Microinjections with hyaluronic acid in combination with glycerol: How do they influence biophysical viscoelastic skin properties?

BACKGROUND: Skin quality improvement with hyaluronic acid microinjections is increasing as a clinical treatment indication and as a scientific issue. This present study assessed changes in biomechanical viscoelastic skin properties after microinjections with the skin quality booster CPM‐HA20G (Belotero Revive). MATERIALS AND METHODS: Fifteen subjects have been randomized in a 2:1 ratio to receive either three treatments (total 3 ml per side) or a single‐dose treatment (total 1.5 ml per side) with CPM‐HA20G at dermal level into the lower cheeks via microinjections. Treatments were provided 4 weeks apart. Biophysical measurements were performed describing the viscoelastic skin properties and the underlying skin structure. The measurements were performed before injection (week 0) and on follow‐up visits 4, 8, 16, 24, and 36 weeks after the last injection treatment. RESULTS: One (p = 0.028) as well as three (p = 0.003) consecutive treatments with CPM‐HA20G improved statistically significant skin firmness (R0). For the multiple‐treatment group improved significant differences were observed for skin fatigue (R3; p = 0.007) and skin density (p = 0.017) with stable skin thickness levels (p > 0.05), too. There were zero‐to‐weak correlations between skin thickness and biomechanical skin properties (R0, r (s) = 0.084; R3, r (s) = 0.093). CONCLUSION: Overall, microinjections with CPM‐HA20G improved biomechanical viscoelastic skin properties with a stronger and more pronounced effect in the multiple‐treatment group. The observed changes may explain some of the skin quality improvements observed after treatment with CPM‐HA20G.