Gone are the days where treatments such as fractional lasers and chemical peels dominated the aesthetics scene. Today, it’s all about “radiofrequency” and “microneedling” to treat an array of conditions, including stretchmarks and cellulite, acne and acne scars. 

Almost every clinic in Singapore is marketing this technique, claiming the device they carry is the best. As a consumer, I get it can be confusing. 

With so many types of microneedling brands out there – which one should you choose? At Ozhean Zoey, I personally only use Secret RF even though there are so many other RF devices out there, and for good reason, which I’ll talk about later.

What is RF microneedling and its mechanism?

RF microneedling uses tiny needles along with radiofrequency (RF) energy in order to rejuvenate the skin¹. It creates microwounds in the skin that trigger the production of capillaries, elastin and collagen. The skin that grows back is thicker and smoother, helping with a variety of skin problems such as:

• Fine lines
• Wrinkles 
• Stretch marks 
• Large pores 
• Acne scars 
• Scars from injury or surgery 
• Hyperpigmentation 
• Loose, sagging skin 
• Cellulite 
• Hyperhidrosis (excessive sweating)

Why should you choose Secret RF?

Secret RF uses a 2MHz bi-polar radiofrequency and delivers this RF energy precisely at adjustable depths ranging from 0.5mm to 3.5mm using ultra-fine gold-plated microneedles. These patented microneedles are able to make contact with the skin without any bruising or bleeding, and hence there is almost no downtime at all. 

Secret RF also has various modes and at a higher heat setting, it is able to stimulate fibroblasts in both subdermal and dermal layers for effective skin remodelling. The device also comes with adjustable handpieces and treatment tips, so it is suitable for all skin types. Even darker skin² can be treated without the worry of side effects such as post-inflammatory hyperpigmentation. I’ve had great success treating patients with darker skin tones. 

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How does Secret RF compare with other RF devices?

There are a number of RF devices out there in the market. Secret RF is one of the newer technologies and hence boasts more benefits. 

Some RF microneedling devices are fractional while others are non-fractional. For the non-fractionated approach, bulk heating is used without precision for exact placement of the heat. This means there are opportunities for errors in depth of penetration and temperature control. This bulk heating could be too superficial, leading to burns or pigmentation changes, or too deep, leading to fat loss. The dermis needs exact heating for stimulation of collagen production, which can only be done in a fractional manner. Hence, opting for fractional technology will be your best bet. 

The microneedles of each device are capable of being adjusted to different modes to change the penetration depth into the skin. Of course, deeper scars would require deeper penetration, while naturally thinner areas would normally work well with more superficial penetration. It really depends on what your skin problems are, and the doctor will personalise your treatment accordingly. 

As for the duration of the procedure, Secret RF is the clear winner, with a total time of only 15 to 20 minutes, unlike the usual 30 to 45 minutes for most of the other treatments. Some can even take up to an hour or more! In my opinion, that is way too long. 

When choosing an aesthetic treatment, patients usually look for 3 things: 

1. How effective is this treatment in bringing results?
2. How long is each treatment session, is it going to be tedious aka is it a lunchtime treatment? 
3. Does this treatment require a long downtime? 

Most patients are busy working individuals who can only pop in for treatments during their lunch hour — hence why many modern aesthetic procedures are marketed as “lunchtime treatments”. These treatments should only take 30 minutes tops AND allow them to go back to work and resume their regular activities after. Simply put, patients do not have the time to spend an hour or more at the clinic with additional downtime — which is what most present (and older) RF devices require.

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Secret RF only requires 1 to 3 treatment sessions with intervals of 1 month to see the effects. There is barely any downtime, and minimal discomfort with a numbing cream applied. Its side effects are minor and will go away within 24 hours. 

Here is a comparison table that clearly differentiates Secret RF from other microneedling RF devices. 

	Secret RF	INTRAcel	Infini	Sylfirm	Potenza	Endymed
Key technology	Fractional RF	Fractional RF	Fractional RF	Fractional RF	RF	Fractional RF
Gold tip (for less pain)	Yes	No	Yes	Yes (gold coated)	Tiger tip	Yes
Penetration	0.5 - 3.5mm	Up to 2mm	0.5 - 3.5mm	Up to 4mm	0.5 - 4mm	0.5 - 5mm
Duration of procedure	15 - 20min	40 - 45min	30min - 2h	20 - 45mins	30 - 45min	30 - 45min
Number of treatments needed for noticeable results	1 – 3	1 - 3	1 - 2 for mild scars  4 - 8 for severe scars	1 - 6	1 - 4	5 - 6
Interval between treatments	3 - 4 weeks	2 - 3 months	2 - 3 months	3 - 4 weeks, with longer intervals for maintenance	6 weeks	1 - 2 weeks
Downtime	Little to none	24 hours	1 - 5 days	Little to none	5 days	Little to none
Discomfort	Minimal discomfort with numbing cream	Painful with numbing cream	Mild discomfort (mild stings) with numbing cream	Minimal discomfort with numbing cream	Mild discomfort (mild stings) with numbing cream	Minimal discomfort with numbing cream
Side effects	Redness  Minor swelling  Skin irritation	Redness  Swelling Pinpoint bleeding  Dry and flaky skin  Risk of Post inflammatory hyperpigmentation	Redness Tightness  Itching  Warm sensation	Redness Inflammation	Redness Tingling Pinpoint bleeding  Warm sensation	Redness Warm sensation
Cost	$800 - $1200	$200 - $300	$850 - $2500	$500 - $800	$1200 - $1500	~$300

As you can see, Secret RF is not the cheapest option, neither is it the most expensive. A mistake people often make is to go for the cheaper packages, but there is usually a good reason why it is so cheap in the first place. Cheaper options often come with more pain, more side effects and are less effective.

This is also not to say that you must definitely choose the most expensive one. While expensive treatments may offer higher quality, the outcome of the treatment ultimately still depends on the skill of your doctor. In my opinion, Secret RF is good because it’s on the middle ground – not too costly yet still of high standard. 

Read to find out how Secret RF treats ageing and acne scars. 

Do you have any questions for me regarding Secret RF or microneedling in general? I am more than happy to answer them!

References 

1. Alessa, D., & Bloom, J. D. (2020). Microneedling Options for Skin Rejuvenation, Including Non-temperature-controlled Fractional Microneedle Radiofrequency Treatments. Facial plastic surgery clinics of North America, 28(1), 1–7. https://doi.org/10.1016/j.fsc.2019.09.001
2. Cohen, B. E., & Elbuluk, N. (2016). Microneedling in skin of color: A review of uses and efficacy. Journal of the American Academy of Dermatology, 74(2), 348–355. https://doi.org/10.1016/j.jaad.2015.09.024 

We all want youthful-looking skin that’s free of acne scars, and you must have heard that laser treatments can help.

Previously, we explained why lasers are not long term solutions for acne treatment in Singapore - the same applies to acne scars. 

Laser treatment for acne scars are designed to minimise the appearance of acne scars that are a result of old acne outbreaks. These acne scars are unsightly and a concern for many men and women out there. However, in contrast to what other doctors and clinics market, lasers alone do not provide satisfactory and long term resolution for acne scars and are often extremely harsh on the skin. 

If you’re relying solely on lasers to resolve your acne scar issues - reconsider. Instead, consider treatments that reach deeper into the problem such as Secret RF.  It might deliver more benefits, reduced downtime and better resolution of acne scars. Here’s how.

Limitations of conventional lasers

To set the record straight, lasers can work - except they are often not as efficient especially when used on their own Granted, conventional lasers help to reduce the appearance of small acne scars and improve your skin texture, but they may prove to have inadequate results for deeper larger scars. The reason being is that lasers are absorbed in the skin from the surface inwards which means their therapeutic effects are mainly confined to superficial skin.  That also means that to reach deeper skin where deeper scars reside, higher laser fluences or energies are needed, and that will mean excessive energies administered to the superficial skin resulting in unwanted complications such as PIH and inadequate scar removal.

In aesthetics, we work with ablative and nonablative lasers. Ablative lasers (e.g. Fractional CO2 laser) create wounds that destroy scar tissue and tighten the collagen in the skin, while nonablative lasers promote new collagen production by heating the skin. Ablative lasers are thought to be more effective in scar removal due to their higher photothermal energies delivered, but are also harsher and riskier to patients. They come with a series of side effects such as;

• Redness
• Swelling
• Scabbing
• Pain
• Longer downtime of at least 2 weeks

Ablative lasers with excessive energies also have a greater chance of causing hyperpigmentation during the healing process, especially in those with darker skin tones. This is known as post-inflammatory hyperpigmentation (PIH). These dark spots are discolourations of the skin due to an inflammatory wound caused by the laser, which triggers melanocytes or pigment cells to release excessive amounts of pigment that cause the PIH. PIH can also be worsened with exposure to the sun. 

Unfortunately, PIH doesn’t go away in a matter of days; recovery from PIH can take anywhere from 3 to 24 months and is a separate issue to treat. 

Granted Pico lasers can offer a more superior recovery and lower risks of PIH compared to conventional ablative lasers such as CO2 lasers due to it’s LIOB effect.  

However, as we have mentioned above, its effects are mostly superficial and simply cannot remove or reduce scar tissue that deeper in origin. That is why pico lasers can still offer frustrating and disappointing results even in many sessions.

What Secret RF can do for acne scars

Secret RF is a fractional radio frequency (RF) microneedling technique that is able to treat deeper acne scars because the microneedles reach the correct depth where deeper scars reside (and where the problem is). As a result, collagen is stimulated and remodeled in the skin. 

We are also able to adjust the microneedles to deliver energy to the skin at various depths. This enables the treatment to be customised to address different skin conditions that patients may have, and works brilliantly even for darker skin types. 

In addition, a procedure called RF subcision can be performed with Secret RF treatment.  This treatment is particularly important for rolling and deep scars as the skin is depressed by deep scars in and under the skin. This is a treatment that releases the deep skin scar tissue and allow the skin to rise.  As a result, the appearance of rolling and boxcar scars are visibly diminished— with little trauma and complications that typically come with a conventional subcision. This is due to the radiofrequency releasing the scar tissue which is significantly less traumatic compared to a physical subcision.

As Secret RF works by the mechanics of triggering collagen and elastin production, patients often find that apart from healing their acne scars, they get the benefits of tighter, healthy-looking skin and an overall youthful appearance.

How Secret RF works with PICO laser

At Ozhean Zoey Aesthetics, we use both Secret RF and the pico laser to treat acne scars as we find that they complement each other well - as proven by our patients. 

1. Secret RF targets deeper layers of skin tissue and inactivates sebaceous glands, preventing future acne from recurring altogether 
2. The pico laser uses minimal heat to target problem areas and mechanical force to break up superficial scar tissue in the skin. It is used to treat superficial layers of skin tissues. 

Let’s not also forget that both stimulate collagen activity - so their combined effect can effectively treat acne scars both at the root and surface. 

We recommend at least 4-6 sessions for acne scars for more pronounced results. 

Do you have any questions for us? We are more than happy to answer them! 

References 

1. Connolly, D., Vu, H. L., Mariwalla, K., & Saedi, N. (2017). Acne scarring—pathogenesis, evaluation, and treatment options. The Journal of clinical and aesthetic dermatology, 10(9), 12. 
2. Chandrashekar, B. S., Sriram, R., Mysore, R., Bhaskar, S., & Shetty, A. (2014). Evaluation of microneedling fractional radiofrequency device for treatment of acne scars. Journal of cutaneous and aesthetic surgery, 7(2), 93.

The quest for younger-looking skin often involves a series of treatments - fillers, botox and other injectables to treat the trajectory of ageing. Then there’s also the effects of saggy skin and cellulite on our body, which would require a slew of other anti-ageing treatments. 

We’ve talked about what Secret RF can do for acne and acne scars, but most are unaware that it can also treat other natural effects of ageing like melasma, wrinkles, fine lines and other skin conditions. Yes, Secret RF can be used on the body for body contouring purposes - how does it work, and what benefits can we expect? 

Let us dive into the mechanics of exactly how Secret RF helps you to combat ageing and melasma.

Improved extracellular matrix

Secret RF uses radiofrequency (RF) currents from needle tips that induce direct changes in the dermo-epidermal junction and dermis with minimal ablation (destruction of tissue) to the epidermis. Secret RF can effectively treat melasma because it improves the impaired extracellular matrix (ECM) of the skin, commonly found in melasma lesions.

Combination therapy

A combination of micro-needling RF and laser toning has been shown to work well in loosening melanocytes from epidermal cells. The microneedles are able to create pores that allow the melanosomes (where melanin is stored) to drop off into the dermis. 

Elimination of melanin

Through the micro-needling method, it is also easier to eliminate melanin, the pigment cells causing the dark spots. Using microscopes, scientists have found that melanocytes, the cells producing melanin pigment, shrank and reduced in volume after using combination therapy of micro-needling RF and laser toning. This indicates that the melanocytes have been damaged, which in turn results in reduced melanin production. 

Reduced inflammation 

It is known that exposure to ultraviolet (UV) rays can trigger inflammation and hence the release of histamine from mast cells in the skin. This then stimulates the proliferation of melanocytes that migrate to the area. It has been shown that the micro-needling RF technique is able to reduce inflammation and mast cell numbers, hence improving melasma. 

Thickening of the skin

Dermatologists have postulated that melasma is associated with thinning skin as shown in skin biopsies. This thinning skin may be due to the normal effects of ageing, which can be counteracted through Secret RF. Secret RF has added benefits of thickening the dermal layers of the skin and stimulating collagen production for more supple skin. Therefore, by thickening the skin, Secret RF is able to treat melasma, fine lines and wrinkles, tightening the skin and producing distinct rejuvenation effects. 

Other applications (Secret RF body)

We often associate collagen production with its positive effects on our face, but triggering collagen production can have effects in many aspects, including our body and conditions like sweaty armpits. 

As a whole, Secret RF has been shown to improve: 

• Acne
• Acne scars
• Scars from surgery 
• Axillary hyperhidrosis or sweaty armpits (RF micro-needling destroys sweat glands by using heat or thermal energy)
• Stretch marks 
• Cellulite
• Hair loss (RF energy is released into the collagen fibres of the scalp, which triggers new collagen and elastin fibres as well as growth factors. As a result, hair loss slows down and the structure and thickness of hair is restored) 

So, Secret RF can treat not only acne and acne scars, but also help you to combat the effects of ageing and treat hyperpigmentation woes like melasma. Here at Ozhean Zoey, we are dedicated to eradicating your skin problems and helping you to restore young and healthy-looking skin – and what better way to do that than by providing you with our Secret RF services?

References 

1. Sarkar, R., Arora, P., Garg, V. K., Sonthalia, S., & Gokhale, N. (2014). Melasma update. Indian dermatology online journal, 5(4), 426.
2. Jung, J. W., Kim, W. O., Jung, H. R., Kim, S. A., & Ryoo, Y. W. (2019). A face-split study to evaluate the effects of microneedle radiofrequency with Q-switched Nd: YAG laser for the treatment of melasma. Annals of Dermatology, 31(2), 133-138.
3. Seo, K. Y., Kim, D. H., Lee, S. E., Yoon, M. S., & Lee, H. J. (2013). RETRACTED ARTICLE: Skin rejuvenation by microneedle fractional radiofrequency and a human stem cell conditioned medium in Asian skin: a randomized controlled investigator blinded split-face study. Journal of Cosmetic and Laser Therapy, 15(1), 25-33.
4. Tan, M. G., Jo, C. E., Chapas, A., Khetarpal, S., & Dover, J. S. (2021). Radiofrequency Microneedling: A Comprehensive and Critical Review. Dermatologic Surgery, 47(6), 755-761.

In a humid country like Singapore, experiencing sweaty underarms is not uncommon at all. However, some people suffer from excessive sweating, otherwise medically known as hyperhidrosis. Epidemiological studies show that this condition affects about 1% of our population;  while seemingly small, it doesn’t change the distress experienced by these patients. 

I’ve had patients come to me with concerns that they cannot wear particular clothing or must always bring a change of clothes because the issue of excessive sweating is so real, and many feel painfully embarrassed being in social situations. This added anxiety causes even MORE sweating, which exacerbates the problem. 

So why isn’t hyperhidrosis talked about enough? Well, firstly, this condition by itself is not life-threatening; secondly, many are unaware that there ARE effective treatments that can control sweaty armpits and yield long term results. 

My therapy of choice is Secret RF microneedling. 

But first, how can you tell if your sweaty armpits are a cause for concern?

If you have hyperhidrosis, you may notice: 

Visible sweating without effort or exertion 

According to The American Academy of Dermatology Association, a sign of excessive or unhealthy sweating is when you experience beads of sweat even when you’re not exerting yourself. However, this guideline will obviously differ in Singapore, where the climate is so humid you perspire even without effort! 

As a general rule, I advise patients to observe their sweat patterns when they’re in a cool environment. Is there still lots of sweating, and is your clothing sweat-soaked? 

Sweating interferes with your everyday life 

Do your sweaty armpits require a change of clothes every few hours or so? Does sweat drip heavily on your immediate objects e.g. phone, laptop?

Your underarms are soft, white and even peel 

Skin that is constantly wet tends to turn soft and white and in severe instances peel. 

Skin infections 

Do your armpits often get infections or rashes that resemble a heat rash? 

Body odour 

Patients with sweaty underarms often give out body odour. It is not the sweat itself that smells bad, but rather the substances bacteria on the skin create when they come into contact with sweat. 

Generally, if you feel like your sweaty underarms are impacting your quality of life and do not improve with top of the funnel treatments (e.g. antiperspirants), it may be time to seek help. 

Next, your line of treatment would depend on the type of hyperhidrosis you have. 

Types of hyperhidrosis in Singapore

Primary hyperhidrosis

Patients with primary hyperhidrosis are usually healthy and experience excessive sweating since they were a child. They experience: 

• Focal excessive sweating, usually at the armpits 
• Excessive sweating on BOTH sides of the body; for sweaty underarms, both underarms sweat excessively 
• Sweating that begins shortly after waking up 

Such patients would benefit the best from sweaty underarm treatment like Secret RF. 

Secondary hyperhidrosis 

Patients with secondary hyperhidrosis experience excessive sweating as a result of another medical condition, such as: 

• Diabetes 
• Gout 
• Obesity 
• An overactive thyroid gland 

In some cases, this type of sweating could also be caused by certain medications. For patients with secondary hyperhidrosis, I recommend complementing your current treatment protocol with sweaty underarm treatment to control the sweating. 

What is the best treatment for underarm sweating?

There are a few treatment options available for hyperhidrosis, with the most common non-invasive ones being; 

1. Antiperspirants  
2. Botulinum toxin 

Both work to narrow or inhibit the sweat gland, but the former is not preferred for sweaty armpits and the latter produces transient results and is extremely costly. 

The third most common therapy is surgery, which although effective comes with side effects like burning, scarring and significant patient downtime. About 18-20% of patients experience symptom recurrence too. 

It is for these reasons I prefer microneedling RF to treat sweaty underarms as they fulfil the following criteria: 

• Outpatient treatment that requires only local anaesthesia 
• Short recovery time 
• Long-term efficacy 
• Efficient cost-wise 
• It actually works

Microneedling radiofrequency for sweaty underarms work by destroying eccrine glands through a process known as thermolysis. This removal is permanent and the sweat gland cannot be restored, hence treating the problem entirely. But let the literature speak for itself — a handful of studies evaluating RF energy have shown that bipolar RF devices are safe and effective in treating hyperhidrosis. 

In a 2016 study, patients were required to define the severity of their hyperhidrosis based on the scale below. 

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Prior to treatment, almost all gave their condition a score of 3 and 4, but on follow up visits after a year, most labelled their condition as a 1 or 2. 41.6% of patients did not experience relapse after one year. In another study, 30% also found that they no longer had armpit hair; but in general, all who were treated felt a sense of relief. 

Why I prefer Secret RF for sweaty underarm treatment

While all novel bipolar RF devices work by the same mechanism, as an aesthetic doctor practicing at Ozhean Zoey, I prefer Secret RF due to the appliance’s gold-plated micro needles that allow for perfect contact with skin without bruising or bleeding. This protects both the upper skin layers and the structures beneath the subcutaneous fat. 

Apart from sweaty underarms, Secret RF can also effectively treat acne. Read more here. 

Do you have a question for me regarding treatment for sweaty armpits? Feel free to ask away and I am more than happy to help. 

References 

1. Abtahi-Naeini, B., Naeini, F. F., Saffaei, A., Behfar, S., Pourazizi, M., Mirmohammadkhani, M., & Bolandnazar, N. S. (2016). Treatment of Primary Axillary Hyperhidrosis by Fractional Microneedle Radiofrequency: Is it Still Effective after Long-term Follow-up?. Indian journal of dermatology, 61(2), 234. https://doi.org/10.4103/0019-5154.177789
2. Kirsten, D. (2013). Treatment of Hyperhidrosis [Ebook]. prime-journal.com. Retrieved 30 September 2021.