Fractional carbon dioxide laser resurfacing combined with multilayer hyaluronic acid skinbooster injections for periocular, neck, and décolleté rejuvenation: A prospective multicenter observational interim analysis

Objectives: The objective of the study is to evaluate the short-term clinical outcomes and tolerability of a structured sequential protocol combining fractional carbon dioxide laser resurfacing with multilayer hyaluronic acid (HA) skinbooster injections for rejuvenation of the periocular region, neck, and décolleté. Material and Methods: This prospective, non-interventional, multicenter observational study enrolled consecutively treated adults with aging-related changes in the periocular, neck, or décolleté regions. Participants underwent a three-phase protocol consisting of HA skinbooster priming, fractional carbon dioxide laser resurfacing, and subsequent refinement injections. The pre-specified interim analysis assessed outcomes at day 42 using patient- and investigator-reported 5-point Likert scales. Paired baseline-to-day 42 comparisons were analyzed using the Wilcoxon signed-rank test. Results: Thirty-one participants completed the day 42 assessment, with no dropouts. The cohort was 80.6% female, the median age was 55.5 years, the age range was 29–74 years, and all participants had Fitzpatrick skin types II to III. All evaluated patient- and investigator-reported domains improved significantly from baseline to day 42 (all p < 0.001). Mean patient scores increased from 2.48–2.74 at baseline to 4.23–4.58 at day 42, and mean investigator scores increased from 2.68–3.13 to 3.97–4.48. Mean patient satisfaction was 4.58/5.0, willingness to recommend treatment was 4.65/5.0, minimal post-inflammatory hyperpigmentation occurred in 1/31 participants (3.2%), and the median downtime was 3 days. Conclusion: In this interim analysis, the sequential combination protocol was associated with clinically relevant short-term improvement across the assessed skin-quality domains and good tolerability. Because of the single-arm observational design, absence of image-derived endpoints at this interim stage, and lack of region-specific efficacy scoring, the findings should be interpreted as hypothesis-generating real-world data. Controlled comparative studies are required to determine the incremental contribution of HA skinbooster treatment over fractional carbon dioxide laser monotherapy.