Background

Radiofrequency (RF) devices are being increasingly used for cosmetic dermatology applications. Recent studies have reported an apparent dualistic nature of RF devices for hair, causing either removal or growth depending on the modality of RF.

Materials and methods

PubMed/MEDLINE and Web of Science searches were conducted in July 2022 according to PRISMA guidelines for studies discussing RF technology in hair applications (n = 19).

Results

The majority of studies describe the utility of RF devices in removal of unwanted hair (n = 15). Bipolar RF has been used in combination with intense pulsed light for effective long-term removal of body and facial hair. The chromophore-independent method of energy delivery in RF makes it a viable add-on therapy for treating lighter colored hair and darker Fitzpatrick skin types. Monopolar RF is used for eyelash removal in patients with trichiasis. In contrast, fractional RF has been used to stimulate hair growth in patients with alopecia areata and androgenetic alopecia.

Conclusions

Preliminary evidence supports the use of bipolar and monopolar RF devices for hair removal, while fractional RF appears to be an emerging technology for hair growth. Additional studies are needed to investigate the efficacy, mechanisms, and parameters of radiofrequency devices for various hair applications.

Introduction

The prevalence of frontal fibrosing alopecia (FFA) is increasing worldwide, though the pathogenesis remains unknown. Anecdotal reports describe alopecia occurring in an FFA pattern following facial surgical procedures, but this potential link remains unexplored.

Objective

The objective of this study is to determine if a significant association exists between the diagnosis of FFA and a history of facial and scalp surgical procedures.

Methods

This retrospective study comparing data from frontal alopecia patients to controls was conducted at a tertiary medical center. Additionally, a literature review was conducted on scarring alopecias occurring from scalp procedures.

Results

Fifty percent of frontal alopecia patients (n = 54) reported a history of facial surgical procedures compared to 9.8% of controls (n = 51) (OR: 7.8 [95% CI: 2.77-25.98, p < 0.001]). Although no significant differences were observed in current daily facial sunscreen use, sunscreen use prior to alopecia onset was significantly higher in frontal alopecia (p = 0.295; p = 0.021). Sunscreen use was not a significant modifier in the association between frontal alopecia and facial surgical procedures (p = 0.89).

Conclusions

A significant association exists between frontal alopecia clinically consistent with FFA and a history of facial surgery, the nature of which is unclear. The role of sunscreen use and frontal alopecia development in this setting needs to be better elucidated.