Synergistic effect of microneedle-delivered extracellular matrix compound and radiofrequency on rejuvenation of periorbital wrinkles

Abstract

Background: A combination of minimally invasive modalities can induce collagen regeneration more quickly and promote the penetration of topical agents, thus promoting skin rejuvenation. In this study, we aimed to investigate the synergistic efficacy of extracellular matrix compound (ECM-C) via microneedle (MN) and radiofrequency (RF) on periorbital wrinkles.

Method: A total of 25 participants with periorbital wrinkles were selected for this study. The left and right side of the periorbital area was randomly given ECM-C via MN or ECM-C via MN combined with RF. MN combined with ECM-C treatment was given 5 times at 2 weeks intervals, whereas RF treatment was given 3 times at 4-week intervals. The following items were assessed: wrinkles by VISIA^® system; biophysical parameters such as skin hydration, transepidermal water loss (TEWL), erythema index, and melanin index by CK multiple probe adapter; and skin elasticity and skin thickness by DermaLab Combo^® photographs were taken at the baseline and 2 weeks after the last treatment. Subjective assessments, such as Crow's Feet Grading Scale (CFGS) and Global Aesthetic International Scale (GAIS), were also recorded.

Result: A total of 25 participants with an average age of 43 years participated in this trial. Periorbital wrinkles on both sides decreased after the treatment, and the side treated with ECM via MN and RF showed better improvement than the other side with ECM-C via MN alone. Skin hydration increased after the treatment on both sides. TEWL, skin erythema, and skin melanin indexes were not changed. Skin elasticity and skin thickness increased more on the side of ECM-C via MN and RF than on the other side of ECM-C via MN alone. The evaluation scores for CFGS improved on either side; however, no difference was found for CFGS and GAIS between intergroup comparisons after the treatment.

Conclusion: The objective assessment of wrinkles, elasticity, and thickness of periorbital skin improved more on the side with ECM-C treatment via MN combined with RF than on the other side of ECM-C treatment via MN only. However, no statistically significant difference was found between the subjective CFGS and GAIS evaluation of the two sides.

Keywords: extracellular matrix; microneedle; periorbital wrinkles; radiofrequency; skin biophysical parameters.

Figure 1

Comparison graph of biophysical parameters measured by CK. TEWL, transepidermal water loss. ** p < 0.01.

Figure 2

Comparison graphs of periorbital wrinkles measured by VISIA. *p < 0.05, **p < 0.01.

Figure 3

Comparison of the periorbital wrinkles in a 49-year-old woman based on the VISIA images. Her left periorbital area was treated with ECM-C via MN; the wrinkles score assessed by the VISIA images system decreased from 5.55 to 1.84; her right periorbital area was treated with ECM-C via MN and radiofrequency; the wrinkles score assessed by the VISIA images system decreased from 6.26 to 1.13.

Figure 4

Comparison of the periorbital wrinkles in a 59-year-old woman with the VISIA images system. Her left periorbital area was treated with ECM-C via MN; the wrinkles score assessed by the VISIA images system decreased from 13.54 to 5.78; her right periorbital area was treated with ECM-C via MN and radiofrequency; the wrinkles score assessed by the VISIA images system decreased from 17.37 to 3.80.

Figure 5

Comparison graphs of skin elasticity and thickness measured by UBM. * p < 0.05, ** p < 0.01.

Figure 6

Ultrasound images of a 40-year-old woman at the baseline and at 2 weeks after the last treatment. A1 and B1 show images taken at the baseline (A1: skin elasticity = 5.3, skin thickness = 1,290.3 μm; B1: skin elasticity = 5.3, skin thickness = 1,158.7 μm). A2 shows the image taken 2 weeks after the last ECM-C via MN treatment (skin elasticity = 5.6, skin thickness = 1,422 μm). B2 represents the image taken 2 weeks after the last ECM-C via MN and RF treatment (skin elasticity = 6.1, skin thickness = 1,457 μm). Echogenicity color scale: white>yellow>red>green>black.

Figure 7

CFGS assessment graph presentation by doctor. CSGF, Crow's Feet Grading Scale; 0 = no wrinkles, 1 = very fine wrinkles, 2 = fine wrinkles, 3 = moderate wrinkles, 4 = severe wrinkles.

Figure 8

GAIS assessment graph presentation by participants. GAIS, Global Aesthetic Improvement Scale; −1 = worse than the baseline, 0 = no change, 1 = improved, 2 = much improved, 3 = very much improved.