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Lasers and pulsed light systems are only for those who have very dark skin; RF therapies are color blind and can be used on people with any skin color. One of the most advanced RF treatments is the FDA-cleared multisource phase-controlled 3DEEPTM technology, which uses six independent RF generators. Multiple electrical fields that are generated cause the RF energy to flow through a deeper layer of the skin. Innovative technology reduces the amount of energy that is absorbed by the skin, allowing for highly effective heating of the dermis and the subcutaneous tissue. This treatment eliminates the need for active cooling of the epidermis.

To prevent heating the tissue, it is necessary to be in a full position when the electrodes are fully positioned and the handpiece is in motion. It is possible to deliver RF energy to the skin at a constant rate to patients based on the resistance of their skin.

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Ultra-focused ultrasound (HIFU) is very precise.

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HIFU, also called high intensity focused ultrasound (HIFU), has recently become very popular for treating patients who want to lose weight and/or have their skin look younger. It is similar to RF in that it requires heating the tissue with RF energy to cause apoptosis; it does not rely on heating the tissue with electricity. High-intensity focused ultrasound can deliver energy to deep layers of the skin and to fibroblasts that will cause a highly effective process for coagulating the blood without damaging the epidermis. If energy is delivered very precisely, it causes tissue to heat to temperatures that are >65°C within about 1 to 3 seconds, causing the formation of collagen in the tissue. In addition to producing a high temperature, HIFU causes damage to cell membranes within seconds. This causes cell death and/or necrosis. This damage causes cell death and tissue death. It is very easy to see the effects of these devices, as there is always a clear line between the tissue that is being treated and that that is normal. Microcoagulation of the skin causes it to become firmer gradually by contracting and remodeling collagen.

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High-intensity focused ultrasound was developed for eyebrow lifting in the early 1990s and has since been used safely to treat skin conditions in a wide variety of skin types and to improve the appearance of the abdomen and thighs. This treatment is suitable for patients who are suffering from mild to moderate skin laxity or who have not had a wound healed completely. Patients who are very old or who have extremely thin skin are not good candidates for HIFU.

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HIFU devices direct ultrasound energy to a small area of the skin, which then passes harmlessly through the skin. Using transducers that deliver different frequencies and different focal depths, dermatologists can deliver HIFU therapy that is tailored to each patient.

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HIFU can cause very little pain, although it may cause some skin irritation in some patients. Typically, if a patient undergoes HIFU treatment, all the symptoms of their treatment disappear spontaneously within 4 weeks, and in some cases within 12 weeks of the treatment starting. Some patients report a mild burning or painful sensation at the site of the treatment and mild blisters afterwards. One patient developed what appears to be an unclean skin area at the treatment site. HIFU does not cause a change in the way serum lipids or liver function tests are performed, because they are quite accurate.

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