# Radiofrequency Microneedling With 1927 nm Thulium Laser Versus Radiofrequency Microneedling Monotherapy for Rejuvenation of Photoaged Skin

## TL;DR

This study compares the effectiveness of combining radiofrequency microneedling with a thulium laser versus using radiofrequency microneedling alone for improving aged skin on the lower face and neck.

## Contribution

The study introduces a novel combination treatment of RFMN and 1927 nm Tm laser for photoaged skin rejuvenation.

## Key findings

- Both treatments reduced submental volume, but only the combination improved hyperpigmented lesions.
- The combination group showed greater improvements in skin tone and overall appearance.
- No serious adverse events were reported with either treatment.

## Abstract

The combination of radiofrequency microneedling (RFMN) with fractional 1927 nm thulium (Tm) laser has gained popularity in clinical practice. However, comparative studies remain limited.

To evaluate the efficacy and safety of combined RFMN/Tm laser treatment versus RFMN alone for rejuvenation of photoaged skin of the lower face and neck area.

A prospective, evaluator‐blinded, clinical study. Patients were assigned to a combined protocol consisting of 1–3 RFMN treatment sessions immediately followed by Tm laser, supplemented by three additional Tm laser sessions at 6–8‐week intervals. Study endpoints were compared with data from our previously published RFMN monotherapy cohort. Outcomes were assessed using validated clinical grading scales, computer‐assisted analysis of submental volume, and a standardized color space system to quantify skin tone evening. Pain was assessed using a numeric rating scale. Adverse events (AEs) were monitored throughout the study period.

26 received the combined treatment, and 27 patients were treated with RFMN alone. Mean ages were 50.7 ± 7.4 and 55.6 ± 8.9 years, respectively. Both groups showed significant reductions in submental volume without significant differences between them. However, only the combination group demonstrated a distinct improvement in hyperpigmented lesions, as quantified by the color analysis. Blinded evaluations noted improvements in the melomental area, jawline, and neck in both groups, while greater improvements in skin tone evening and therefore overall appearance were seen only in the combination group. No serious AEs were reported.

Both treatment modalities effectively addressed lower facial and neck laxity. The addition of Tm laser to RFMN provided additional benefits in treating pigmentary irregularities and improving overall clinical outcome without notably compromising downtime. Larger studies are warranted to validate these findings and assess long‐term outcomes.

This study was preregistered in clinicaltrials.gov (NCT06029725) on 23 August 2023