Hi,
In principle, Agnes RF would be “better” compared to fractional CO2 for treating syringomas. This is because the insulated needle of Agnes RF can be inserted directly to where the syringoma is and the skin surface is minimally damaged during the procedure. I have found Fractional CO2 laser not very effective in treating syringomas as the treatment does not destroy the syringoma completely and the leftover syringoma grows back rather quickly.
In my experience, the good old technique of electrocautery or conventional CO2 laser ablation is still the gold standard of syringoma treatment, although significant downtime is expected due to the aggressive nature of the treatment. When performed by an experienced doctor, the risk of permanent scarring is actually very low. The added advantage is my patients are often pleased with the reduction of periorbital fine lines due to the collagen stimulation from the conventional ablation.
Hence in terms of treatment effectiveness, I would rank the various options as follows:
1) Electrocautery and conventional CO2 laser ablation (most effective)
2) Agnes RF
3) Fractional CO2 laser (least effective)
At least for syringoma treatment, “old and tested” still remains the best option available.
Hope this helps!
