Combined therapies with RF Combo Jector

AUTHOR:

dr Agnieszka Górna

pediatrician, aesthetic medicine physician

Radiofrequency is one of the most effective methods for improving skin quality, which is why it is used in the treatment of such challenging aesthetic concerns as acne scars. Dr. Agnieszka Górna was among the first in Poland to start using the RF Combo Jector device. Its uniqueness lies in the ability to operate in four different modes, including a unique combination of radiofrequency with microneedling mesotherapy.

The use of the synergistic effect of radiofrequency and polylactic acid allows for fast and truly spectacular results in the treatment of acne scars – and this indication is where my journey with RF Combo Jector began. Today, I use this therapy much more broadly, and I utilize the device in practically every injection procedure, as in injector mode it can deliver a wide range of substances.

Treatment of acne scars

Acne vulgaris is currently a major problem, affecting not only adolescents but also adults up to the age of 30. Unfortunately, in many cases it leaves scars caused by severe inflammation, often due to delayed treatment and improper skincare.

What is the mechanism of action of radiofrequency on acne-prone skin?

First, RF reduces the size of sebaceous glands and decreases their activity, leading to reduced sebum production.
Second, by inducing controlled micro-injuries in the skin, RF stimulates healing processes and promotes the production of collagen and elastin, making the skin denser, firmer, and more elastic, while scars are remodeled and smoothed.
Third, it stimulates anti-inflammatory cytokines and growth factors and improves skin circulation, which helps reduce inflammation and its recurrence, thereby lowering the risk of acne scar formation.

Studies conducted in Korea have shown that particularly good results in acne scar therapy are achieved by combining microneedle radiofrequency with poly-D,L-lactic acid. In patients, skin thickness significantly increased, while the fat layer remained largely unchanged.¹
The combination of these two technologies – thanks to enhanced collagen stimulation – boosts the effectiveness of scar treatment and significantly reduces inflammation.²

Additionally, in this study, a laser was used to even out the skin surface and accelerate healing processes. Interestingly, the safety of combined RF therapy was also evaluated in patients simultaneously taking isotretinoin. This strong medication, used in the treatment of severe acne, significantly affects tissue structure and regenerative capacity, but also dries the skin and increases its sensitivity. Therefore, invasive procedures – especially energy-based ones – are usually discouraged during treatment.

The combination of microneedle RF with PDLLA was found to be safe in these patients when appropriate intervals were maintained to minimize the risk of damage and allow time for regeneration.

However, it should be remembered that visible improvement in scars resulting from stimulation appears only after several weeks or months, so patients should always be informed and asked for patience. That said, within just a few days after combined RF microneedling + Juvelook therapy, we often observe a reduction in inflammation and erythema.

I am a pediatrician, and young patients often come to me – I perform acne scar treatments in adolescents aged 16 and older. Microneedling RF alone already gives very good results in this group, but when I see significant post-inflammatory changes, I administer PDLLA during the first session, of course in small amounts, as it has strong biostimulatory effects. As mentioned earlier, studies show it can be used even during isotretinoin therapy, which is a major advantage for patients.³

A particularly challenging case in my practice involved a patient with an extensive burn scar from a bioethanol fireplace and a skin graft. Beyond aesthetics, contractures around the knee joints prevented leg extension and hindered the start of physiotherapy. Since the dense scar tissue made injection difficult, I first performed two sessions of intensive microneedle RF to break down the tissue, followed by two sessions combining Juvelook with RF. The skin became more elastic, better vascularized, lighter, and the patient was able to begin rehabilitation.

Treatment of melasma

Another challenging aesthetic concern where the combination of RF and poly-D,L-lactic acid proves effective is melasma.

A recent study⁴ showed that PDLLA can reduce melasma symptoms – characteristic dark pigmentation on the face, especially on the cheeks, forehead, and upper lip. After treatment, the skin became more even-toned and discoloration lightened, even though PDLLA does not act directly on melanocytes.

In this case, the mechanism is based on reducing UVB-induced pigmentation by decreasing damage to the basement membrane. Additionally, PDLLA activates fibroblasts and stimulates collagen synthesis, reducing melanogenesis induced by SASP (senescence-associated secretory phenotype).

SASP occurs in aging cells exposed to various stressors, such as DNA damage and oxidative stress. These cells stop dividing but remain metabolically active, releasing pro-inflammatory mediators and enzymes that degrade the extracellular matrix. This leads to chronic inflammation and further tissue damage.

SASP plays a key role in aging processes, and this chronic inflammation negatively affects fibroblast function, potentially increasing melanin production and worsening pigmentation. PDLLA restores proper fibroblast activity, supporting skin regeneration, reducing inflammation, and indirectly decreasing melanogenesis.

Treatment of stretch marks and cellulite

This is another common dermatological issue, mainly associated with rapid weight changes, pregnancy, and – among younger individuals – growth spurts and hormonal changes.

When the skin is excessively stretched, collagen and elastin fibers are damaged, leading to visible, shiny streaks – essentially a type of scar.

Typically, single modalities such as microneedling or laser treatments are used, combined with topical care. However, the synergy of RF and PDLLA enables more effective treatment, delivering visible results in a relatively short time.

Studies⁵ confirm that using microneedle RF injector combined with polylactic acid improves collagen production, making stretch marks less visible and the skin smoother and firmer. Both treatments stimulate collagen synthesis, which is crucial for tissue regeneration and reducing the appearance of stretch marks.

This combined therapy also shows excellent results in treating cellulite. The skin becomes uneven and dimpled due to irregular fat distribution. After reviewing research on RF for cellulite treatment, I began combining it with PDLLA in my patients.

One patient, after losing 50 kg, struggled with stretch marks, cellulite, and skin laxity. She also complained about flat buttocks, so we divided the treatment into two stages: first, modeling and firming the buttocks using Lenisna combined with hyaluronic acid, followed by two sessions combining RF with Juvelook. The results were truly impressive, with a visible reduction in stretch marks and cellulite.

For stretch marks, I usually perform 2–4 treatments every 3 weeks. Alternating RF and Juvelook works particularly well on fresh lesions. For older, fibrotic ones, I sometimes begin by mechanically breaking their structure with a long cannula.

In cellulite therapy, I often include a dedicated cocktail administered with RF Combo Jector in injector mode. The results – smooth, firm skin – are truly impressive.

Other applications

RF Combo Jector offers highly versatile use – it’s like having four devices in one (a convenient, wireless “gun”). It can be used for needle or microneedle RF, as a standard injector, or – when used with Juvelook – for simultaneous mesotherapy and radiofrequency in a single application.

RF + Juvelook mesotherapy works excellently for revitalizing the skin of the face, neck, and décolleté. However, this method cannot be used to administer Juvelook in the lower eyelid or tear trough area (a cannula must be used there). After about a month, microneedle RF can be applied separately in this area to improve skin texture, reduce dark circles, and diminish puffiness.

Without the RF function, the device is also a convenient injector. I often use it for administering botulinum toxin in hyperhidrosis treatment (underarms, hands, feet). Patients are very satisfied – the procedure is fast, comfortable, and precise, improving effectiveness.

I also use the injector for autologous preparations such as platelet-rich plasma and, more recently, autologous exosomes (AutologIX), a PRP-derived concentrate with five times higher exosome concentration, providing strong regenerative and reparative properties.

Interestingly, RF Combo Jector has two buttons, allowing comfortable use both horizontally and vertically – especially useful for scalp treatments, where I now combine RF with exosomes.

Advantages of RF Combo Jector

What do I particularly like about RF Combo Jector?

It is lightweight, ergonomic, and easy to use. It works quickly and precisely, offering full control over depth and spacing depending on the product used. Most importantly, it allows for an almost unlimited number of combination therapies with other products.

Compared to manual mesotherapy, patients experience greater comfort and faster healing. For practitioners, it ensures safety, precision, control, and convenience – especially when treating large areas like the scalp, where manual work can be physically demanding.

Highly recommended!

¹ Seo SB, Wan J, Chan LKW, Lee KWA, Kim SB, Yi KH. Poly‑d,l‑lactic acid‑enhanced atrophic scar treatment via transdermal microjet drug delivery in Asians. Skin Res Technol. 2024 Jun;30(6):e13762.

² An MK, Hong EH, Suh SB, Park EJ, Kim KH. Combination therapy of microneedle fractional radiofrequency and topical poly‑lactic acid for acne scars: A randomized controlled split‑face study. Dermatol Surg. 2020 Jun;46(6):796‑802.

³ Wan J, Yi KH. Efficacy of subdermal poly‑d,l‑lactic acid injections for the treatment of melasma. J Cosmet Dermatol. 2025 Jan;24(1):e16650.

⁴ Kim J, Lee YI, Kim J, Jung JY, Lee WJ, Lee JH. Safety of combined fractional microneedle radiofrequency and CO₂ as an early intervention for inflammatory acne and scarring treated with concomitant isotretinoin. Dermatol Surg. 2020 Oct;46(10):e71‑e77.

⁵Seo SB, Kim SB, Yi KH. Effective improvement methods for striae distensae: A novel approach utilizing laser‑induced micro‑jet injectors with poly‑d,l‑lactic acid. J Cosmet Dermatol. 2024 Sep;23(9):2876‑2881. doi: 10.1111/jocd.16366. Epub 2024 May 16.