title: Enhanced full-face skin rejuvenation using synchronous intense pulsed optical and conducted bipolar radiofrequency energy (ELOS): introducing selective radiophotothermolysis.
abstract: BACKGROUND
  The authors previously reported their experience achieving non-ablative skin enhancement with serial, full-face, intense pulsed light treatments in a large series of patients. A new method for skin renewal electro-optical synergy (ELOS), which combines intense pulsed optical energy and conducted bipolar radiofrequency (RF) energy into a single pulse, has been recently introduced. Intense pulsed optical energy and bipolar RF energy have been used in dermatologic surgery for many years; however, this study represents the therapeutic impact of the combined energies.
  
  
  OBJECTIVE
  The authors report their experience using an ELOS system (Aurora SR, Syneron, Yokneam, Israel) on 108 consecutive patients treated with a series of full-face procedures.
  
  
  METHODS
  Patients received 5 full-face treatments every 3 weeks. Each treatment consisted of 1 to 8 full-face and segmental passes. The number of passes, specific wavelength of pulsed optical energy, and RF energy were determined by the patient's skin type, dyschromia, wrinkle pathology, and presence of a tan. A total of 540 treatments were performed on 108 subjects. All patients had pre- and post-procedural photographs. Results were assessed by double-blinded physician photographic evaluation and patient satisfaction scales.
  
  
  RESULTS
  Overall skin improvement was rated at 75.3%. Overall average wrinkle improvement was 41.2%, with an average Class 1 wrinkle improvement of 64.7%, Class 2 wrinkle improvement of 38.6%, and Class 3 wrinkle improvement of 20.4%. Improvement in skin laxity was rated at 62.9%. Skin texture was reported to improve 74.1%. Improvement in the appearance of pore size was rated at 65.1%. Average improvement in erythema and telangiectasia was 68.4%. Average improvement in hyperpigmentation and dyschromia was 79.3%. Overall patient satisfaction was 92%. The overall minor complication rate, including blistering, crusting, and stripping was 8.3%, and the major complication rate was less than 1%. One small, depressed nasal scar was observed in one patient.
  
  
  CONCLUSIONS
  This study demonstrates the safety and efficacy of a new technology using combined optical and conducted bipolar RF energies for noninvasive skin rejuvenation. The results show improvement in wrinkle reduction and amelioration of erythema, telangiectasia, and hyperpigmentation comparable to that reported for other intense pulsed light technologies.
authors.affiliation: Weill Medical College of Cornell University, NY, USA. nssderm@sadickdermatology.com
authors.forename: Neil S
authors.initials: NS
authors.lastname: Sadick
authors.forename: Macrene
authors.initials: M
authors.lastname: Alexiades-Armenakas
authors.forename: Patrick
authors.initials: P
authors.lastname: Bitter
authors.forename: George
authors.initials: G
authors.lastname: Hruza
authors.forename: R Stephen
authors.initials: RS
authors.lastname: Mulholland
mesh_terms: D000328:Adult; D000368:Aged; D005145:Face; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010789:Phototherapy / Q000379:methods*; D000078702:Radiofrequency Therapy; D012060:Rejuvenation; D015595:Skin Aging / Q000528:radiation effects*