Assessment Skin Quality and Efficacy of Dermal Line After Four Bipolar Radiofrequency Microneedling Treatments

Not Applicable

Completed

Conditions: Aging

Interventions: Device: InMode Morpheus8 System

Registration Number: NCT05085730

Lead Sponsor: University of Texas Southwestern Medical Center

Brief Summary: This study intends to evaluate the safety and effectiveness of the InMode Morpheus8 System to treat facial and neck skin and assess its effect on skin quality and dermal lines. This device has been FDA cleared for full body subdermal adipose tissue remodeling.

Detailed Description: The primary objective of this study is to evaluate the safety and efficacy of a bipolar fractional radiofrequency treatment via use of the InMode Morpheus8 System to achieve skin texture and quality change and to treat facial fine lines and wrinkles of the lower face.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 13

Inclusion Criteria

Healthy male and female adults between ages 21-70 years of age.
Presence of facial dermal lines and skin changes of the lower face associated with age or environmental exposure.
Confirmed BMI ≤ 35.
Subjects who can read, understand, and sign the Informed Consent Form.
Subjects willing and able to comply with all study requirements.
Fitzpatrick skin type I-VI.
Minimum of 1 on the Lemperle Wrinkle Assessment Scale, Allergan Fine Line Scale and Allergan Skin Roughness Scale
Subject is willing not to undergo any type of aesthetic procedure that could confound the study device treatment effects until he/she completes the study.

Exclusion Criteria

Active localized or systemic infections, that may alter wound healing.
Immunocompromised subjects.
Subjects with coagulation disorder.
History of skin photosensitivity disorders, or use of photosensitizing drugs (e.g., tetracycline or sulfa drugs).
Pregnant and/or lactating (All female volunteers will be advised about using birth control during the period of study).
5 on the Lemperle Wrinkle Assessment Scale or 4 on the Allergan Fine Line Scale and/or Allergan Skin Roughness Scales
Scarring in areas to be treated.
Tattoos in the treatment areas to be treated.
Significant open facial wounds or lesions.
Severe or cystic acne in treatment areas.
Current active smoker.
Use of Accutane (Isotretinoin) within the past 6 months.
Use of topical retinoids within 48 hours.
Use of prescription anticoagulants.
Pacemaker or internal defibrillator.
History of skin disorders resulting in abnormal wound healing (i.e. keloids, extreme dry and fragile skin).
Subjects on current oral corticosteroid therapy or within the past 6 months
Metal implants in the treatment area.
In the opinion of the investigator, subject is unwilling or unable to adhere to all study requirements, including application and follow-up visits.
Subjects with a history of radiation therapy to the treatment area.
Subject has a history of allergy to lidocaine or ester-based local anesthetics.
Subjects with significant cardiac history or rhythm disturbance who may be unable to tolerate lidocaine with epinephrine.
Subjects with any skin pathology or condition in the treatment area that could interfere with evaluation or with the use of typical ancillary medical treatments or care used before, during or after treatments (e.g. psoriasis, rosacea, eczema, seborrheic dermatitis, vitiligo, hyper or hypo-skin pigmentation conditions such as post inflammatory hyperpigmentation).
Subjects who are unwilling to shave excessive hair in the treatment area that might influence or impair evaluation in the opinion of the Investigator.
Subjects have undergone skin resurfacing or tightening treatments in the treatment area over the past year.
Subjects have undergone dermatological treatments such as fillers and neurotoxins for the past 6 months in the treatment area.
Subjects have undergone laser and light treatments in the treatment area over the past 3 months.
Subjects have undergone superficial peel or microdermabrasion within 4 weeks.

Study & Design

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Treatment	InMode Morpheus8 System	All subjects will receive 4 separate treatments with the InMode Morpheus8 System.

Primary Outcome Measures

Name	Time	Method
Change of Fine Lines and Wrinkles	Baseline, 3 Months and 6 Months	Lemperle Wrinkle Assessment Scale- wrinkling will be assessed according to scales definitions. 0- No wrinkles 1. Just perceptible wrinkles 2. Shallow wrinkles 3. Moderately thick wrinkles 4. Deep wrinkles, well defined edges 5. Very deep wrinkles, redundant folds Lower value would indicate improvement.
Change of Fine Lines	Baseline, 3 Months and 6 Months	Allergan Scale for Fine Lines- fine lines of the midface/cheeks will be assessed according to the scales definition. 0- None 1. Minimal (1-2 superficial lines) 2. Moderate (3-5 superficial lines) 3. Severe (\<5 superficial lines; no crosshatching) 4. Diffuse (diffuse superficial lines; crosshatching) Lower value would indicate improvement
Change of Skin Roughness	Baseline, 3 Months and 6 Months	Allergan Skin Roughness Scale Assessment- roughness will be assessed according to the scaled definitions based on skin coarseness, crosshatching and elastosis in midface area. 0- None (smooth visual skin texture) 1. Minimal (slightly course and uneven visual skin texture) 2. Moderate (Moderately coarse and uneven visual skin texture; early elastosis) 3. Severe (severe coarse visual skin texture, crosshatching lines; some elastosis) 4. Diffuse (extreme coarse visual skin texture, deep crosshatched creases; extreme elastosis) Lower value would indicate improvement
Global Aesthetic Improvement Scale (GAIS)	3 Months and 6 Months	Scale will be used to assess aesthetic change 1. Very much improved 2. Much improved 3. Improved 4. No Change 5. Worse Lower value would indicate improvement

Secondary Outcome Measures

Name	Time	Method
Biomechanical Tissue Measurements (Stiffness)	Baseline, 3 Months and 6 Months	Bio-Mechanical Tissue Characterization (BTC2000) is a laser measurement system for objective, quantitative and sensitive analyses of the bio-mechanical properties of: Skin to assess skin thickness, density, firmness as well as the integrity of the stratum corneum.
Adverse Events	Baseline, Day 30, Day 60, Day 90, Month 3 and Month 6	Adverse events will be monitored at each visit
Change in Exploratory Thickness/Density- High Resolution Ultrasound	Baseline, 3 Months and 6 Months	high resolution ultrasound will be utilized to assess skin thickness/density.
Biomechanical Tissue Measurements (Energy Absorption)	Baseline, 3 Months and 6 Months	Bio-Mechanical Tissue Characterization (BTC2000) is a laser measurement system for objective, quantitative and sensitive analyses of the bio-mechanical properties of: Skin to assess skin thickness, density, firmness as well as the integrity of the stratum corneum.
Change in Histology Assessments	Baseline and 6 Months	Histological assessments (microscopic study-tissue structure, elastin, collagen and hyaluronic acid expression) will be completed after taking biopsies ( from the cheek adjacent to the nasolabial fold within the designated area for treatment) of the skin area to correlate changes to the skin after treatments. Histology studies the structure of the tissue. Collagen 3, Collagen 1, Elastin, Macrophage are biomarkers. Histology was only compared between baseline and 6 months. Fold changes compared to control were calculated from fluorescence intensity of a confocal microscopy images.
Change in Barrier Skin Function- TEWL	Baseline, 3 Months and 6 Months	Transepidermal Water Loss Measurements (TEWL measurements) (via Bio Aquaflux) will be used to evaluate barrier function of the skin epidermal layer after treatments. It is used to assess skin thickness, density, firmness as well as the integrity of the stratum corneum. Skin barrier dysfunction results in increased TEWL.
Biomechanical Tissue Measurements (Laxity, Elasticity)	Baseline, 3 Months and 6 Months	Bio-Mechanical Tissue Characterization (BTC2000) is a laser measurement system for objective, quantitative and sensitive analyses of the bio-mechanical properties of: Skin to assess skin thickness, density, firmness as well as the integrity of the stratum corneum.
Biomechanical Tissue Measurements (Elastic, Viscoelastic and Ultimate Deformation)	Baseline, 3 Months and 6 Months	Bio-Mechanical Tissue Characterization (BTC2000) is a laser measurement system for objective, quantitative and sensitive analyses of the bio-mechanical properties of: Skin to assess skin thickness, density, firmness as well as the integrity of the stratum corneum.
Change in Gene Expression	Baseline and 6 Months	Gene expression assessments will be completed to analyze protein related to collagen, elastin, and the extracellular matrix production. Gene Expression studies cellular activity and Collagen 1, Collagen 3, Elastin, LOX, IL8 and MMP2 are all biomarkers. Gene expression was only compared between baseline and 6 months. Fold changes were compared to control from Ct values of RT-qPCR reactions. * Ct: threshold cycle * RT-qPCR: Quantitative reverse transcription polymerase chain reaction)