 0.99 ∼ 1.34). Although there was no difference in pain level and crusting time between the two groups (SMD =0.20, 95% CI: -0.72 ∼ 1.12; SMD = -0.93, 95% CI: -2.38 ∼ 0.52), PIH incidence of FRF was significantly lower than that of the laser group (RR = 0.12, 95% CI: 0.04 ∼ 0.35). The duration of erythema after FRF treatment was also obviously shorter than that after the laser treatment (SMD = -0.78, 95% CI: -1.37 ∼ -0.18). Subgroup analysis showed that at least a 12-week follow-up was required to observe the full effects of FRF.

Conclusions: FRF could be a better choice for atrophic acne scar patients with active acne. FRF is superior in treating atrophic acne scar patients prone to pigmentation.