Hyaluronic Acid Dissolving Microneedles and Nonablative Fractional Laser for Infraorbital Wrinkles: A Prospective, Randomized, Split-Face Study

Background. Recently, hyaluronic acid dissolving microneedles (HA-DMNs) have been widely used in antiwrinkle research studies. However, the comparison of HA-DMNs with nonablative fractional laser (NAFL), which is regarded as the gold standard in the treatment of facial wrinkles, is still lacking. Objective. The purpose was to compare the therapeutic effects and adverse effects of HA-DMNs and NAFL on infraorbital wrinkles. Methods. A prospective, randomized, split-face trial was performed with HA-DMNs on one side and NAFL on the other. The wrinkle numbers, photo-numeric scores, and VISIA assessment scores were compared at baseline and 2, 4, 8, and 12 weeks post-treatment. Reflectance confocal microscopy (RCM) was used to monitor collagen fibers. Adverse effects and subjects’ satisfaction scores were evaluated using scales. Results. The final analysis included 28 patients. The wrinkle numbers and photo-numeric scores decreased on both the HA-DMNs side and the NAFL side in week-2, 4, 8, and 12. The VISIA scores decreased on the HA-DMNs side in week-8 and on the NAFL side in week-2. There were no significant differences in these indexes between the two sides. The RCM images demonstrated a similar increase in collagen density on the two sides. Burning, erythema, edema, and crust scores were higher on the NAFL side than on the HA-DMNs side. There was no significant difference in the subjects’ satisfaction scores of the two sides. Conclusion. HA-DMNs are effective treatment options for infraorbital rejuvenation. From the change of wrinkle numbers and scores, HA-DMNs provided comparable efficacy as NAFL in an observation period of 12 weeks. Meanwhile, HA-DMNs offered a more favorable adverse effect profile than NAFL therapy. Mild but persistent pain, erythema, and edema during the HA-DMNs therapy are noteworthy and require improvement.