Radiofrequency for skin tightening – Does it work? | Ask Doctor Anne

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I have been on a skincare device kick lately, so after looking at the data behind LED Light Therapy and the data on Microcurrent, let’s discuss Radiofrequency, which is used in devices aiming to tighten sagging skin. (More info: LED Masks for skin rejuvenation and The science behind microcurrent devices like the NuFace)

 

Radiofrequency for skin tightening
Can a radio frequency device like this really lift your skin?

 

What is radiofrequency, what does it claim to do, what are the benefits, what are potential side effects you need to be aware of and, most importantly, are they worth your hard earned money?

Let’s talk!

 

 

What is Radiofrequency?

According to Wikipedia, Radiofrequency is the oscillation rate of an alternating electric current or voltage or of a magnetic, electric or electromagnetic field or mechanical system in the frequency range from around 20kHz to around 300 GHz. That means the frequencies sit above audio frequency and below infrared frequency and yes, just like the name would suggest, some of the energy created from radiofrequency currents can be used as electromagnetic or radio waves.
Said easy, radiofrequency in skincare are waves that are created by electrical current and emitted into the tissue. And yes, that sounds similar to LED Light Therapy, ultrasound or lasers, the difference is the frequency of the waves created. Different frequency means different effects.

 

What does radiofrequency do to your face?

When radiofrequency goes into the skin, it creates heat in the tissue. The amount of heat depends on the depth and the tissues impedance. Fat for example heat up much easier and quicker than the surrounding tissues.
The heating up of the tissue has two main mechanisms in which it alters the skin.

First it works on collagen fibers by breaking up the hydrogen bonds in the collagen triple helix, which leads to the fibers shortening and thickening, a process called collagen contraction that has an immediate tightening effect on the area treated.

The collagen damage set also initiates a wound healing response, which means new blood vessels, new collagen and new elastin are produced over the following period of time, giving you a delayed long-term effect.

The amount of collagen contraction and wound healing response depends on the temperature in the tissue and the amount of time the tissue stays at that temperature, so for the same effect you either need a lower temperature for a long period of time or a high temperature for a short period of time. A temperature too high can lead to collagen ablation, meaning the collagen is destroyed beyond repair – definitely not what we want.

Depending on the device used, radiofrequency can also cause fat loss – remember: fat creates more heat than the surrounding tissue, so the temperatures in fat are higher quicker, which can lead to the fat cells dying off. Depending on where you use it, that can be what you want or an undesirable effect – the fat in your cheeks for example is some you want to keep.

 

Are there studies on radiofrequency for skin tightening?

There are studies done on radiofrequency (Sources are listed below), but just like it is with LED and microcurrent, that doesn’t mean there is hard evidence for or against its effects. Most of the studies are low in methodological quality and level of evidence and they also use different devices, settings and protocols, which makes it difficult to compare their results for a concise conclusion and so far does not allow telling which parameters are ideal to achieve the best results at the lowest risk of adverse effects.

Most studies were done on women and the effects shown were either on the upper third of the face, where they showed subtle brow lifting that was statistically significant, but barely noticeable to the patients themselves, or on the lower part of the face including the neck, where moderate laxity could be, again subtly, improved.

The effect on wrinkle depth was also measured, but the results in the different studies were very inconcise here, so at this point in time I wouldn’t be able to say if there was or wasn’t an effect.

In general the effect seems to be better, the younger a person is, which might be explained with the lack of collagen that can be targeted in older skin and overall seem to be subtle, but still lead to consumer satisfaction and – this again something I seem to repeat in every vpost on such a topic – more research is needed to get a better idea of ideal settings, candidates and effects that can be expected.

 

Potential side effects of radiofrequency

What the studies are all showing though is that the risk of side effects when used by a professional or used at home following the manufacturer instructions, is very low. The most common side effects were swelling and redness that subsided quickly, burns on the skin when used too often or too long on the same area and fat loss in the treatment area.

So when you ask “Does radiofrequency damage the skin?”, the answer is:

It depends.

When used correctly, it should not damage the epidermis, the upper layers of the skin, but it should do some damage to the dermis to trigger the wound healing effect and to stimulate collagen production. When NOT used correctly, it is entirely possible to burn your face, which is not the effect you are going for. I assume.

As the heat created through radiofrequency is lower than it is when using lasers and there isn’t as much of a wound, it seems to be a potential alternative for those that aren’t a good candidate for laser due to hyperpigmentation or melasma, but if I would suffer with either, I would probably get a consultation with an experienced practitioner before I underwent radiofrequency therapy in office and would probably not experiment with at home devices. (More info: Different types of hyperpigmentation and their treatment)

 

Radiofrequency and fat loss

Now I quickly touched on fat loss through radiofrequency before: Fat heats up quicker and easier, meaning you are able to reach temperatures that destroy the fat cells quicker than you can reach similar temperatures in the surrounding tissue.

In a small study done in 2017, 90% of women experienced fat loss and face slimming in the treatment area in the following 5 weeks. While fat loss in the jowls or under the chin, when paired with skin tightening, might be a desired effect, it usually isn’t in the cheek area, where fat loss is perceived as a sign of aging.

At home devices operate at lower temperatures than in office ones and should keep the heat below the fat blizzing cut off, but as most of the ones I have seen do not measure the actual temperature reached in the tissue and it also depends on your facial structures, it is probably wiser to use the lower setting in the areas where you definitely do not want to risk losing plumpness.

On the other hand, this effect is often utilized when radiofrequency is combined with other interventions like liposuction.

 

Can I use radiofrequency every day/ How often should you do radiofrequency on the face?

The exact amount of time you need to do a radiofrequency treatment depends on the device you are using. While in office treatments are done once with several weeks in between, the at home devices usually recommend using it 2-3 times a week for optimal results. What you need to be aware of though is that the mechanism here is that you trigger the wound healing process in the skin – in order to get results, you need to give the body time to heal. If you use your device 24/7, it doesn’t really stand a chance of doing that!

 

How long does radiofrequency skin tightening last?

The results you are getting are twofold: You have both immediate results, the visible manifestation of the collagen contraction we talked about earlier that leads to immediate lifting, and the collagen stimulation that happens in the following weeks and months and that firms and lifts the skin over time.
If you have a treatment done in office, you can expect to see improvement in the following 3-6 months. Nothing is permanent though, as the natural aging process and collagen destruction through UV radiation, pollution and other lifestyle factors do continue. It is more of a step back before you continue your journey than a permanent roadblock.

 

Who is the best candidate for radiofrequency therapy?

Just like it is with any other skincare device, it should only ever be considered in addition to a good skincare routine with proper sunscreen use, as this routine is much more cost-effective and easier to implement.
According to the data we have, the results are best in middle-aged people with light to moderate skin laxity, but even there the effects are usually described as subtle. A possible explanation for that is that the older we get, the more collagen is already gone and can’t be targeted for the collagen contraction and consecutive healing process introduced, so the already subtle results are even less noticeable.

This might also be an explanation as to why severely sun damaged skin reacts less well to the treatment – collagen that is destroyed can’t be targeted.

You are not a suitable candidate for radiofrequency if you have a pacemaker or any other implantable cardiac device and you should proceed with caution and always speak to your doctor if you suffer from a condition that affects the healing properties or the temperature sensitivity of your skin like diabetes, multiple sclerosis or similar.

There is no data on the use of radiofrequency in pregnancy or breastfeeding, so it is not recommended during this time. (More info: Which skincare is safe to use in pregnancy?)

 

Are radiofrequency devices for at home use worth your money?

If buying an at home device is right for you depends on different factors:

  • Do you belong into the category of middle aged people with moderate skin laxity that are most likely to see results?
  • Do you have a good routine, especially regarding sun protection, in place already?
  • Are you willing to invest the time of repeatedly using the device 2-3 times a week for between 5 and 15 minutes?
  • Are you okay with getting subtle results for that effort?

If the answer to one or more of them is no, it is probably better to explore other options first.

 

Sources

Cosmetic NONINVASIVE AND MINIMALLY INVASIVE SKIN TIGHTENING. (2020). https://doi.org/10.1097/GOX.0000000000002861

Bonjorno, A. R., Gomes, T. B., Pereira, M. C., de Carvalho, C. M., Gabardo, M. C. L., Kaizer, M. R., & Zielak, J. C. (2020). Radiofrequency therapy in esthetic dermatology: A review of clinical evidences. Journal of Cosmetic Dermatology, 19(2), 278–281. https://doi.org/10.1111/jocd.13206

de Araújo, A. R., Soares, V. P. C., da Silva, F. S., & Moreira, T. da S. (2015). Radiofrequency for the treatment of skin laxity: Mith or truth. Anais Brasileiros de Dermatologia, 90(5), 707–721. https://doi.org/10.1590/abd1806-4841.20153605

Han, S. H., Yoon, Y. M., Lee, Y. W., Choe, Y. B., & Ahn, K. J. (2018). Usefulness of Monopolar Thermal Radiofrequency Treatment for Periorbital Wrinkles. Annals of Dermatology, 30(3), 296. https://doi.org/10.5021/AD.2018.30.3.296

Zhou, S., Schmelz, A., Seufferlein, T., Li, Y., Zhao, J., & Bachem, M. G. (2004). Molecular mechanisms of low intensity pulsed ultrasound in human skin fibroblasts. Journal of Biological Chemistry, 279(52), 54463–54469. https://doi.org/10.1074/JBC.M404786200

 

 

Can radio frequency devices really lift and tighten your skin
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Should you consider getting one, here are a few options I have found (I am currently testing the Medicube Ussera Age-R Deep Shot, review will follow)

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