Table 1.
Summary of studies using RF for hair removal
| Hair removal | ||||||||
|---|---|---|---|---|---|---|---|---|
| Source | Type of study (evidence level) | Target | System/settings | RF modality | Adjunct | Patients | Treatment plan | Results/findings |
| Yaghmai et al. (2004) | Prospective multicenter study (II) | Facial/body hair | IPL + RF system Aurora DS (Syneron Medical Ltd., Yokneam, Israel) RF: 1 MHz, 10–20 J/cm3, 200 ms pulse Optical energy: 680–980 nm, 14–30 J/cm2, 25 ms pulse |
Bipolar | IPL | 60 F, 9 (age range: 18–64 year/o) Skin type: I–VI |
IPL + RF: 1 tx | 90 days post-tx Average hair count reduction from baseline: 46% AEs: transient hyperpigmentation, hypopigmentation, erythema, perifollicular edema, crusting |
| Garden et al. (2020) | Prospective multicenter study (II) | Facial/body hair | Combined IPL and RF me system (Syneron Medical Ltd., Yokneam, Israel) RF: 6.78 MHz, 2 W, 2 s pulse Optical energy: 550–100 nm, 2–4 J/cm2, 6 ms pulse |
Bipolar | IPL | Study 1:50 F and 8 M (age range: 18–58) Study 2:19 F (age range: 20–59) Skin type: I–VI |
Study 1 (body hair): IPL+ RF (7 weekly tx) → non-maintenance versus maintenance (monthly tx for 6–12 month) Study 2 (facial hair): IPL + RF (4 tx over 2–5 days → 2 weekly tx → 6 biweekly tx) |
Study 1 Mean hair reduction, 6 month post-tx Maintenance: 56% Non-maintenance: 47% Mean hair reduction, 12 month post-tx Maintenance: 52% Non-maintenance: 37% Study 2 Mean hair reduction Post-tx: 45% 12 month post-tx: 42% AEs: mild pain, transient erythema |
| Erkiert-Polguj et al. (2021) | Prospective single-center study (II) | Axillary hair | IPL + RF system (Mimari, Poland) Optical energy: 420–630 nm, 7 mm depth, 28 J/cm2−34 J/cm2, 2× passes RF: 7 mm depth |
Bipolar | IPL | 33 F with dark hair (age range: 21–47) Skin type: II–III | IPL (one axilla) (4 total tx, 4 week intervals) IPL + RF (other axilla) (4 total tx, 4 week intervals) |
3 month post-tx Mean hair reduction IPL: 33.4% IPL + RF: 38.82% AEs: mild burning and stinging sensation during tx |
| Sadick et al. (2004) | Prospective single-center study (II) | Facial hair | IPL + RF system RF: 20 J/cm3, up to 120 ms pulse, 4 mm depth Optical energy: 680–980 nm, 24–30 J/cm2, short pulse profile mode |
Bipolar | IPL | 36 F with white and blonde facial hair (age range: 38–83 year/o) Skin type: I–V | IPL + RF (4 total tx over 9–12-mo period) | 6 month post-tx Average hair clearance of 48% Slightly increased clearance rate for blonde hair (52%) versus white hair (44%) AEs: transient hyperpigmentation and mild persistent erythema |
| Sadick et al. (2004) | Prospective single-center study (II) | Facial/body hair | IPL + RF system Aurora DS (Syneron Medical, Yokneam, Israel) RF: 10–20 J/cm3, up to 120 ms pulse, 4 mm depth Optical energy: 680–980 nm, 15–26 J/cm2, up to 120 ms pulse |
Bipolar | IPL | 40 adults (age range: 18–46 year/o) Skin type: II–V |
IPL + RF (4 total tx over 9–12-mo period, at 8–12-wk intervals) | 6 month post-tx Average hair clearance of 75% observed in all body locations. No significant dependence on skin type AEs: transient erythema |
| Sochor et al. (2011) | Randomized controlled trial (I) | Leg hair | IPL + RF system Aurora DS (Syneron Medical Ltd., Yokneam, Israel) RF: 1 MHz, 5–20 J/cm3 Optical energy: 680–980 nm, 30 J/cm2 Diode Laser MeDioStar XT (Asclepion, Germany) 810 nm, 32 J/cm2 pulse |
Bipolar | IPL | 40 F with varying hair color (age range: 20–53 year/o) Skin type: II–III |
IPL (2 total tx, 4–6-wk intervals) versus IPL + RF (2 total tx, 4–6-wk intervals) versus diode laser (2 total tx, 4–6-wk intervals) | 8 month post-tx Mean hair count reduction IPL: 39.16% IPL + RF:47.15% Diode laser: 49.90% IPL + RF and Diode both > IPL alone IPL + RF comparable to diode lasers AEs: Tx-associated pain, mild erythema, perifollicular edema, and transient hyperpigmentation |
| Garden et al. (2014) | Prospective multicenter study (II) | Facial/body hair | Combined IPL and RF device Bipolar me system (Syneron Medical Ltd., Yokneam, Israel) RF: 6.78 MHz, 2 W, 6 ms pulse Optical: 550–1200 nm, 2–4 J/ cm2 |
Bipolar | IPL | 89 F, 9 M with brown/ black hair (age range: 23–60 year/o) Skin type: I–VI |
IPL + RF Study 1 (n = 94) 7 total tx, at 1-wk intervals followed by 3 additional tx at 4-wk intervals (maintenance side) versus zero additional tx (no maintenance side) Study 2 (n = 37) 3 total tx at 2–4-d intervals |
Study 1 1 month post-tx 55% reduction in hair count bilaterally 3 month post-tx maintenance = 58% reduction no maintenance = 43% reduction Study 2 2 month post-tx 44% hair reduction AEs: transient erythema, edema, itching. One subject with blistering in axilla |
| Schroeter et al. (2006) | Prospective single-center study (II) | Not specificed | IPL + RF system Aurora DS Bipolar (Syneron Medical Ltd., Yokneam Israel) Mean energy used per patient RF: 18.6 J/cm3 IPL: 23.2 J/cm2 |
Bipolar | IPL | 17 F with blond hair (age range: 45–66 year/o) Skin type: I–II |
IPL + RF 4–12 total tx, 30–798-day duration |
Mean of 8.45 tx 54.7% mean hair reduction Correlation found between hair removal and the number of tx (Pearson correlation coefficient: −0.15) No serious AEs observed |
| Goldberg et al. (2005) | Prospective single-center study (II) | Facial hair | IPL + RF system Aurora DS Bipolar (Syneron Medical Ltd., Yokneam Israel) RF: 20 J/cm3, 4 mm depth Optical energy: 680–950 nm, 24–30 J/cm2, short pulse profile mode |
Bipolar | IPL, 5-ALA | 15 F with non-pigmented facial hair (age range: 45–65 year/o) Skin type: II–IV |
IPL + RF (2 total tx, 4–6 week intervals) + Topical aminolevulinic acid versus IPL + RF (2 total tx, 4–6 week intervals) |
6 month post-tx Mean terminal white hair removal ILP + RF: 35% ILP + RF + topical ALA: 48% 0/5 patients with vellus hair responded to tx AEs: transient post-tx erythema |
| Karsai et al. (2009) | Retrospective study (II) | Facial hair | IPL + RF system Aurora DS Bipolar (Syneron Medical Ltd., Yokneam, Israel) RF: 1 MHz, 20 J/cm3 Optical energy: 680–980 nm, 30 J/cm2 Mean fluence used per patient IPL: 23.7 J/cm2 RF: 17.6 J/cm3 |
Bipolar | IPL | 24 F (age range: 12–76 year/o) Skin type: II–II |
IPL + RF (3 total tx at 4–6 week intervals followed by additional tx at 3-mo intervals) | Mean of 5.2 treatments 3.2 month mean follow-up: no/poor clearance: 22.2% moderate: 28.9% good: 46.7% excellent: 2.2% AEs: erythema, swelling, and hyperpigmentation |
| Farshi et al. (2012) | Double-blind, randomized, placebo-controlled study (I) | Facial hair | IPL + RF Aurora/ELOS system Bipolar (Syneron Medical Ltd., Yokneam, Israel) RF: 18–25 J/cm3 Optical energy: 18–26 J/cm2 |
Bipolar | IPL, finasteride | 75 F with facial hirsutism (age range: 21–52 year/o) Skin type: III–IV |
IPL + RF (3 total tx at 4-wk intervals, additional 1tx at 6 month f/u) + finasteride (2×/daily) versus IPL + RF (3tx q4wk, 1 tx at 6 month F/U) + placebo (2×/daily) | 6 month post-tx mean hair density (IPL + RF) + finasteride: 19.7 → 8 5(IPL + RF) + placebo: 19.1 → 9 Finasteride treatment with IPL + RF is significantly more effective than monotherapy AEs: mild discomfort and transient erythema |
| Salour et al. (2011) | Double-blind, randomized clinical trial (I) | Trichiasis | RF Ellman Surgitron (Cynosure Monopolar LLC., Westford, MA, USA) RF: 4-MHz, (power = 2), 2–3 mm depth, cut-coag mode Green argon laser continuous mode 930-nm argon coherent device, 50-µm diameter, 760-mW |
Monopolar | none | 56 F, 44 M with trichiasis (age range: 14–98 year/o) | Single tx RF (n = 48) versus argon laser (n = 52) |
3 month post-tx Treatment success 82.4% RF group 62.9% in laser group Recurrence 17.6% RF group 37.1% laser group RF is significantly more effective than argon laser therapy for treating trichiasis AEs: notching observed in 4 patients (3 RF, 1 argon laser) |
| Kim et al. (2014) | Prospective single-center study (II) | Trichiasis | Ellman Surgitron (RF) (Cynosure LLC., Westford, MA, USA) 3.8-MHz, 2–3 mm depth, cut and coag mode, power = 3 | Monopolar | Mitomycin C |
14 F, 7 M with trichiasis (age range: 40–76 year/o) | Single tx Group 1 (9 F, 5 M) RF ablation + injection of 0.02% mitomycin C Group 2 (5 F, 2 M) RF ablation (monotherapy) |
6 month post-tx Recurrence 16.4% RF + mitomycin C 60.7% RF (monotherapy) 0.02% mitomycin C in conjunction with RF ablation significantly improves success rate of RF ablation treatment in trichiasis patients AEs: eyelid notching reported in two patients in group 2 |
| Kezirian et al. (1993) | Prospective single-center study (II) | Trichiasis | Ellman Surgitron FFPF (Cynosure LLC., Westford, MA, USA) 3.8-MHz, power: 2.5, 2–3 mm deep |
Monopolar | None | 16 F, 10 M with trichiasis (age range: 67–90 year/o) | Single RF tx | 6 month post-tx success rate: 67% AEs: eyelid notching (n = 2), granuloma (n = 1), and persistent erythema and tenderness post 1 month (n = 1) |
| Mehta et al. (2022) | Case report (IV) | Axillary hair | maXium (KLS Martin Group, Freiburg, Germany) RF: 5–10 W, applied to 0.25-mm acupuncture needles |
Monopolar | None | 1 patient with hidradenitis suppurativa | Single RF tx of axillary hair | Hair density decreased from 23/cm2 to 4/ cm2 (83% reduction) Hidradenitis suppurativa lesions healed a month after procedure but recurred 4 months later AEs: mild hyperpigmentation |