Radiofrequency Treatment Versus Topical Therapy for Facial Acne Vulgaris

Acne vulgaris is a common inflammatory skin condition involving the pilosebaceous unit. Increased sebum production, abnormal follicular keratinization, proliferation of Cutibacterium acnes, and inflammation contribute to its development. Standard treatments for mild-to-moderate acne include topical medications such as retinoids and benzoyl peroxide. Radiofrequency has also been investigated as a non-pharmacological approach to acne treatment, with previous studies suggesting potential effects on sebum production, inflammatory lesions, and dermal structure.

This is a prospective, randomized, parallel-group, open-label clinical trial designed to compare a sequential RF treatment protocol with standard topical therapy in adults with mild-to-moderate inflammatory facial acne vulgaris. Approximately 60 eligible participants will be randomized in a 1:1 ratio to an RF treatment group or an active topical comparator group.

Participants assigned to the RF group will receive three treatment sessions at 6-week intervals using the Density Noir System (6.78 MHz). Treatment consists of two sequential phases. The first phase uses the Classic F Tip in MONO+BI mode to provide global facial treatment. The second phase uses the Classic E Tip in bipolar mode to provide targeted treatment of individual inflammatory acne lesions.

Participants assigned to the topical comparator group will use a fixed-combination gel containing adapalene 0.1% and benzoyl peroxide 2.5%, applied once daily to the entire face for 12 weeks.

The primary efficacy assessments are the change from baseline in inflammatory lesion count and facial sebum production. Safety and tolerability will be assessed by evaluating acute local skin responses after RF treatment and by monitoring adverse events throughout the study. Secondary assessments include Investigator Global Assessment (IGA), erythema index, dermal thickness measured by high-frequency ultrasound, Dermatology Life Quality Index (DLQI), procedural pain, durability of treatment response, and participant satisfaction.

Participants will be followed for approximately 24 weeks, including the treatment period and post-treatment follow-up.

Inclusion criteria

• Male or female participants aged 18-40 years.
• Clinical diagnosis of mild-to-moderate inflammatory facial acne vulgaris, defined as Investigator Global Assessment (IGA) Grade 2 or 3.
• Presence of 10-40 inflammatory facial lesions (papules and pustules).
• Willing and able to comply with the study requirements, treatment schedule, and follow-up visits.
• Able to understand the study procedures and provide written informed consent.

Exclusion criteria

• Severe acne, including nodulocystic acne.
• Active skin infection, open wound, or other significant dermatologic condition in the treatment area that may interfere with study assessments or treatment.
• Use of systemic isotretinoin within the protocol-specified period before enrollment.
• Recent use of systemic or topical acne treatments that may interfere with evaluation of the study interventions.
• Previous energy-based device treatment to the facial area within the protocol-specified period before enrollment.
• Pregnancy or breastfeeding.
• Presence of an implanted electronic device or other contraindication to radiofrequency treatment.
• Known hypersensitivity or contraindication to adapalene, benzoyl peroxide, or other components of the comparator treatment.
• Any medical condition or medication use that, in the investigator's judgment, may affect participant safety, study participation, or interpretation of study results.