Treatment of hypertrophic scars and keloids with a radiofrequency device: a study of collagen effects.
OBJECTIVE
To determine the efficacy and safety of the ThermaCool TC radiofrequency system for treatment of hypertrophic and keloid scars and evaluate treatment associated collagen changes.


METHODS
Six subjects with hypertrophic and four with keloid scars were treated with the ThermaCool device: one-third of the scar received no treatment (control), one-third received one treatment and one-third received two treatments (4-week interval). Scars were graded before and then 12 and 24 weeks after treatment on symptoms, pigmentation, vascularity, pliability, and height. Biopsies were taken from four subjects with hypertrophic scars and evaluated with hematoxylin and eosin (H & E) staining, multiphoton microscopy, and pro-collagen I and III immunohistochemistry.


RESULTS
No adverse treatment effects occurred. Clinical and H & E evaluation revealed no significant differences between control and treatment sites. Differences in collagen morphology were detected in some subjects. Increased collagen production (type III > type I) was observed, appeared to peak between 6 and 10 weeks post-treatment and had not returned to baseline even after 12 weeks.


CONCLUSIONS
Use of the thermage radiofrequency device on hypertrophic scars resulted in collagen fibril morphology and production changes. ThermaCool alone did not achieve clinical hypertrophic scar or keloid improvement. The collagen effects of this device should be evaluated further in order to optimize its therapeutic potential for all indications.
Meshkinpour
Azin
A
Beckman Laser Institute, University of California, Irvine, CA 92612, USA.
Ghasri
Peyman
P
Pope
Karl
K
Lyubovitsky
Julia G
JG
Risteli
Juha
J
Krasieva
Tatiana B
TB
Kelly
Kristen M
KM
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D017439:Cicatrix, Hypertrophic / Q000473:pathology* / Q000601:surgery*; D003094:Collagen / Q000528:radiation effects; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007627:Keloid / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D003094:Collagen