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A Pilot Study

Brian D. Zelickson, MD; David Kist, BA; Eric Bernstein, MD; Douglas B. Brown, PhD; Sergey Ksenzenko, PhD; Jay Burns, MD; Suzanne Kilmer, MD; David Mehregan, MD; Karl Pope, MS

Arch Dermatol. 2004;140:204-209.

Background  Many light- and laser-based systems are used to reduce cutaneous wrinkles, and some have been shown to stimulate dermal collagen production. Using the ThermaCool TC radiofrequency device to treat bovine tendon and human abdominal skin, we documented the cutaneous effects of a radiofrequency-based system for nonablative treatment.

Observations  Electron microscopy of bovine tendon treated at varied heat and cooling settings revealed collagen fibrils with increased diameter and loss of distinct borders as deep as 6 mm. Human skin treated at varied heat and cooling settings and examined by means of routine light microscopy demonstrated no significant changes in the epidermis or dermal ground substance immediately after treatment; there was scattered mild perivascular and periadnexal inflammation. Three and 8 weeks after treatment, no observable changes were noted. Ultrastructural analysis, however, disclosed isolated, scattered areas of collagen fibrils with increased diameter and loss of distinct borders. In addition, Northern blot analysis demonstrated an increase in collagen type I messenger RNA steady-state expression.

Conclusions  Our findings suggest that collagen fibril contraction occurs immediately after treatment and gives rise to tissue contraction and thermally mediated wounding, which induces new collagen production.

From the Department of Dermatology, University of Minnesota (Dr Zelickson), and the Cutaneous Electron Microscopy Laboratory, University of Minnesota Medical School (Mr Kist), Department of Dermatology, Minneapolis; University of Pennsylvania, Philadelphia (Dr Bernstein); the DAKDAK Photoaging Technologies Division, Charles River Laboratories, Elkins Park, Pa (Drs Brown and Ksenzenko); Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas (Dr Burns); Laser & Skin Surgery Center of Northern California, Sacramento (Dr Kilmer); the Pinkus Dermatopathology Laboratories, Monroe, Mich (Dr Mehregan); and Thermage, Inc, Hayward, Calif (Mr Pope). Dr Burns has served on the medical advisery board of and received funding for research from Thermage, Inc.

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