Case Series: Therapeutic Combination of Voluderm Radiofrequency Microneedling and Glycolic Acid Peel in Scaled-Up Concentrations

Abstract Background Glycolic acid (GA) is an α-hydroxy peeling agent, which causes controlled removal of the epidermis, with or without the dermis. Studies have shown the ability of GA to stimulate fibroblast proliferation, induce collagen synthesis, and decrease collagen degradation. The Voluderm radiofrequency microneedling (Pollogen, Israel) utilizes an array of microelectrodes to penetrate the epidermis and deliver energy to the skin. The controlled fractional thermal injury promotes neocollagenesis in correction of skin laxity and wrinkle reduction. It was theorized that GA and Voluderm could synergistically boost collagen production in combined treatment. Objectives Safety and efficacy of the combination treatment was investigated in patients seeking corrections of the age-related skin deteriorations. Methods Seven female patients (age 42-70 years old, Fitzpatrick II-IV) with photo- and chrono-damaged skin received 5 treatments of Voluderm followed by the GA peel at increasing 30-70%concentrations. Results Clinical photography taken 6 months after the treatment demonstrated improvement in elasticity, wrinkling, roughness, pigmentation, erythema, and pore size across the entire treated group. Efficacy quantified by the physician and patients per 1-5 Global Aesthetic Improvement Scale was average 4.3 and 4.5, respectively. The treatments were tolerated well without pre-procedural anesthesia. Skin phenomena observed after GA application were suggestive of the acid passing to deeper layers. Conclusions A novel combination of Voluderm RF microneedling and glycolic acid at increased concentrations provided safe and effective synergy in the treatment of aging facial skin. Visible results demonstrated skin tightening, reduction of rhytidids, and improvement of the skin texture which may be a result of the combination.