Safety and Efficacy of a Hybrid Sequential Monopolar/Bipolar Pulsed Radiofrequency Device for Facial Rejuvenation in Skin Types III and IV: A Case Series

Non-ablative radiofrequency (RF) treatments have emerged as a popular modality for skin tightening, offering effective results with minimal downtime. This case series evaluates the clinical outcomes of a novel high-frequency (6.78 MHz) hybrid RF system that combines monopolar and bipolar energy with active cooling, in five patients with Fitzpatrick skin Types III and IV. Treatments targeted facial zones, including the midface, lower face and perioral regions. All patients tolerated the treatment well, reporting low pain scores (VAS 2–3/10), with no pigmentary changes, scarring or other adverse events. Objective wrinkle reduction was observed in three patients, ranging from 16.6% to 45.1%. Active contact cooling maintained epidermal temperatures below 42°C, reducing pain and preventing thermal injury. All patients reported good-to-excellent satisfaction with the outcomes. These findings are consistent with the literature supporting the safety and efficacy of RF in darker skin types and emphasise the protective role of active cooling in minimising thermal injury. This case series demonstrates the safety, effectiveness and comfort of hybrid RF with integrated active cooling for non-invasive facial rejuvenation in patients with skin of colour.