Non-Light-Based Energy Devices in Aesthetics: Current Evidence and Emerging Innovations

Non-light-based energy devices are increasingly used in aesthetics as minimally invasive treatments that employ thermal, mechanical, and electromagnetic energy for multiple aesthetic indications. This review summarizes current evidence and emerging innovations in this rapidly evolving field.

A targeted PubMed search was performed using the keywords radiofrequency, microwave, ultrasound, and energy-based devices. English-language articles were included, supplemented by citation tracking and authors' clinical expertise.

Radiofrequency (RF) devices demonstrate efficacy for skin laxity, rhytides, acne, acne scarring, and vascular lesions through thermally induced dermal remodeling. Fractional RF microneedling is particularly effective in darker skin phototypes with low risk of postinflammatory hyperpigmentation. High-frequency RF ablation provides precise, low-pain treatment of benign cutaneous lesions. Ultrasound-based devices, including high-intensity focused ultrasound, are effective for skin tightening and facial contouring. Cryolipolysis devices achieve significant localized fat reduction with evidence of dermal remodeling. Microwave energy-based devices are effective for axillary hyperhidrosis, osmidrosis, cellulite reduction, submental skin tightening, and facial rejuvenation. Cold atmospheric plasma devices show promise for skin rejuvenation and wrinkle reduction, acne treatment, melasma, and enhanced transdermal drug delivery.

Non-light-based energy devices offer versatile, safe treatment options across aesthetics with minimal downtime and applicability to all skin phototypes. Ongoing advances emphasize precision delivery, combination therapies, and personalized treatment strategies.