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Specialists in Radiowave Surgery, Laser and Non-Surgical Treatments

Clinics - Manchester, Stockport, Cheadle, Devon & Cornwall

Radiofrequency ablation (radiosurgery, high frequency electrosurgery) is a dermatosurgical procedure that aims at the surgical management of benign and malignant skin conditions by using various forms of alternating current at ultra high frequency (500-4000 kHz).

The most common form of radiofrequency ablation used in dermatology involves the application of high-voltage electromagnetic energy in the form of a damped sine wave. This form of current may be applied by electrofulguration, electrodessication or electrocoagulation.

Radiofrequency ablation (RFA) has gained importance in the recent years as it is highly effective in the cutting of the skin lesions with adequate hemostasis at the same time because of good coagulation.

Radiofrequency can be used for:-

• Full-thickness excision of nevi, 
• Treatment of Xanthelasma
• Removal Pearly Penile Papule
• Excision of Dermatofibroma
• Excision of seborrheic keratosis
• Warts and verrucae
• Treatment of Campbell de Morgan Spots
• Shave techniques that produce partial-thickness removal of superficial lesions and removing vascular lesions such as hemangiomas or pyogenic granulomas.

Factors Affecting the Efficacy of RFA     

Intensity of the power setting: The cutting of the tissue should be brisk and with the smallest electrode and power setting that is required to minimize the tissue damage and bleeding. The correct output power can be determined by starting at a low power and increasing the power until the desired outcome is attained (destruction, coagulation or cutting). In general, coagulation requires higher power settings than cutting, which requires higher power settings than desiccation or fulguration. The power settings for treating cutaneous lesions are generally low (10-20W).

Surface area of the electrode and contact time : An electrode of a small size causes less lateral heat spread and requires lower power setting. The cutting current procedures are best accomplished with a fine needle or wire electrodes. Movement of the electrode through the tissue should be continuous and fast to avoid build-up of lateral heat that causes tissue damage.

The type of current selected : The selection of the waveform depends upon whether cutting or coagulation is the primary aim. This gives precise results with minimal tissue damage.

Presence of moisture : The presence of moisture on the surface of the tissue prevents charring. Therefore, the surface should be moistened with saline soaked gauze.

Waiting period : A waiting period of 10s is ideal between two passages of electrode used for cutting in the same surgical field. It allows adequate cooling and prevents cumulative heat damage.

Advantages 

RFA is a simple, safe procedure with wider applications. It causes less lateral heat spread and tissue damage and provides better control in comparison to electric cautery. The cutting mode of radiofrequency is more effective and versatile in comparison to the carbon dioxide laser. As hemostasis occurs simultaneously, the time required for the surgery is less. There are fewer side effects and complications. RFA can be easily combined with other surgical modalities such as cryotherapy and laser for treatment.