Using high-intensity focused ultrasound in conjunction with monopolar radiofrequency yielded greater skin tightening and wrinkle reduction than either modality alone, according to new data.

High-intensity focused ultrasound (HIFU) and monopolar radiofrequency (RF) are both popular as non-invasive skin-tightening and wrinkle reduction therapies that are used separately and together, but data on their effectiveness in combination are limited. Eunsoo Park, MD, of Soonchunhyang University Bucheon Hospital, South Korea, and colleagues, conducted a study looking at the combination and presented the results at the American Society for Laser Medicine and Surgery (ASLMS) 43^rd Annual Conference on Energy-based Medicine and Science in Baltimore.

The researchers reviewed data from individuals randomized to treatment for wrinkles using HIFU or HIFU plus monopolar thermal RF between August 2021 and August 2023. Efficacy was assessed using an automatic skin diagnosis system, with clinical photos assessed by a blinded clinician.

The mean wrinkle score in the combination group decreased from 17 to 15 in the HIFU monotherapy group and from 18 to 14 in the combination group, a significant difference (P < 0.01). As assessed by the clinician, “effective” results occurred in 80.0% of the HIFU monotherapy group and 87.5% of the combination group. The combination group exhibited a tendency for higher efficacy, but this difference was not statistically significant, the researchers noted.

The researchers also assessed patient satisfaction on a scale of 1 to 10 at the end of the follow-up period. Satisfaction was significantly higher in the combination group versus the HIFU monotherapy group (7.62 vs. 6.70, P = 0.0335).

The HIFU therapy included 4-MHz, 4.5 mm depth transducers applied at 0.7 J/mm² on each side, with 80-90 shots, and 7-MHz, 3.0 mm depth transducers applied at 0.4 J/mm² on each side, with 30-70 shots. The combination group underwent RF first, with an intensity of 3.0-2.5 J/mm² and 200-300 shots applied to the entire face, followed by the HIFU procedure using 4-MHz, 4.5 mm depth transducers at 0.7 J/mm² on each side, with 50-70 shots, and 7-MHz, 3.0 mm depth transducers applied at 0.4 J/mm² on each side, with 40-60 shots. Adverse effects included swelling and erythema, and were mild and self-limiting in both groups, the researchers said.

The findings were limited by the relatively small sample size, but the results suggest that simultaneous HIFU and RF yield more effective skin tightening, they concluded.

Source: Park E, et al. COMPARATIVE CLINICAL STUDY ON THE SKIN TIGHTENING EFFICACY OF HIGH INTENSITY FOCUSED ULTRASOUND ALONE OR IN COMBINATION WITH MONOPOLAR RADIOFREQUENCY TREATMENT. Presented at: American Society for Laser Medicine and Surgery 43^rd Annual Conference on Energy-based Medicine and Science. April 11-14, 2024; Baltimore.