The use of radio-wave surgery: An underestimated method for small hyperpigmented flat or macular lesions on face

Background: Although choosing the appropriate treatment method is relatively easy for papular or protuberant lesions, for small macular lesions it may not be so, because they are generally percepted as mild lesions by the patient and she/he usually has the anxiety of final disfigurement which may result esthetically worse than the original one. It is reasonable to choose the method which will reveal the least scar formation and lowest recurrence rate with cost-effectiveness, in removal of superficial small macular lesions for cosmetic purposes.

Methods: Fifty-six male and female patients with small hyperpigmented flat or macular lesions, less than or equal to 5 mm diameter on their face, who referred to hospital dermatology clinic for removal and received an interventional therapy with a radio-wave surgery unit in the years 2018-2019 were retrospectively recruited. Besides the observation of scar formation and residual erythema, 3-month recurrence rates were also analyzed.

Results: At the end of 3 months, there was no scar on any lesion site. Mild erythema was detected on 15 lesion sites out of a total of 218 (6.9%).The total recurrence rate was 7.7%. The mean age of the patients with at least one recurrence was significantly greater than the patients with no recurrence, and the lesions greater than 3 mm were more prone to recur than the lesions less than or equal to 3 mm.

Conclusion: Although no method of lesion removal can warrant a scarless result without recurrence, for benign macular hyperpigmented lesions of the face up to 5 mm in diameter, radio-wave surgery may be preferred due to both its minimal scar formation and recurrence rate, in addition to its cost-effectiveness.