Mechanisms and efficacy of home-based facial rejuvenation devices: An evidence-based review

Summary: Abstract Body: Recent years have seen a growing interest in improving skin appearance and reversing age-related changes, driven by an increased awareness of the impact of skin health on overall well-being and self-esteem. As individuals seek more accessible and convenient alternatives for dermatologic care, home-based devices for facial rejuvenation have gained popularity. This review aims to evaluate the safety and efficacy of home-based devices for facial rejuvenation, providing insights into their mechanisms, clinical outcomes, and levels of supporting evidence. The strength of evidence was classified according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Level A evidence signifies consistent results from randomized controlled trials, while Level D evidence reflects case studies or observational studies with variable outcomes. We also provided recommendations categorized as Grade I, indicating that benefits outweigh risks, and Grade II, indicating that risks outweigh benefits. Fractional laser, using the PaloVia device, earned Level A evidence and a Grade I recommendation due to its effectiveness in promoting collagen synthesis and enhancing wound healing. LED and radiofrequency home devices obtained Level B evidence and a Grade I recommendation for their ability to stimulate collagen and elastin synthesis, as well as promoting fibroblast proliferation. In contrast, microneedling home devices, which promote collagen induction and growth factor release, are not recommended for home use (Grade II) and obtained Level D evidence due to numerous reported adverse events. By understanding the strengths and limitations of these technologies, healthcare providers can provide informed guidance on the safety, efficacy, and the levels of evidence associated with these home-based devices for facial rejuvenation. Haya S. Raef¹, Simonetta I. Gaumond^{2, 3}, Amaris N. Geisler¹, Ariel E. Eber² 1. Department of Dermatology, Emory University, Atlanta, GA, United States. 2. Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, United States. 3. Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, United States. Stem Cell Biology, Tissue Regeneration and Wound Healing