AYUMI NAKANISHI / ANAKANISHI@STARBULLETIN.COM Dr. John McCurdy Jr., shown here on Tuesday, said his study found that radiofrequency resurfacing is the safest and most effective for Asians and other patients with pigmented skin because low-temperature radio wave energy generates less heat.

Skin fix good
for Asians

A Honolulu surgeon finds
that a treatment for wrinkles
works well on Asian skin

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Helen Altonn
haltonn@starbulletin.com

A low-temperature method of reducing wrinkles and age spots is effective for all skin types and has special advantages for Asians, says a Honolulu plastic surgeon.

Dr. John McCurdy Jr., a specialist in Asian cosmetic surgery, studied effects of a radiofrequency resurfacing procedure known as Coblation (an acronym for "cold ablation") on 15 Asians and 16 Caucasians.

The results are comparable to deep chemical peeling and laser-based techniques, but healing is faster and there are fewer complications, he said.

The Asians participating in the study did not have long-term pigmentation problems that often occur for their skin types with traditional resurfacing methods, he said.

As a result, they had reduced wrinkles and improved complexion similar to the whites, he said. McCurdy reported his findings at a recent meeting of the American Academy of Facial Plastic and Reconstructive Surgery in New York and elaborated on the study in an interview.

He said he had two goals:

First, to determine if Coblation would be a safe and effective treatment for Asian skin, "given the fact that it is much more reactive and many surgeons are reluctant to use any type of skin resurfacing in this population."

Second, to compare the rate of healing between Asian and Caucasian skin.

McCurdy said he found radiofrequency resurfacing is the safest and most effective for Asians and other patients with pigmented skin because low-temperature radio wave energy generates less heat.

It uses fewer than 200 degrees Fahrenheit on the tissue vs. more than 1,000 degrees Fahrenheit for some lasers, he said.

It also uses a different type of energy, "disrupting the surface of the skin by ionized particles rather than heat that's generated by laser," he said.

"It's good; I like it," said Kye Kim, one of McCurdy's patients. She said she had a "puka face" because of many pimples at one time.

"Now, it's pretty smooth, pretty clean," she said, adding that she looks younger.

PHOTOS COURTESY DR. JOHN MCCURDY The method used by McCurdy tends to be less damaging to those with more skin pigmentation. Above are before and after pictures of a woman who underwent the procedure.

Skin resurfacing to treat fine wrinkles, pigmentary problems and other facial skin disorders has been around a long time in various forms, including dermabrasion, deep chemical peeling and lasers, McCurdy said.

"People felt the laser would offer tremendous advantages because it could be operator-controlled," he said. But the laser resurfaces by burning the skin, resulting in some significant complications and delaying healing, he said.

"Many surgeons are becoming rather disenchanted with the laser, not to mention many patients now are really scared about it. In patients with pigmented skin, which we have a lot of in Hawaii, mainly Asians and other patients, there were even greater problems with laser."

He said the pigment of Asian skin is much more reactive, and the healing process is markedly delayed. "Even Asians with light-colored skin, the healing period was really protracted."

Coblation causes less skin damage, thus accelerating healing and reducing complications, McCurdy said, "most importantly, complications due to either increased or decreased pigmentation, which is fairly common in laser treatment."

He said results were "really dramatic" for white patients, who healed in an average of three to five weeks, and were especially beneficial for Asians because of reduced discoloration.

Healing from radiofrequency resurfacing took three to four weeks longer for the Asians than for the whites, but it still was faster than laser skin resurfacing, which can take three to six months to heal completely, McCurdy said.

"And sometimes, hypopigmentation (less than normal) appears one to two years after treatment. Increased pigmentation, or hyperpigmentation, usually goes away but hypopigmentation frequently is permanent," he added, noting studies on the mainland have shown little or no decrease in pigmentation after Coblation.

A patented technology developed in Silicon Valley, Coblation initially was used for orthopedic surgery and other medical problems, such as brain tumors and sleep apnea, McCurdy said. The Food and Drug Administration cleared it to treat wrinkles and skin blemishes in 2000.

An assistant clinical professor of surgery at the University of Hawaii's John A. Burns School of Medicine, McCurdy wrote a medical textbook, "Cosmetic Surgery of the Asian Face," and has published more than 80 scientific articles and medical chapters.

He was guest editor for a special issue on "Surgery in the Asian Patient" for the Facial Plastic Surgery Clinics of North America. His paper on the benefits of Coblation will be published in the Archives of Facial Plastic Surgery.

His cosmetic surgery practice is at 1188 Bishop St., Suite 2402.