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Adv Biomed Res 2018,  7:71

Can Fractionated Microneedle Radiofrequency be an Effective Procedure for Treatment of Fox–Fordyce Disease? A Medical Hypothesis

1 Department of Orthodontic, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran
3 Skin Diseases and Leishmaniasis Research Center, Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran

Date of Web Publication24-Apr-2018

Correspondence Address:
Dr. Bahareh Abtahi-Naeini
Skin Diseases and Leishmaniasis Research Center, Department of Dermatology, Isfahan University of Medical Sciences, Isfahan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/abr.abr_288_16

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How to cite this article:
Kabiri S, Pourazizi M, Abtahi-Naeini B. Can Fractionated Microneedle Radiofrequency be an Effective Procedure for Treatment of Fox–Fordyce Disease? A Medical Hypothesis. Adv Biomed Res 2018;7:71

How to cite this URL:
Kabiri S, Pourazizi M, Abtahi-Naeini B. Can Fractionated Microneedle Radiofrequency be an Effective Procedure for Treatment of Fox–Fordyce Disease? A Medical Hypothesis. Adv Biomed Res [serial online] 2018 [cited 2023 Feb 8];7:71. Available from:


Fox–Fordyce disease (FFD), also known as apocrine miliaria, is a chronic and pruritic disorder of the apocrine glands. It presents as dome-shaped, skin-colored, and discrete perifollicular papules in the axillary skin.[1] Although the pathogenesis of FFD is not fully understood, occlusion of the apocrine duct resulting from the accumulation of keratin in the follicular infundibulum has been shown to have an important role. The lymphohistiocytic infiltration may be the cause of intense pruritus.[1]

Treatment of FFD is difficult and can be challenging; however, treatment is often necessary because of associated pruritus. There is no standard guideline for treatment of FFD because data on treatments are limited to case reports and small series. The initial preferred treatment options are topical corticosteroids, topical clindamycin, and topical calcineurin inhibitors.[2] Oral and procedural therapies are primarily reserved for refractory disease.[3]

The fractionated microneedle radiofrequency (FMR) device, which delivers heating in a fractional manner, was introduced for the use in skin treatments including skin rejuvenation,[4] acne scar,[5] axillary hyperhidrosis,[6],[7] and striae alba.[8] The FMR device delivers uniform heat at a controlled depth to the dermal-hypodermal layers where the sweat glands and hair follicles are present,[4] resulting in thermolysis of the sweat glands and subsequent necrosis.[9]

It has been shown that FMR in the treatment of primary axillary hyperhidrosis (PAH) can induce a decrease in the number and size of both sweat glands and hair follicles.[9]

The existence of zones of thermal wounds between areas of unaffected zones can be a supply of reservoir cells to promote healing, so there is less downtime and considers as a safe modality.[10],[11] In addition, skin needling with microneedles has been reported to stimulate the migration and proliferation of keratinocytes and fibroblasts by inducing the release of several growth factors,[4],[12] which may alter the patterns of infiltration around the hair follicle and may contribute to the resolve of intense pruritus.

Although there are no reports on the application of FMR in FFD, given the important role of occlusion of the apocrine gland in the pathogenesis of FFD and the efficacy of FMR on sweat glands and hair follicles, we hypothesized that FMR can be effective against FFD. Therefore, clinical studies on this subject are warranted.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Kamada A, Saga K, Jimbow K. Apoeccrine sweat duct obstruction as a cause for Fox-Fordyce disease. J Am Acad Dermatol 2003;48:453-5.  Back to cited text no. 1
Kaya Erdogan H, Bulur I, Kaya Z. Clinical effects of topical tacrolimus on fox-fordyce disease. Case Rep Dermatol Med 2015;2015:205418.  Back to cited text no. 2
Ahmed Al-Qarqaz F, Al-Shannag R. Fox-Fordyce disease treatment with fractional CO2 laser. Int J Dermatol 2013;52:1571-2.  Back to cited text no. 3
Seo KY, Yoon MS, Kim DH, Lee HJ. Skin rejuvenation by microneedle fractional radiofrequency treatment in Asian skin; clinical and histological analysis. Lasers Surg Med 2012;44:631-6.  Back to cited text no. 4
Cho SI, Chung BY, Choi MG, Baek JH, Cho HJ, Park CW, et al. Evaluation of the clinical efficacy of fractional radiofrequency microneedle treatment in acne scars and large facial pores. Dermatol Surg 2012;38(7 Pt 1):1017-24.  Back to cited text no. 5
Fatemi Naeini F, Abtahi-Naeini B, Pourazizi M, Nilforoushzadeh MA, Mirmohammadkhani M. Fractionated microneedle radiofrequency for treatment of primary axillary hyperhidrosis: A sham control study. Australas J Dermatol 2015;56:279-84.  Back to cited text no. 6
Abtahi-Naeini B, Naeini FF, Saffaei A, Behfar S, Pourazizi M, Mirmohammadkhani M, et al. Treatment of primary axillary hyperhidrosis by fractional microneedle radiofrequency: Is it still effective after long-term follow-up? Indian J Dermatol 2016;61:234.  Back to cited text no. 7
[PUBMED]  [Full text]  
Fatemi Naeini F, Behfar S, Abtahi-Naeini B, Keyvan S, Pourazizi M. Promising option for treatment of striae alba: Fractionated microneedle radiofrequency in combination with fractional carbon dioxide laser. Dermatol Res Pract 2016;2016:2896345.  Back to cited text no. 8
Naeini FF, Saffaei A, Pourazizi M, Abtahi-Naeini B. Histopathological evidence of efficacy of microneedle radiofrequency for treatment of axillary hyperhidrosis. Indian J Dermatol Venereol Leprol 2015;81:288-90.  Back to cited text no. 9
[PUBMED]  [Full text]  
Fatemi Naeini F, Pourazizi M, Abtahi-Naeini B, Nilforoushzadeh MA, Najafian J. A novel option for treatment of primary axillary hyperhidrosis: Fractionated microneedle radiofrequency. J Postgrad Med 2015;61:141-3.  Back to cited text no. 10
Hruza G, Taub AF, Collier SL, Mulholland SR. Skin rejuvenation and wrinkle reduction using a fractional radiofrequency system. J Drugs Dermatol 2009;8:259-65.  Back to cited text no. 11
Hantash BM, Renton B, Berkowitz RL, Stridde BC, Newman J. Pilot clinical study of a novel minimally invasive bipolar microneedle radiofrequency device. Lasers Surg Med 2009;41:87-95.  Back to cited text no. 12

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