Objective::Facial acne and scars not only cause cosmetic issues,but also cause mental problems, so we conducted this study to investigate the quality of life of patients with acne vulgaris of various degrees of severity, in order to provide evidence for establishing effective clinical treatment strategies.Methods::We used a self-made questionnaire to assess the demographics, symptoms, and physical signs of patients with acne vulgaris, as well as the acne severity, treatment efficacy, impact of acne on mental health, and effect of acne on daily life. The severity of acne was classified into 4 grades based on the latest acne grading guideline. The chi-squared test and Fisher's exact test were used for categorical data, and Spearman’s correlation was used for ordinal variables.Results::Of the 94 patients who responded to the questionnaire, the responses of 9 patients were excluded because of incomplete data. As the acne severity grading increased and the self-assessed appearance rating decreased, the impacts on daily life, social activity, and mental health increased. There was a weak correlation between the acne severity grading and self-assessed appearance rating ( P = 0.020, rs = ?0.253). The impact of acne severity on the quality of life was mainly reflected as influences on personal reputation ( P = 0.016) and recreation and leisure activities ( P = 0.042); the self-assessed appearance mainly affected the patients’ professional careers ( P = 0.010). The severity of acne ( P = 0.005) and the effects of acne on attention ( P = 0.010) and intimacy ( P = 0.024) varied by sex. Females were less tolerant of appearance blemishes, while males were more troubled by the physical discomforts caused by acne. Conclusion::The impact of facial acne on quality of life is related to the acne severity grading, patients’ self-assessed appearance rating, and sex. In clinical practice, therapeutic regimes should be formulated in accordance with the different needs of each patient.

To explore the efficacy and safety of fractional micro-needling radiofrequency (FMRF) in the treatment of enlarged pores on the cheek in a Chinese cohort. Patients with enlarged facial pores who underwent FMRF between January 2020 and December 2022 were included in this study. Blinded clinical assessments were performed by two independent dermatologists using a six-grade photographic enlarged pore scale and a quartile grading scale. Patients were asked to rate the degree of pain related to treatment on a visual analog scale (VAS), with scores ranging from 0 (no pain) to 10 (worst pain ever). A paired t-test was used to analyze the six-grade photographic enlarged pore scores. A total of 22 patients received three consecutive sessions of FMRF treatment, with intervals of 1–3 months, and underwent follow-up as scheduled. The mean six-grade photographic enlarged score was 3.55 ± 0.96 at baseline, while the score decreased significantly to 2.59 ± 0.59 after three treatment sessions (P < 0.05). The improvement score of the patients, assessed by two independent dermatologists, was 2.31 ± 0.71, according to the quartile grading scale. The mean VAS score was 6.42 ± 1.44. FMRF is effective and safe for the treatment of enlarged facial pores after three sessions.

PURPOSE:This split-face randomized study compared the efficacy and safety between 1064-nm picosecond laser with fractionated microlens array (MLA) and 1565-nm nonablative fractional laser to treat enlarged pores. METHODS:Participants with enlarged facial pores were enrolled and underwent three consecutive sessions at 2-week intervals with either a 1064-nm picosecond laser with MLA or a 1565-nm nonablative fractional laser. Images were captured at each visit. Objective (pore number) and subjective assessments, including patient self-evaluations and quartile improvement scales, were used to evaluate the treatment efficacy. The pain levels and adverse effects were recorded at each subsequent visit. RESULTS:The participants were 3 men and 22 women with enlarged facial pores. At the initial and 2-month checkups after the last treatment, the pore numbers were significantly decreased bilaterally for both lasers. The respective quartile improvement scale scores for the 1064-nm picosecond and 1565-nm fractional lasers were 2.22 ± 1.06 and 2.14 ± 1.11, while those for patient self-assessment were 3.72 ± 0.74 and 3.68 ± 0.75. The pore number, quartile improvement scale score, and patients' self-assessments did not differ significantly between the two lasers. Treatment with the 1064-nm picosecond laser better reduced pain compared with the 1565-nm nonablative fractional laser (4.11 ± 1.33 vs. 4.83 ± 1.17). The occurrence of pigmentation did not differ significantly between the lasers. CONCLUSION:Both the 1064-nm picosecond laser with MLA and the 1565-nm nonablative fractional laser are viable options for treating enlarged pores, and showed comparable respective efficacies; however, the former was less likely to cause hyperpigmentation and was better tolerated.

KEY POINT:The 1064-nm picosecond laser with holographic optics demonstrated significant efficacy in treating atrophic acne scars. BACKGROUND:Picosecond lasers with fractionated optics have enabled the development of a breakthrough skin rejuvenation method. The authors compared the fractionated, non-ablative neodymium-doped yttrium aluminum garnet 1064-nm picosecond laser with holographic optics and the fractional CO2 laser in treating atrophic acne scars. METHODS:One side of each patient's face was randomly allocated and treated with three sessions of the 1064-nm picosecond laser with holographic optics at 2-month intervals. In contrast, the other side was treated with the fractional CO2 laser. Participants were followed up 3 months after the final session. The primary outcome included the physicians' evaluation using the ECCA grading scale and a four-point scale to assess improvement. The patients' assessment of progress, their overall satisfaction and preferences, and the side effects were also evaluated. RESULTS:No significant difference was observed between the two lasers in terms of the mean ECCA scores after treatments (P = 0.209). The physicians' improvement assessment was more significant for the fractional CO2 laser (P = 0.001). The patients' evaluation of improvement and subjective satisfaction were consistent with physicians' four-point scale results. The picosecond laser side had fewer adverse effects (P < 0.001). CONCLUSION:The fractionated, non-ablative Nd: YAG 1064-nm picosecond laser with holographic optics and the fractional CO2 laser were effective and safe in treating atrophic acne scars. Significantly better clinical outcomes were observed with the fractional CO2 laser, whereas fewer adverse effects were noted with the 1064-nm picosecond laser with holographic optics.

The role of fractional picosecond-domain lasers in scar remodeling is being increasingly recognized. In this study, we aimed to evaluate the efficacy of a fractional 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) picosecond laser for treating early-stage traumatic and surgical scars in an Asian population. Thirty-seven patients with 49 early-stage traumatic and surgical scar lesions were enrolled. Participants underwent three treatment sessions with a fractional 1064-nm Nd:YAG picosecond laser at 4–8-week intervals. Two non-involved dermatologists evaluated the treatment response using the Vancouver Scar Scale (VSS) and Global Aesthetic Improvement Scale (GAIS). After treatment, the early-stage traumatic and surgical scars significantly improved. The treatment effects differed markedly according to the number of treatment sessions (F=219.71, P<0.001). The VSS scores were 5.56 ± 2.17 and 3.85 ± 2.02 in the postoperative period after one (P<0.001) and three (P<0.001) sessions, respectively, compared with the baseline VSS score (6.94 ± 1.85). After three treatment sessions, 69.39 www.springer.com/00266 .

Background . Becker’s nevus (BN) severely affects a patient’s appearance and can lead to depression, especially when it involves the face or neck. Currently, there is no effective treatment. Laser therapy has become popular, but its efficacy has not been confirmed. We evaluated the efficacy and safety of lasers in treating BN. Methods . This retrospective study involved 49 patients exposed to different laser treatments who completed at least one treatment session and follow-up. Results . The patients treated with the 755-nm alexandrite picosecond laser and Q-switched 694-nm ruby laser gained relatively good results: 3.07 ± 1.09 and 2.87 ± 1.14 on the five-point scale and 3.47 ± 0.73 and 3.40 ± 0.85 on the GAIS, respectively. However, the results of the 755-nm alexandrite picosecond laser with a diffractive focus lens array and the fractionated 1064-nm neodymium-doped: yttrium aluminum garnet picosecond laser were poor. Furthermore, there were marked differences between the number of treatment sessions and treatment effects, both for the five-point grading score for pigment clearance ( F = 15.246, p < 0.001) and GAIS ( F = 15.469, p < 0.001). Concerning different lasers and efficacy, there were no marked differences between the five-point grading scale and the GAIS ( p > 0.05). Conclusions . Although the efficacy of various lasers for BN is not satisfactory and there are no marked differences between picosecond and Q-switched lasers, they can help in selecting an appropriate laser for slight-to -moderate pigment removal. The 755-nm alexandrite picosecond laser is a new option, whereas nonablative fractional picosecond lasers for BN are not recommended. Increasing the number of treatment sessions can improve the curative effect slightly.

Melanosomes can more effectively absorb energy from a 532 nm laser, destroying the melanosomes. We used a PSNYL pulse width of 240– 400 ps and QSNYL pulse width of 5– 20 ns, both of which are significantly lower than the heat relaxation time (50– 250 ns) of melanosomes and can effectively destroy the melanin particles in the epidermis. In this study, although there was a statistical difference of the lesion clearance rate between QSNYL treatment groups and PSNYL treatment groups, the two groups showed similar visual efficacy. However, shortening the pulse width has a positive effect; for example, for the treatment of nevus of Ota, a shorter pulse width can improve the efficacy of a single treatment significantly, reducing the number of treatments. 5

OBJECTIVE:The 730 nm picosecond titanium sapphire laser is a novel laser that shows promising results in treating freckles. This study aimed to further investigate the efficacy and safety of the 730 nm picosecond titanium sapphire laser for treating freckles in Asian patients compared with those of the 755 nm picosecond alexandrite laser. METHODS:Each face of 86 participants was split into two parts and randomly assigned either one session of 730 or 755 nm picosecond-laser treatment each. Efficacy and safety were determined based on blinded visual evaluations and self-reports at each follow-up visit. RESULTS:The treatment outcomes of the 730 nm picosecond laser for the treatment of freckles were comparable to those of the 755 nm picosecond laser, with 68.99 ± 7.42% and 69.27 ± 7.75% clearance, respectively (p > 0.05). Participants achieved similar Global Aesthetic Improvement Scale scores (4.04 ± 0.31 vs. 4.02 ± 0.30, respectively [p > 0.05]). Additionally, the 730 nm picosecond laser was perceived to be less painful than the 755 nm picosecond laser (4.69 ± 1.63 vs. 5.65 ± 1.80 nm, p < 0.0001). CONCLUSION:The 730 nm picosecond laser is safe and effective for the treatment of freckles in Asian patients. Besides, the 730 nm picosecond laser is less painful than the 755 nm picosecond laser.

Taking beixi village landslide as an example, the cause and mechanism of rain-induced landslide are deeply analyzed. The stability of landslide under natural state and rainfall state is analyzed respectively by using finite element strength reduction method, and the influencing factors of landslide are analyzed and the safety and stability of landslide is evaluated. The results show that :(1) The disaster mechanism of beixi village landslide is due to the strong water permeability of clay layer, and the weathering layer is easy to soften when it meets water, and rainwater infiltration is easy to form weak interlayer, which induces local deformation and finally slides.(2) The landslide of Beixi Village is in a stable state under natural conditions; the landslide was in an basically stable state under saturation condition. (3) According to the plastic cloud map of sliding surface, there is stress concentration in the landslide front, which endangers the lower buildings. It is suggested that slope cutting + gravity retaining wall + drainage engineering prevention and control measures. The formation mechanism of the landslide can provide engineering reference for the disposal and prevention of similar landslides.

Objective:To investigate the effect of different incubation time of aminolevulinic acid (ALA) on photodynamic inhibition of Propionibacterium acnes biofilms. Methods:Propionibacterium acnes biofilms were formed in 24-well plates with pre-placed cell slides and 96-well plates. The formation of the biofilm structure was observed by confocal laser scanning microscopy (CLSM) , and the growth activity of the biofilm was assessed by the tetrazolium salt XTT assay. The in vitro successfully constructed biofilm models were divided into 6 groups: negative control group receiving neither ALA treatment nor LED radiation, ALA group incubated with ALA alone for 30 minutes, LED group receiving LED radiation alone, ALA-PDT1 group, ALA-PDT2 group and ALA-PDT3 group incubated with ALA for 15, 30 and 60 minutes respectively followed by LED radiation. After the treatment, CLSM was performed to observe the biofilm structure, as well as to determine the dead/living bacteria ratio, and XTT assay to assess the growth activity of the biofilm. Differences among groups were analyzed using one-way analysis of variance and least significant difference- t test. Results:CLSM showed that the Propionibacterium acnes biofilm model was successfully constructed in vitro. The dead/living bacteria ratios were 0.90 ± 0.16, 1.75 ± 0.19, and 2.57 ± 0.32 in the ALA-PDT1 group, ALA-PDT2 group and ALA-PDT3 group respectively, which were significantly higher than the dead/living bacteria ratio in the negative control group (0.31 ± 0.01; t= 55.56, 138.62, 74.64, respectively, all P<0.001) ; the biofilm viability value was significantly lower in the ALA-PDT1 group, ALA-PDT2 group and ALA-PDT3 group (0.35 ± 0.02, 0.26 ± 0.02, 0.18 ± 0.01, respectively) than in the negative control group (0.43 ± 0.00; t= 35.66, 2.64, 110.96, respectively, all P < 0.001) . CLSM showed that the structure of the Propionibacterium acnes biofilm was destroyed under the action of ALA-PDT, and the destruction was aggravated with the prolongation of incubation time of ALA. Conclusion:The prolongation of incubation time of ALA can enhance the inhibitory effect of ALA-PDT on Propionibacterium acnes biofilms.

Nevus of Ota has been successfully treated by lasers. Currently, 1064 nm picosecond Nd:YAG lasers have become available for the treatment of pigmented disorders. However, there are few studies concerning the application of 1064 nm picosecond Nd:YAG laser in nevus of Ota. This study aimed to evaluate the efficacy and safety of a 1064 nm picosecond Nd:YAG laser for the treatment of nevus of Ota. We conducted a retrospective analysis of Chinese patients with nevus of Ota who had been treated with a 1064 nm picosecond Nd:YAG laser. Those who had any other laser treatment during the period of picosecond laser treatment were excluded. Via a visual analog scale for percentage of pigmentary clearance in standard photographs, the treatment efficacy was assessed by three blinded physician evaluators. A total of 16 subjects were included in this retrospective study. The average age at the beginning of treatment was 16.87 years old (range of 4 months to 59 years), and all patients were of Fitzpatrick skin type IV. Total treatment ranged from 1 to 5 sessions. A 1064 nm picosecond Nd:YAG laser with a mean fluence of 1.8-4.3 J/cm2 was used at 3-12 month intervals. The mean efficacy score for all 16 patients was 2.56 after one session, and the mean efficacy score of 13 patients who completed two sessions and nine patients who completed three sessions were 3.15 and 3.51, respectively. Postinflammatory hyperpigmentation after treatment was only observed in 1 (1/16, 6.25%) patient. The 1064 nm picosecond Nd:YAG laser is an effective and safe approach for treating nevus of Ota.

Accurate assessment is the basis for the effective treatment of acne vulgaris. The goal of this study was to achieve standardised diagnosis and treatment based on a deep learning model that was developed according to the current Chinese Guidelines for the Management of Acne Vulgaris. The first step was to divide each image of acne vulgaris into four regions. Each of these four regions of the same patient was then combined to form a complete facial region. The second step was to classify the images based lesion type, in accordance with the current Chinese guidelines, and by treatment strategy adopted by experienced dermatologists. The final step was to evaluate the performance of the deep learning model in patients with acne vulgaris. The results showed that the average F1 value of the assessment model is 0.8 (optimum value = 1). The weighted kappa coefficient between the evaluation according to the artificial intelligence model and the evaluation by the attending dermatologists was 0.791 (95% confidence interval 0.671–0.910, P < 0.001), indicating a high degree of consistency. The assessment model based on deep learning and according to the Chinese guidelines had a slightly higher overall performance is comparable to that of the attending dermatologist.

Background and Objectives Picosecond lasers (PSL) constitute a significant technological advancement and exert rejuvenating effects upon the skin. This study was conducted to investigate changes in the skin upon treatment with the fractionated 1064‐nm Nd: YAG PSL through in vivo and ex vivo human histological analysis. Study Design/Materials and Methods In vivo back skin specimens were treated with a fractionated 1064‐nm PSL at 1.3, 2.1, and 2.9 mJ fluence for two passes, and 2.9 mJ for 10 passes, and then stained with hematoxylin and eosin (H&E). Ex vivo foreskin specimens after circumcision surgery were treated with a PSL at 1.3, 2.1, and 2.9 mJ fluence for two and 10 passes, followed by H&E staining. Ex vivo skin tissue sections treated with a PSL at 2.9 mJ fluence for 10 passes were also immunostained for Melan‐A and CD31. Results Intraepidermal vacuoles were observed, along with pigment accumulation and inflammatory cell infiltration in the vacuoles at 24 hours after PSL treatment in the in vivo skin specimens. The vacuoles expanded as the fluence increased. Numerous intraepidermal vacuoles were observed, with dermal hemorrhage and inflammatory cell infiltration upon high‐fluence, multi‐pass PSL treatment in the in vivo skin specimens. PSL treatment yielded both epidermal and dermal vacuoles in ex vivo skin specimens. Melan‐A‐positive cells were seen in the cystic wall of vacuoles in the epidermal basal layer, whereas CD31‐positive cells were detected in the cystic wall of some dermal vacuoles. Conclusions The fractionated 1064‐nm PSL produced epidermal vacuoles and dermal lesions, with histological differences between the in vivo and ex vivo skin specimens. Lasers Surg. Med. © 2021 Wiley Periodicals LLC

Background and Objectives To compare the efficacy and safety of 1064‐nm and dual‐wavelength (532/1064 nm) picosecond Nd:YAG lasers with a holographic optic in the treatment of facial photoaging. Study Design/Materials and Methods In this prospective, randomized split‐face study, each half of each participant′s face was randomly treated with a 1064‐nm or 532/1064‐nm picosecond laser. All participants underwent five treatment sessions and follow‐up visits 1 and 3 months after the final treatment. The primary outcomes were measured as the global photoaging scores, determined by two physicians who were blinded to the treatments. The secondary outcomes were the participant‐assessed Global Aesthetic Improvement Scale (GAIS) and satisfaction scores. Histopathological examinations were performed. Results Global photoaging scores decreased significantly after treatment with either laser. The global photoaging scores, GAIS scores, and satisfaction scores did not differ significantly between the 1064‐nm and 532/1064‐nm picosecond laser treatments. Histological changes were similar between the two groups. Intraepidermal vacuoles and dermal hemorrhaging were observed immediately and 24 h after treatment. After five treatments, neocollagenesis was observed in the upper dermis of both groups, and elastic fibers were more elongated and orderly. Conclusions Treatments with 1064‐nm and 532/1064‐nm picosecond Nd:YAG lasers were comparably effective at improving photodamaged facial skin by remodeling the collagen and elastin network through laser‐induced optical degradation and vascular damage.

Objective This study used deep learning for diagnosing common, benign hyperpigmentation. Method In this study, two convolutional neural networks were used to identify six pigmentary diseases, and a disease diagnosis model was established. Because the distribution of lesions in the original training picture is very complex, we cropped the image around the lesions, trained the network on the extracted lesion images, and fused the verification results of the overall picture and the extracted picture to assess the model performance in identifying hyperpigmented dermatitis pictures. Finally, we evaluated the image recognition performance of the two convolutional neural networks and the converged networks in the test set through a comparison of the converged network and the physicians' assessments. Results The AUC of DenseNet-96 for the overall picture was 0.98, whereas the AUC of ResNet-152 was 0.96; therefore, we concluded that DenseNet-96 performed better than ResNet-152. From the AUC, the converged network has the best performance. The converged network model achieved a comprehensive classification performance comparable to that of the doctors. Conclusions The diagnostic model for benign, pigmented skin lesions based on convolutional neural networks had a slightly higher overall performance than the skin specialists.

Objective To investigate the effect of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) on Propionibacterium acnes (P.acnes) biofilm. Methods P.acnes biofilms were constructed on a cell slide and treated with ALA-PDT.According to different light doses,the biofilms were divided into six groups:ALA-PDT group [ALA-PDT1 (50 J/cm2),ALA-PDT2 group (100 J/cm2),ALA-PDT3 group (200 J/cm2)],ALA-only group (ALA group),light-only group (LED),and a negative control group (ALA-PDT-group).The biofilm structure and the ratio of the dead bacteria/live bacteria were observed using a laser confocal microscope (CLSM).Biofilm viability was measured using the XTT assay. Results CLSM showed that the biofilm structures of ALA group and LED group were not significantly different from that of ALA-PDT-group,whereas the biofilm structure was more seriously damaged in ALA-PDT1 group,ALA-PDT2 group,and ALA-PDT3 group than in the ALA-PDT-group.The ratios of the dead/live bacteria in ALA-PDT-group,ALA group,LED group,ALA-PDT1 group,ALA-PDT2 group,and ALA-PDT3 group were 0.350±0.033, 0.305±0.046, 0.330±0.032, 1.525±0.439, 2.293±0.148 and 3.092±0.189,respectively.ALA group(md=0.003, P=1.000)and LED group(md=-0.025, P=1.000)did not significantly differ from the ALA-PDT-group.However,the ratio of dead/live bacteria in ALA-PDT-group was significantly lower than those in ALA-PDT1 group (md=-0.162, P<0.001),ALA-PDT2 group (md=-0.254, P<0.001),and ALA-PDT3 group (md=-0.352, P<0.001).The values of the XTT assay were were 0.462±0.028,0.465±0.044,0.437±0.047,0.301±0.040,0.207±0.001,and 0.110±0.007,respectively,in ALA-PDT-group,ALA group,LED group,ALA-PDT1 group,ALA-PDT2 group,and ALA-PDT3 group.Although the values of XTT assay in ALA(md=-0.044, P=1.000)and LED groups (md=-0.020, P=1.000)did not significantly differ from that in ALA-PDT-group,it was significantly higher in ALA-PDT-group than in ALA-PDT1 group (md=1.175, P<0.001),ALA-PDT2 group (md=1.942, P<0.001),and ALA-PDT3 group (md=-0.352, md=2.742, P<0.001). Conclusions ALA-PDT has an inhibitory effect on P.acnes biofilm.ALA-PDT destroys biofilm structure and inhibits biofilm viability.

Objective:To compare the efficacy and safety of picosecond alexandrite laser and ultrapulsed fractional CO 2 laser for the treatment of facial atrophic acne scars in a prospective, split-face clinical trial. Methods:From October 2015 to October 2017, patients with facial symmetrical atrophic acne scars were enrolled from Department of Cosmetic Laser Surgery, Hospital for Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College. The left side of the face of the patients was treated with ultrapulsed fractional CO 2 laser, and the right side of the face was treated with a 755-nm picosecond alexandrite laser with a diffractive lens array. All patients received 3 sessions of laser treatment at a 2-month interval. The severity of scars was evaluated by 2 dermatologists before and after the treatment according to the ECCA grading scale (échelle d′évaluation clinique des cicatrices d′acné) , and clinical efficacy was self-assessed by the patients according to a 4-point scale. Pain scores and adverse reactions were recorded. Paired t test was used to compare ECCA scores and pain scores between the 2 sides of the face, as well as between pre- and post-treatment values, and Wilcoxon rank sum test was used to compare the 4-point scores between the 2 groups. Results:There was no significant difference in the ECCA score between the picosecond laser side and the fractional laser side before the treatment ( t = 1.06, P = 0.300) , while the ECCA score was significantly higher in the picosecond laser side than in the fractional laser side after 3 sessions of treatment (70.98 ± 21.48 vs. 58.04 ± 17.63, t = 3.76, P = 0.001) . Compared with the pre-treatment severity score of scars, the improvement in severity score was significantly less in the picosecond laser side than in the fractional laser side (2.21 ± 1.09 vs. 2.83 ± 1.11, z = 2.70, P = 0.007) . Compared with the fractional laser side, the picosecond laser side showed significantly lower pain scores (3.71 ± 0.62 vs. 6.23 ± 1.06, t = 11.93, P < 0.001) and less adverse reactions, which mainly manifested as transient erythema and edema. Conclusions:Both picosecond alexandrite laser and fractional CO 2 laser can effectively improve atrophic acne scars. Fractional CO 2 laser is more effective, but picosecond alexandrite laser has less adverse effects.

PURPOSE:Radiofrequency equipment, including invasive fractional microneedle radiofrequency (FMR) and noninvasive fractional radiofrequency (FR), has facilitated progress in the field of active acne treatment, but clinical data are limited. This study aimed to compare the efficacy and safety of FMR and FR in the treatment of moderate-to-severe acne vulgaris.METHODS:Ten patients with moderate-to-severe acne were enrolled in a 24-week, prospective, single-blind, randomized, comparative clinical trial with a split-face design. Fractional microneedle radiofrequency treatment was provided on one side of the face and FR on the opposite side. Three consecutive treatments were performed at 4-week interval. Objective assessment of efficacy was performed using the Acne Severity Index (ASI), and acne inflammatory lesions and noninflammatory lesions were evaluated.RESULTS:After the first treatment, ASI and both inflammatory and noninflammatory lesions of the FMR-treated side were improved to a greater degree than the FR-treated side. Patients' subjective satisfaction was also better regarding the FMR-treated side. After subsequent treatments, efficacy improves for both groups, and no significant differences in the above efficacy parameters between the two groups were observed. Pain scores were significantly higher for the FR-treated side than the FMR-treated side.CONCLUSION:Fractional microneedle radiofrequency is faster and more effective than FR for the treatment of moderate and severe acne after only one treatment. However, after several treatment sessions, both FMR and FR proved to be safe and effective for long-term treatment of moderate-to-severe acne. Therefore, invasive radiofrequency, such as FMR, or noninvasive radiofrequency, such as FR, can successfully treat active acne.