Efficacy and safety of using noninsulated microneedle radiofrequency alone versus in combination with polynucleotides for treatment of periorbital wrinkles
Open accessAbstract
INTRODUCTION: A few studies have evaluated the efficacy and safety of noninsulated radiofrequency microneedling (RFMN) to treat periorbital wrinkles in Asian patients. Recently, wound healing accelerators, polynucleotides (PNs), have received attention in wound management. However, their efficacy and safety have not been fully elucidated following RFNM. This study aimed to evaluate the efficacy and safety of noninsulated RFMN for periorbital wrinkles and the synergistic effect of PNs after RFMN. METHODS: Thirty subjects with Fitzpatrick skin types III to V and facial wrinkles (Fitzpatrick grades I and II) were enrolled. All volunteers were treated over the entire face with noninsulated RFMN for three sessions at 2-week intervals. The left and right sides of each patient's face were randomly assigned to receive PNs (treatment group) or normal saline solution (control group). The indentation and maximum depth of wrinkles were objectively measured using Antera 3D. Subjective self-evaluations were obtained at baseline, 2 weeks after the third treatment, and at 1, 2, 3, and 6 months after the final treatment. In addition, pain scores, immediate reactions, and other adverse effects were evaluated. RESULTS: Twenty-nine subjects completed the treatment protocol. Most presented with grade II wrinkling (69%). At 2-month follow-up, Antera 3D image analysis revealed faster improvement for the treatment group. At 6-month follow-up, the majority of subjects reported an improvement of 25-75% in their periorbital wrinkles. The average pain score was 2.2 out of 10. No serious adverse events (infection, pigmentary alteration, persistent erythema, or scarring) were observed. CONCLUSIONS: Noninsulated RFMN is safe and effective for treating periorbital wrinkles and can be used as a modality for transdermal drug delivery. Topical polynucleotides as an adjunctive treatment provide additional benefits for periorbital wrinkle treatment. TRIAL REGISTRATION NUMBER: TCTR20201105007.
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In a randomized, double-blind, split-face trial, PN-based fillers demonstrated superior outcomes to HA fillers in improving skin roughness, pore size, and hydration.
“Notably, in a randomized, double-blind, split-face trial, PN-based fillers demonstrated superior outcomes to those of HA fillers in terms of improving skin roughness, pore size, and hydration.”
From Comparison of Polynucleotide and Polydeoxyribonucleotide in Dermatology: Molecular Mechanisms and Clinical Perspectives (2025) · cites this paper as [170]
The Methods describe a randomized, double-blind, split-face study, but the comparison was topical PN-containing serum versus normal saline after radiofrequency microneedling—not PN fillers versus HA fillers. The Methods and Results assess periorbital wrinkles, not skin roughness, pore size, or hydration. The serum itself contained HA, so the paper cannot establish PN superiority over HA. (LLM, conf=0.88)
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Experimental — accuracy not yet measuredRejuran®, a commercially available purified PN, has shown efficacy in treating crow's feet, with improvements substantiated by objective measurements such as the crow's feet grading scale (CFGS), GAIS, standardized photography, and 3D image analysis.
“Rejuran®, a commercially available purified PN, has shown efficacy in treating crow’s feet, with improvements substantiated by objective measurements such as the crow’s feet grading scale (CFGS), GAIS, standardized photography, and 3D image analysis [170].”
From Comparison of Polynucleotide and Polydeoxyribonucleotide in Dermatology: Molecular Mechanisms and Clinical Perspectives (2025) · cites this paper as [170]
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Experimental — accuracy not yet measuredIn the periorbital region, PN injections were well-tolerated and associated with minimal side effects.
“These benefits were particularly evident in the periorbital region, where PN injections were well-tolerated and associated with minimal side effects [14,170].”
From Comparison of Polynucleotide and Polydeoxyribonucleotide in Dermatology: Molecular Mechanisms and Clinical Perspectives (2025) · cites this paper as [170]
The Abstract Results report low average pain and no serious adverse events, and the Conclusions describe the combined treatment as safe for periorbital wrinkles. However, the Methods identify the PN product as topical serum applied after radiofrequency microneedling, not a PN injection; the paper therefore does not establish that PN injections were well-tolerated. (LLM, conf=0.90)
Experimental — accuracy not yet measuredIn Yogya et al., no statistically significant differences in maximum wrinkle depth were observed between the PN and control sides at any follow-up time point.
“no statistically significant differences in maximum wrinkle depth were observed between the PN and control sides at any follow-up time point (p>0.05)”
In Yogya et al., wrinkle indentation began to improve earlier on the PN-treated side, with a statistically significant between-group difference at the two-month follow-up.
“wrinkle indentation began to improve earlier on the PN-treated side, with a statistically significant between-group difference evident at the two-month follow-up (p<0.05; p=0.006).”
In Yogya et al., at six months, 51% of subjects reported improvement exceeding 50%.
“51% reported improvement exceeding 50%”
In Yogya et al., at six months, 82% of subjects on both sides reported more than 25% self-assessed improvement.
“82% of subjects on both sides reported more than 25% self-assessed improvement”
Low-risk judgments were assigned to Yogya et al. [7], Jeon et al. [12], and Kim et al. [13].
“Low-risk judgments were assigned to Yogya et al. [7], Jeon et al. [12], and Kim et al. [13].”
DNA fragment Optimizing Technology (DOTTM), developed by PharmaResearch Co. Ltd., has been used in the production of both PN and PDRN formulations.
“DNA fragment Optimizing Technology (DOT™), developed by PharmaResearch Co. Ltd., has been used in the production of both PN and PDRN formulations [24,169,170,171].”
From Comparison of Polynucleotide and Polydeoxyribonucleotide in Dermatology: Molecular Mechanisms and Clinical Perspectives (2025) · cites this paper as [170]
The Methods describe a PN serum identified as a Reanzen Co. product, and the Discussion describes PNs generally. Neither passage addresses DOT™, PharmaResearch, PDRN, or whether that technology is used to produce PN and PDRN formulations (searched those terms and DNA-fragment production). (LLM, conf=0.74)
Experimental — accuracy not yet measuredHPT and similar innovations have been adapted for PN-based products.
“More recently, HPT and similar innovations have also been adapted for PN-based products.”
From Comparison of Polynucleotide and Polydeoxyribonucleotide in Dermatology: Molecular Mechanisms and Clinical Perspectives (2025) · cites this paper as [170]
The Methods describe a topical PN product used alongside radiofrequency microneedling, and the Discussion describes that combination as a drug-delivery approach. Neither section says HPT or a similar innovation was adapted for PN-based products (searched: HPT, purification technology, PN product innovations). (LLM, conf=0.72)
Experimental — accuracy not yet measured
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Alhussain, A. M., Turki M. Albusayys, S., Alfhadi, M. A., Bu Mozah, S. A., AlShammari, S. S. S., Alanazi, H. A. M., Adil Alqazanli, S., Nouruldeen Alabdullah, A., M. ALrashidi, N., Almazrou, A. A., et al. (2026) · Cureus · doi:10.7759/cureus.112403 · Cited by 1 · see citing works
- Authors
- Yogya, Y., Wanitphakdeedecha, R., Wongdama, S., Nanchaipruek, Y., Yan, C., & Rakchart, S.
- Affiliations
- Siriraj Hospital (TH)
- Corresponding author
- Wanitphakdeedecha, Rungsima
- Venue
- Dermatology and Therapy
- Published
- 2022-04-30
- Volume
- 12
- Issue
- 5
- Pages
- 1133-1145
- ISSN
- 2190-9172 (ISSN-L)
- 2193-8210
- PMC
- PMC9110589
- OpenAlex
- W4225289731
- Cited by
- 26
- References
- 0
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 3 · 2023: 3 · 2022: 1
- FWCI
- 4.02
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Dermatology and Therapy (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Mahidol University
- Faculty of Medicine Siriraj Hospital, Mahidol University
- Topics
- Health Sciences › Medicine › Dermatology › Dermatologic Treatments and Research
- Health Sciences › Medicine › Dermatology › Facial Rejuvenation and Surgery Techniques
- Health Sciences › Medicine › Complementary and alternative medicine › Acupuncture Treatment Research Studies
- Keywords
- periorbital wrinkles, polynucleotides, facial rejuvenation, transdermal drug delivery, wrinkle depth, treatment safety, Asian patients
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