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Background. Zoster-associated pain (ZAP) is often refractory to conventional treatments and can seriously affect patients' physical and mental health. High-voltage pulsed radio frequency (H-PRF) is a new method for treating ZAP with pulse voltages above 60 V or even up to 100 V. The purpose of this paper was to conduct a systematic review and meta-analysis to evaluate the efficacy of H-PRF in the management of ZAP. Methods. PubMed, Embase, and the Cochrane library were searched from their inception to June 2022 to identify controlled trials which evaluated the effectiveness of H-PRF compared with standard PRF and sham operations. The primary outcome was pain scores at different treatment times. The secondary outcomes included SF-36 scores, rescue analgesic dose, and side effects. Results. We reviewed 6 randomized controlled trials involving 428 patients. There was no significant difference between the H-PRF and standard PRF pain scores at 1 week after surgery and the sham operation group at 1 month. At 1, 3, and 6 months, the H-PRF group had better pain score than the standard PRF group, and at 3 months, the pain score was better than the sham operation group. The H-PRF group showed improvement in the SF-36 score, and there were no significant complications in the H-PRF group. Conclusions. H-PRF is an effective and safe treatment method that has better effects in relieving pain and improving the quality of life and physical and mental health. Although H-PRF provides pain relief rates comparable to those of the control group in the early stages, it remains the preferred and alternative treatment for relieving herpes zoster-related pain. [ABSTRACT FROM AUTHOR]

Facial erythema is a representative symptom of rosacea patients that greatly impairs quality of life. Recently, the therapeutic effects of intradermal injection of botulinum toxin type-A on erythema have been investigated. Fractional microneedling radiofrequency has been reported to be effective in dermal remodeling and anti-inflammation. To obtain enhanced therapeutic effects with a less painful and easier approach, a treatment regimen using transdermal botulinum toxin delivery with fractional microneedling radiofrequency was developed. We aimed at investigating the efficacy and safety of transdermal botulinum toxin delivery with fractional microneedling radiofrequency in treating the erythema of rosacea. This was a retrospective review of 20 patients with facial erythema associated with rosacea. All patients underwent two sessions of treatment at 4-week intervals. Standardized photographs were taken, and the clinicians' erythema assessment (CEA), erythema index (EI) measured through a spectrophotometer, investigator's global assessment (IGA), and subjective satisfaction and side effects were evaluated at the baseline and 4, 8, and 12 weeks after the baseline. Compared to the baseline, CEA levels significantly decreased after 8 weeks (P = 0.018) and 12 weeks (P = 0.005). As an objective measure, EI was observed to decrease significantly at 4 weeks (P = 0.04) and 8 weeks after the baseline (P = 0.005) compared with the baseline. Ninety-five percent of patients were either very satisfied or satisfied with the treatment. None of the patients experienced remarkable side effects. A novel treatment regimen involving transdermal botulinum toxin delivery and fractional microneedling radiofrequency may be an effective and safe option for reducing the facial erythema of rosacea. [ABSTRACT FROM AUTHOR]

Background. Postherpetic neuralgia (PHN) is the most common and severe complication after varicella-zoster infection, especially in elderly patients. PHN is always refractory to treatment. Both pulsed radiofrequency (PRF) and short-term spinal cord stimulation (stSCS) have been used as effective analgesia methods in clinic. However, which technique could provide better pain relief remains unknown. Objectives. This study is aimed at evaluating the efficacy and safety of PRF and stSCS in elderly patients with PHN. Study Design. A prospective, randomized-controlled study. Setting. Department of Pain Management, the Second Affiliated Hospital of Guangzhou Medical University. Methods. A total of 70 elderly patients with PHN were equally randomized to the PRF group or stSCS group. Patients in the PRF group received PRF treatment, while patients in the stSCS group received stSCS treatment. The primary outcome was the effective rate. The secondary outcomes included the Visual Analogue Scale (VAS), the 36-Item Short Form Health Survey Questionnaire (SF-36), and the pregabalin dosage. All outcomes were evaluated at baseline and at different postoperative time points. Results. At 12 months after surgery, the effective rate reached 79.3% in stSCS group, while 42.1% in PRF group. The effective rate was significantly higher in the stSCS group than in the PRF group at 3, 6, and 12 months after surgery. VAS scores decreased significantly at each postoperative time point in both groups (P < 0.001). The VAS scores were significantly lower in the stSCS group than in the PRF group at 3, 6, and 12 months after surgery. SF-36 scores (bodily pain and the physical role) were significantly improved at each postoperative time point in both groups (P < 0.001). The SF-36 scores were significantly higher in the stSCS group than in the PRF group at some postoperative time points. The pregabalin dosage was significantly lower in the stSCS group than in the PRF group at 3, 6, and 12 months after surgery. Limitations. A single-center study with a relatively small sample size. Conclusions. Both PRF and stSCS are effective and safe neuromodulation techniques for elderly patients with PHN. However, stSCS could provide better and longer-lasting analgesic effect compared to PRF. [ABSTRACT FROM AUTHOR]

The aim of this questionnaire‐based study was to measure the level of appreciation, practice patterns, and side effects of monopolar radiofrequency treatment among Korean dermatologists practicing the most updated monopolar radiofrequency device (Thermage FLX, Thermage Inc., Hayward, California). According to a total of 52 surveys analyzed, this latest device (Thermage FLX) was considered more effective (57.4%), faster with reduced treatment time (66.0%), and more painful (25.5%) compared with Thermage CPT. Asians in their 40s were considered to benefit most and skin thickness continued to be the most important determinant in terms of responsiveness to Thermage FLX. The interval between treatments was mainly 1 year (51.9%) with the 600 REP 4 cm2 new total tip being preferred by 86.5% of Thermage FLX users. The treatment energy and the complication rate of Thermage was lower than what we reported in 2017 and 2011 which is likely due to the optimized energy delivery of Thermage FLX and the subsequent gentle treatment. We hope our updated data enable dermatologists to better utilize monopolar radiofrequency in their practice. [ABSTRACT FROM AUTHOR]

Despite multiple individual studies proving efficacy of grid fractional monopolar radiofrequency (Grid RF) and near‐infrared irradiation 1064‐nm long‐pulsed neodymium:YAG laser (Laser Genesis), there is a lack of controlled comparative trials between these devices. This study aims to compare the efficacy and safety of Grid RF versus Laser Genesis in the treatment of periorbital rhytides. This is a randomized, single‐blind, split‐face, prospective study. Eight patients with moderate to severe periorbital rhytides were treated with either Grid RF or Laser Genesis on each side of the face. Photographic and live assessment with the Lemperle Wrinkle Assessment grading scale was compared after 2 months. Difference in scores between Grid RF vs Laser genesis groups after 2 months was not statistically significant (P = 0.244). Each group showed statistically significant improvement months post‐procedure (P <.05). Immediate adverse effects and satisfaction scale were similar for both groups (P >.05). At 2 months follow‐up, no adverse effects were seen. Grid monopolar radiofrequency (Grid RF) vs near‐infrared radiation 1064 nm long‐pulsed Nd‐YAG laser (Laser Genesis) were equally efficacious, safe, and well‐tolerated among patients in the treatment of periorbital wrinkles (P >.05). [ABSTRACT FROM AUTHOR]

Pulsed radiofrequency of the suprascapular nerve has shown efficacy in adults with chronic shoulder pain, but its use in pediatrics is relatively new. We present a case of a successful use of pulsed radiofrequency to treat refractory chronic shoulder pain in an adolescent patient. Case Report. We present a 53 kg, 14-year-old female, with a medical history of septic arthritis of the left shoulder within the first month of life leading to persisting pain during childhood. She presented with a complaint of progressive pain starting at age 12, refractory to analgesics including opioids and intra-articular injection of local anesthetic and steroids. After pulsed radiofrequency of the suprascapular nerve, significant pain relief and improvement of the range of motion was obtained. These results were maintained at the 1-, 3-, and 6-month follow-up visits with the pain being reported as mild and manageable with nonsteroidal anti-inflammatory drugs. Conclusion. There is limited data today of the use of pulsed radiofrequency for pediatric chronic pain. We successfully used this intervention in a 14-year-old patient with chronic shoulder pain extrapolating from adult experience and as a last resort after all other treatments had failed. [ABSTRACT FROM AUTHOR]

Trigeminal neuralgia (TN) is a common neuropathic pain that seriously affects the daily life of patients. Many invasive treatments are currently available for patients who respond poorly to oral carbamazepine or oxcarbazepine. Among them, radiofrequency (RF) treatment is a viable option with reliable initial and long-term clinical efficacy. The long-term analgesic effects of radiofrequency thermocoagulation (RFT) at high temperatures (≥80°C) are not superior to those at relatively low temperatures (60–75°C). In contrast, the higher the temperature, the greater the risk of complications, especially facial numbness, masticatory muscles weakness, and corneal hypoesthesia. Some patients even experience irreversible lethal complications. Therefore, we recommend low-temperature RFT (60–75°C) for treatment of TN. The therapeutic effects of pulsed radiofrequency (PRF) are controversial, whereas PRF (≤75°C) combined with RFT can improve long-term effects and decrease the incidence of complications. However, large-scale clinical trials are needed to verify the efficacy of the combination of PRF and RFT. [ABSTRACT FROM AUTHOR]

Recently great attention has been paid to the rejuvenation of the face, neck, and décolleté of women with advanced radial fractional radiofrequency. We aimed to clinically evaluate the results obtained with this treatment method. We treated 10 women aged 42 to 62, suffering from skin aging. After carrying out the hydration and sebometry skin tests in each patient, collecting the medical history and taking photographs of the face and décolleté in the standard projections, a questionnaire was submitted to each patient. Finally, we have submitted the patients to one session of application of radiofrequency energy, by an Italian device named "Thuzzle" (GMV, Rome, Italy). The obtained results show a high effectiveness in improving the texture and tone of skin, decreasing micro wrinkles and spot reduction. Advanced radial fractional radiofrequency treatment method shows promising results. Further studies are required to confirm the findings. [ABSTRACT FROM AUTHOR]