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A handpiece equipped with a single-pin radiofrequency (RF) tip allows pinpoint targeting of enlarged pores on the nose for patients with and without acne. This treatment tip offers precise coagulat
ion to depths up to 5 mm, with greater safety than chemical peels, particularly for Asian patients.
“The ideal patient is someone with enlarged sebaceous glands around pores,” said Choi Seung, MD, director of MH Clinic in Seoul, South Korea. People in their 20s and 30s often suffer from acne, a key indication for Virtue RF treatment with the Exact RF handpiece by SHENB (Seoul, South Korea). “People in their 40s and older often have large pores due to photo-aging caused by ultraviolet (UV) radiation, regardless of acne,” he added.
Rather than horizontal pore widening, enlarged pores indicate sebum buildup resulting from sebaceous gland hyperplasia around pores, Dr. Seung explained. “The larger the glands, the more sebum produced in a given time.”1
Sebaceous glands also transport and store sebum. “Considering that sebum buildup in pores is the main mechanical cause of large pores,” he said, “selective, precise suppression of enlarged sebaceous glands can be an ideal treatment mechanism that reduces excessive sebum secretion and shrinks pores in the long term.”
To begin, patients require pretreatment with Histo Clear Lotion by HISTOLAB (Brea, Calif.) to soften sebum, followed by procaine 5% cream for 30 minutes under occlusion. Dr. Seung treats at depths of 0.5 mm to 1 mm, using RF treatment level 5 with single, 300 ms pulses. Because the Exact RF tip only targets enlarged sebaceous glands around pores, these settings suffice to coagulate sebaceous glands with little to no downtime, he advised. While monitoring with a microscope loupe or surgical microscope, he inserts the non-insulated treatment tip into the center of the glands, perpendicular to the skin’s surface.
Treatment takes around 20 minutes. Patients can wash their face and apply light makeup immediately afterward. Although recovery may vary, people typically experience redness for 
three to seven days and fine scabbing at four to five days. During this time, they must avoid excessive scrubbing or irritating the skin. “Most patients can recover without any major problems about seven days after treatment,” Dr. Seung noted.
Since sebocyte turnover takes approximately four weeks, results appear in six to eight weeks, Dr. Seung reported. “It is difficult to treat all areas in one treatment,” he added, “so it is advantageous to divide up the areas to be treated over three to five sessions.” This approach reduces physician fatigue and eases patient discomfort.
Due to the magnification requirement and the treatment time, he said the procedure is usually performed on its own. Adjunctive treatments such as skin boosters and lasers can follow two weeks later.
Chemical peels used to address pores can have side effects such as post-inflammatory hyperpigmentation (PIH), which occurs more commonly in Asian skin, Dr. Seung advised. “However, pore treatment using Exact RF can minimize side effects such as PIH with minimal downtime, so I believe it will become a more common treatment.”
Reference:
1. Sakuma TH, Maibach HI. Oily skin: an overview. Skin Pharmacol Physiol. 2012;25(5):227-235. doi:10.1159/000338978
