Dose-Dependent Effects of Cross-Linked Hyaluronic Acid Through Intradermal Injection on Female Facial Photoaging: A Prospective Study

Abstract Background Skin photoaging significantly affects skin health and aesthetics, with undesirable appearances negatively impact individual psychological well-being. Intradermal injection of cross-linked hyaluronic acid (HA) has been successfully utilized to improve facial skin photoaging. However, the correlations between the number of treatments and therapeutic efficacy, as well as the dosage and therapeutic outcomes of intradermal injections of cross-linked HA, remain underexplored. Objectives The authors observe the effects of intradermal injection of cross-linked HA in different doses and frequencies on improving facial skin photoaging. Methods A randomized, split-face design with participant blinding, self-controlled, prospective clinical study was conducted to evaluate the efficacy of different dosages of intradermal injections of cross-linked HA in improving mild-to-moderate female facial photoaging. Results Cross-linked HA significantly improved facial photoaging scores, reduced transepidermal water loss, enhanced skin elasticity, and increased patients' satisfaction. The effects were cumulative following sequential treatments, with the high-dosage group demonstrating superior efficacy and longer lasting outcomes compared with the low-dosage group. Conclusions High-dosage, multisession intradermal injection protocols of cross-linked HA offer more effective improvements in the manifestations of facial photoaging, with superior efficacy and longer lasting outcomes. Level of Evidence: 2 (Therapeutic)