Red Deer Umbilical Cord Lining Mesenchymal Stem Cell Conditioned Media after Monopolar Radiofrequency Facial Treatment – A Case Series

Introduction:

Facial wrinkles are a common indicator of ageing, often prompting individuals to seek cosmetic treatments to restore a youthful appearance. Monopolar radiofrequency (MRF) is a valuable non- ablative modality to treat early, mild-to-moderate skin laxity and wrinkles, particularly in the lower face and neck. The technique uses a single active electrode to generate controlled heat in the dermal layers, stimulating collagen and elastin production, promoting tissue contraction, and gradually improving skin texture, tightness, and tone (1). 

Although MRF treatment results in immediate skin tightening, maximum results are only achieved months after treatment; thus, there is ongoing interest in enhancing the efficacy of this treatment (2).

Advances in regenerative medicine have highlighted the potential of stem cell-based therapies, such as cord lining mesenchymal stem cells (CLMSCs)-derived conditioned media (CM), for cosmetic applications to improve tissue repair and rejuvenation. Red Deer Umbilical Cord Lining Mesenchymal Stem Cell conditioned media (RD-CLMSC-CM, otherwise known as PTT-6®) is particularly interesting due to its high concentration of growth factors, cytokines, and extracellular matrix proteins that address intrinsic factors of skin aging, such as the decline in collagen, hyaluronic acid, and elastin levels (3).

This study aims to assess the effect of a serum containing RD-CLMSC-CM (PTT-6®) on skin rejuvenation outcomes after MRF treatment.

Treatment:

Following MRF treatment, a moisturizer (Physiogel® Soothing Care A.I. lotion) was applied to the entire face (approximately one fingertip unit ≈ 0.5g). The moisturizer was followed by CALECIM® Professional Serum, which was applied 1-2 drops at a time and only to the right half of the face. Participants were directed to apply the serum twice daily (morning and evening) for four weeks. Approximately two bottles of serum were used per participant. 

Clinical assessments:

During the study, the participants’ facial photographs were taken using a high-resolution Fujifilm digital camera on their left at (45° and 90°) and right at (-45° and -90°). Photographs were taken before initial treatment with CALECIM® Professional Serum (Week 0) and at follow-up visits at Weeks 2, 4, 6, and 8.

Participant results were also assessed using the QuantifiCare 3D imaging system (QuantifiCare, USA) for measuring skin lifting [14]. QuantifiCare analysis was performed at baseline and 2, 4, 6, and 8 weeks after the start of the CALECIM® Professional Serum regimen.

Results:

The study included ten female participants, with a mean age of 40.6 years, ranging from 30 to 64 years. The participants had Fitzpatrick skin types III and IV, with mild to moderate facial wrinkles (Table 2). All ten participants completed the treatment and follow-up sessions. No adverse events were noted during or after treatment by the participants or the investigator.

The QuantifiCare SkinCare assessments over the 8-week period demonstrated progressive improvements in facial lifting on both sides of the face from baseline. However, the clinical improvements were more pronounced overall on the right side, which received the RD-CLMSC-CM serum treatment plus moisturizer, compared to the moisturizer-only treated side (left).

 
As shown in Table 3 and Figure 1, the difference between the sides was minimal and not statistically significant at week 2. By week 4, however, the mean difference had increased to 0.55, reaching statistical significance (p = 0.004). This significant difference persisted through week 6 (mean difference: 0.56, p = 0.021) and week 8 (mean difference: 0.57, p = 0.019), consistently favoring the right side. Clinical images provided in supplementary figure S1 (Cases 1-3) further illustrate these differences, highlighting the visible improvements on the right side over time.

Discussion:

Most non-invasive skin rejuvenation procedures aim to trigger a wound repair response, encouraging the body to replenish or remodel old or damaged tissues (4). In RF therapy, the controlled thermal damage induces immediate collagen contraction and stimulates ongoing collagen production and remodeling (5). This process mimics wound healing, with collagen remodeling beginning after an increase in type I collagen mRNA expression (6). The resulting increase in collagen fibers leads to gradual skin tightening, with optimal results typically seen 4 to 6 months post-treatment and lasting up to 1 year (7).

The structural integrity of the skin largely depends on fibroblasts, which synthesize elastin and collagen proteins(8). Elastin proteins ensure the skin's elasticity, while collagen fibers contribute to resilience and tensile strength. The human dermis is primarily composed of type I collagen, which consists of three polypeptide chains stabilized through a triple-helix structure formed by cross-linking. However, ageing is accompanied by a decline in these key proteins, along with reduced collagen cross-linking stability and increased oxidative stress and matrix metalloproteinase activity, which together contribute to the development of wrinkles and loss of skin elasticity(9). 

Mesenchymal stem cells (MSCs), particularly those derived from umbilical cord blood and umbilical cord lining, show great promise in addressing skin ageing by boosting collagen and elastin production (3,8). MSCs are known for their rapid proliferation and ability to secrete growth factors such as EGF, TGF-β, PDGF, and GDF- 11, which support skin regeneration and collagen type I synthesis (10). Studies using cord blood and cord lining-MSC-conditioned mediums have shown an increase in the presence of elastic fibers and restructuring of the collagen matrix within the dermis, leading to significant improvements in skin density and wrinkle reduction, thus highlighting their potential as an effective anti-ageing therapy (8,10).

While promising findings exist regarding the use of RD-CLMSC- CM in facial rejuvenation, particularly with ablative resurfacing [8], direct studies on its combination with non-ablative techniques have not yet been conducted. 

In this split-face case series, facial lifting was significantly enhanced on the right side (intervention) at all time points, while on the left side (comparator), significant improvements were evident starting from week 6. This suggests that the use of RD-CLMSC-CM (otherwise known as PTT-6®) accelerates facial lifting after MRF therapy.