A Novel Variable-Pulse Monopolar RF Mode Selectively Targets the Upper Dermis to Improve Barrier Dysfunction in Sensitive Skin

초록

Background: Sensitive skin is a multifactorial condition characterized by impaired epidermal barrier function, neurosensory hyperreactivity, and inflammatory dysregulation, affecting approximately 40%–50% of adults worldwide. Despite its high prevalence, effective therapeutic options remain limited. Objective: To evaluate the efficacy and safety of a novel 6.78 MHz monopolar radiofrequency (RF) pulse pattern for improving both subjective symptoms and objective barrier function parameters in patients with sensitive skin. Methods: In this prospective pilot study, ten adults with sensitive skin underwent 2 sessions of shallow mode monopolar RF treatment at 4-week intervals. Assessments were performed at baseline, week 4, and week 8, including transepidermal water loss (TEWL), stratum corneum hydration (SCH), erythema index (EI), sebum production, melanin index (MI), and patient-reported symptom scores. Safety was assessed throughout the study. In parallel, a murine model was treated using identical shallow mode parameters to evaluate epidermal remodeling, collagen regeneration, and barrier-related molecular markers. Results: All participants completed the study without serious adverse events. TEWL significantly decreased at weeks 4 and 8 compared with baseline (p<0.001), while SCH, EI, and sebum levels showed significant improvement. Patient-reported symptom scores decreased from 65.57±5.49 at baseline to 41.91±4.66 at week 4, representing a 36.1% reduction (p<0.001). Only mild, transient erythema was observed. Preclinical analysis demonstrated epidermal thickening, enhanced collagen remodeling, and upregulation of barrier-related markers. Conclusion: Shallow-mode monopolar RF treatment improved subjective symptoms and objective barrier-related parameters in sensitive skin with excellent tolerability, supported by preclinical findings of upper-dermal remodeling.

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