Pin-Based Fractional Radiofrequency: 2024 International Consensus Recommendations for Aesthetic Skin Indications

Abstract

Background and Objective: Fractional radiofrequency was developed as a potentially lower-risk and downtime alternative to traditional fractional ablative and nonablative lasers for skin resurfacing. Pin-based FRF (pFRF) delivers radiofrequency heat in focal, high-energy density columns within intact skin, without microneedle insertion. The main objective of this publication was to get an expert consensus on best-in-practice protocols for treating common aesthetic indications for resurfacing using a novel pFRF device. Methods: An international panel of 10 dermatologists and plastic and reconstructive surgeons from 6 countries and a variety of practice settings was assembled to develop updated consensus recommendations for using pFRF. A modified Delphi method included: a preliminary questionnaire, video conference roundtable discussion, individual review of initial data, a secondary questionnaire, and multiple rounds of email discussion until a group consensus was reached. Results: The panel developed standardized pFRF protocols for the treatment of acne scars, enlarged pores, skin texture, rhytides, and striae. For each diagnosis, device parameters and techniques are outlined. General requirements for patient preparation, anesthesia, and post-treatment care are described. Special consideration was given to device settings for condition severity and Fitzpatrick skin type. These guidelines are meant to provide new practitioners with a starting point for safe and effective patient treatment. Conclusions: pFRF without microneedles is a useful alternative to fractional laser technology and radiofrequency microneedling for resurfacing patients’ skin texture irregularities. Patients tolerate the procedure and recovery well. Here, protocols for the treatment of 5 common aesthetic skin complaints with a novel pFRF device are provided.