Fractional Radiofrequency (FRF). Your New Weapon

Fractional radiofrequency (FRF) creates zones of thermal damage that stimulate wound healing and dermal remodeling. The result is new collagen, elastin, and hyaluronic acid formation. Clinically FRF improves acne scars, large facial pores, wrinkles, and facial laxity reduction. Recently FRF has been used to treat excessive sweating

What is Fractional Radiofrequency Skin Rejuvenation?

Fractional radiofrequency (FRF) delivers energy and creates zones of affected skin adjacent to unaffected areas. The unaffected areas serve as a reservoir of cells that promote and accelerate wound healing. The treated areas result in thermal damage in the deep dermal collagen, stimulating wound healing, dermal remodeling, new collagen, elastin, and hyaluronic acid formation.

In an innovative approach, Prof Moawad offers his patients a full-face fractional radiofrequency to make tiny holes into the skin to overcome the stratum corneum to enhance PRP and nano-fat. Fractional radiofrequency improves acne scars, large facial pores, wrinkles, and facial laxity reduction. The most common sequence effects are erythema and edema, which are transient (a few days). You may use a topical anesthetic cream before the treatment to minimize pain.

The results are double, and you will enjoy the rejuvenating effect of the fractional radiofrequency resurfacing system and the regenerative effect of growth factors and stem cells present in PRP and nano-fat. Recently, we used fractional radiofrequency before Botox treatment for excessive sweating or hyperhidrosis of the axilla.

Thermal treatment using optical energy for several dermatologic problems has become extremely popular over the past 20 years. Light-based therapies with lasers and intense pulse light (IPL) technologies have increased steadily in aesthetic medicine for epilation, removal of vascular and pigmented lesions, reduction of fine wrinkles, and acne treatment Light-based therapies are helpful for a broad range of dermatological indications.

In laser hair removal, light-colored hair is challenging because it has low melanin levels and, therefore, may not absorb enough energy to achieve thermal destruction of the hair follicle. However, with limitations, the melanin chromophore absorbs Optical energy in the epidermis and hair shafts and hemoglobin in the blood. One of the main limitations is that optical energy must penetrate the epidermis to reach the depth of the targeted site.

Conversely, high pigmentation of the epidermis also poses a problem because it may absorb too much energy, potentially causing adverse effects such as burns and hyperpigmentation. Wrinkles respond poorly to treatment with optical power because collagen fibers do not have chromophores.

These limitations have stimulated investigators to look for new forms of energy that satisfy the principle of selective thermolysis but are devoid of the main disadvantage of optical power for dermatological applications; that is, a healthy interdependence between treatment efficacy/safety and chromophore levels in the epidermis.

Radiofrequency (RF) for selective electro thermolysis has produced a highly efficient thermal effect on biological tissue. Unlike optical energy, RF energy depends on the tissue’s electrical properties rather than the concentration of chromophores in the skin for selective thermal destruction of targeted sites.

Non-ablative radiofrequency (NARF) devices can be classified into several configurations based on how the electrical current passes through the tissue. The first type introduced was monopolar RF, which applies energy to the tissue via a single electrode tip and a grounding plate. Bipolar RF applies heat to the tissue via two points on the tip of a single probe, and the estimated penetration depth is half the distance between the electrodes.
Tripolar RF devices were recently introduced; this technology uses multiple electrode configurations to heat superficial and deeper skin layers. Fractional radiofrequency also is a novel technology in which bipolar RF energy is delivered via a minimally invasive approach using a microneedle electrode assembly.

This technology generates discrete thermal zones of treated tissue to the depth of the reticular dermis with fractional sparing of the epidermis and adnexa, thereby inducing a rapid and vigorous wound-healing response and sustained dermal remodeling profound new collagen formation.

There are two ways to deliver fractional radiofrequency. Fractional radiofrequency is a more modern non-ablative approach. Whereas some devices (Matrix RF device) use electrodes, others use an array of microneedles arranged in pairs between which bipolar RF energy is delivered (ePrime system).

The fractionally delivered energy creates zones of affected skin next to unaffected areas. The unaffected areas found between affected areas initially maintain skin integrity but, in the long term, serve as a reservoir of cells that promote and accelerate wound healing. The treated areas result in thermal damage in the deep dermal collagen, stimulating wound healing, dermal remodeling, new collagen, elastin, and hyaluronic acid formation.
Microneedle Fractional radiofrequency improved acne scars and large facial pores with fewer adverse events than fractional lasers. However, moderate to severe acne scars showing superficial irregularities need multiple microneedles fractional RF treatment sessions for helpful improvement.

A new device has been developed that combines fractionated optical energy with a 915-nm diode coupled with a fractionated bipolar RF. This integrated system targets the epidermis and superficial dermis. The RF part synergistically uses less energy to heat the collagen in the deep dermis and stimulate new collagen formation and contraction (Matrix eLaser).

Fractional radiofrequency devices are a safe, tolerable, and effective modality for wrinkles and facial laxity reduction. This device has been associated with significant improvement in acne scarring, texture, and pigmentation. The most common side effects are erythema and edema, which are transient, and patient discomfort does not seem to be a significant disadvantage. You may use a topical anesthetic cream before the treatment to minimize pain.

Your Consultation at MSI For Fractional Radiofrequency Skin Rejuvenation

The First step for successful treatment is to diagnose skin problems; dark spots, red spots, pimples, scars, wrinkles, or skin folds with advanced diagnostic tools such as wood’s Light, polarized Light, video-dermoscopy, dermatoscopy, and Venoscope according to your skin condition.

Wood’s Light is essential to detect skin Pigmentation in photoaging; Polarized Light is used to identify red and dark skin spots. Video Dermatoscopy enlarges hair, nail, and skin abnormalities thousands of times, venoscope to see blood vessels, and dermatoscopy to evaluate moles.

Am I A Good Candidate for Fractional Radiofrequency Skin Rejuvenation?

Most people of both sexes choose to age gracefully. However, in the era of anti-aging medicine, the tendency is to turn back the clock and undergo some rejuvenation to reduce facial wrinkles, lines, and blemishes. The visible signs of facial skin aging include surface irregularities, such as mottled red-brown dyschromia and fine wrinkling, and coarser textural changes, such as sagging and wrinkling facial skin. Furthermore, people who suffer from active acne or its scars can also help.

In this approach, Prof Moawad is trying to give a wake-up call to your skin to remove injured collagen and elastic fibers, encouraging your fibroblast to synthesize new collagen. We can do that with the help of energy-based devices. These procedures target both intrinsic and extrinsic types of aging.

The MSI 3-dimensional rejuvenation approach focuses on three types of rejuvenation corresponding to different skin layers. The goals of type 1 rejuvenation are optimizing epidermal turnover, uniform chromophore distribution, visible lasers, and Light being most suitable. Type 2 rejuvenation is more in-depth, and targets decreased collagen, disorganized glycosaminoglycans and elastin, and superficial rhytids (non-ablative mid-infrared lasers and IPL and fractional radiofrequency) are the most suitable. Rejuvenation type 3 is the most profound and targets deep dermal collagen disorders, skin laxity, and sagging.

Is there any Skin Preparation Before Fractional Radiofrequency Skin Rejuvenation?

Avoiding photoaging is more cost-effective than trying to reverse the sign of photoaging. Sun protection should include an attitude to prevent sun exposure, especially from 10-4 pm. One should wear protective clothing and apply sunblock every 2 hours. Retinoid is the other cost-effective tool; we must prevent photoaging and treat aging. In the fighting age, bleeding, antioxidants, estrogen, cytokines, and growth factors are promising cosmeceuticals.

Those who have active acne will adhere to their anti-acne treatment. Skin preparation may take one month, especially for dark-skinned people. The patient is instructed to use MSI skincare products prescribed at home with or without Dermal Roller to enhance skin penetration of active ingredients to achieve better results.

Is Fractional Radiofrequency Skin Rejuvenation Fractional Painful?

The fractional radiofrequency typically produces some discomfort. Topical anesthetic agents, such as lidocaine and prilocaine cream (EMLA cream), are used for FRF. Some patients prefer a combination of topical and systemic agents.

How Do I Look Like after fractional Radiofrequency Skin Rejuvenation Fractional?

Edema and redness occur during the first 1 to 3 days. Edema is often most severe on the second and third postoperative days and treated with ice packs, head elevation at night, and, if severe, oral corticosteroids. Cold compresses are used, and wet debridement is performed throughout the first week.

Continued 0.25% acetic acid, normal saline, or cold tap water soaks are followed by applying topical antibiotics (Fucidin) ointment. Sun avoidance during post-laser erythema should be stressed to the patient to reduce the risk of post-inflammatory hyperpigmentation. As with most cosmetic procedures, patient expectations are the most critical determinant of patient satisfaction with the outcome.

Compliment Procedures with Fractional Radiofrequency Skin Rejuvenation

Platelet Rich Plasma (PRP) and FT Lasers: PRP has significant amounts of platelet-derived growth factor, transforming growth factor, vascular endothelial growth factor, epidermal growth factor, and fibroblast showed to enhance early healing through the release of growth factors. In a novel approach, Prof Moawad uses PRP combined with fractional radiofrequency to speed the healing time, decrease the overall erythema and swelling, and improve the efficacy of both modalities in skin rejuvenation.

FRF generates microthermal treatment zones (MTZs) in the dermis, which can increase the absorption of PRP when PRP is topically applied. Combination treatment with PRP and fractional radiofrequency improves skin elasticity, a lower erythema index, and increased collagen density. Read more on PRP and Vampire facelift.


Radiofrequency technology is a new and expanding sector of cosmetic dermatology. Radiofrequency technology advances rapidly, providing dermatologists with an expanding array of skin rejuvenation techniques that result in few adverse effects and minimal patient downtime. Radiofrequency treatments allow physicians to augment targeted tissue layers while sparing melanocytes and the cutaneous surface, preventing dyspigmentation and delayed wound healing.

Future developments will continue to enhance the therapeutic index of RF by tailoring treatment to the individual patient, combining RF with other treatment modalities, and exploring and expanding indications for therapy.