Efficacy of Needle and Microneedle Mesotherapy in Reducing Signs of Skin Aging—A Split-Face Comparative Study

Abstract

Introduction: Major manifestations of facial skin aging include the loss of firmness and elasticity, the appearance of wrinkles, and various pigmentary changes. Mesotherapy—both needle and microneedle-based—is a commonly chosen procedure that effectively revitalizes and stimulates the skin. The aim of this study was to compare the effectiveness of both techniques in reducing the signs of skin aging using a product containing fragmented hyaluronic acid and an amino acid complex. Materials and Methods: The study included 20 female participants aged 35–60 years who underwent a series of four treatment sessions in a split-face design. One side of the face was treated with needle mesotherapy, while the other side received microneedle mesotherapy. In each session, 5 mL of a preparation containing fragmented hyaluronic acid, glutathione, stabilized vitamin C, and an amino acid complex was administered. Skin parameters (hydration, pH, sebum level, erythema, and pigmentation), photographic documentation, participants’ subjective evaluations, and pain scores were assessed. Results: Both techniques led to significant improvements in skin condition. Microneedle mesotherapy was more effective in enhancing hydration, regulating sebum and pH, and was better tolerated in terms of pain. Needle mesotherapy demonstrated greater efficacy in reducing pigmentation. Patient satisfaction was high in both groups. Conclusions: Both needle and microneedle mesotherapy are effective treatments for aging skin, although their mechanisms of action differ. The choice of technique should be tailored to the individual needs of the skin and the expectations of the patient.

1. Introduction

Exogenous (environmentally induced) skin aging is a process resulting from exposure to various environmental factors, primarily excessive ultraviolet (UV) radiation, air pollution, prolonged stays in dry and air-conditioned environments, harmful lifestyle habits (such as smoking and alcohol abuse), poor dietary choices, insufficient sleep, extended exposure to high-energy visible (HEV) blue light, and stress [1,2,3].

The main cause of photoaging is UV radiation, which is estimated to account for approximately 80% of all adverse cellular changes occurring in the different layers of the skin [4]. UV radiation is categorized based on wavelength into short-wave UVC (200–280 nm), medium-wave UVB (290–320 nm), and long-wave UVA-2 (320–340 nm) and UVA-1 (340–400 nm) [5,6,7].

One of the most characteristic features of photoaging is solar elastosis, defined as the accumulation of abnormal elastin fibers in the dermis [8]. Clinically, it manifests as hyperplastic changes perceived as papules or nodules under the skin [9]. UV exposure also impairs the immune system, including degradation of Langerhans cells, thereby increasing the risk of skin cancer. Additionally, there is an overproduction of reactive oxygen species (ROS), which participate in lipid peroxidation, leading to disruption of cell membrane integrity and impaired skin hydration. To protect DNA, the skin overproduces melanin [10,11].

Photoaging may lead to fibroblast degradation, disturbed angiogenesis, and melanocyte alterations [12]. Clinically and histologically, photoaged skin may present with dryness, actinic keratosis, irregular pigmentation, wrinkles, loss of elasticity, telangiectasias, purpura, comedones, sebaceous gland hyperplasia, and an increased risk of basal and squamous cell carcinoma [13,14].

The term “mesotherapy” is frequently used to describe various techniques of delivering active substances into the skin [15]. However, from a scientific and clinical perspective, it is essential to distinguish between needle mesotherapy and microneedle mesotherapy [16]. These procedures differ in their mechanisms of action, degree of invasiveness, delivery precision, and therapeutic objectives. The selection of an appropriate method should consider clinical indications, the patient’s skin condition, pain tolerance, and individual expectations [17,18].

Microneedling is a minimally invasive technique that utilizes pen-like devices equipped with numerous fine needles to create controlled micro-injuries in the skin. Its primary aim is to induce a physical stimulus and trigger a wound healing cascade, which promotes the synthesis of new collagen and elastin [19,20]. During the procedure, active substances are applied topically and penetrate the skin through the created microchannels. In this technique, the delivery of active compounds is considered a secondary mechanism and is less precise in terms of dosage and penetration depth compared to needle mesotherapy [21,22].

Needle mesotherapy involves the intradermal or subcutaneous administration of small deposits of liquid preparations [23]. It allows for the precise deposition of a specific dose at a defined depth within the skin tissue. The method combines two types of stimuli. The first is a physical stimulus—skin puncture—which initiates a complex wound healing cascade. As a result, platelets release numerous growth factors that activate fibroblasts, leading to increased synthesis of type I and III collagen, elastin, and endogenous hyaluronic acid [24]. The second is a pharmacological stimulus, associated with the biological activity of the injected substances. Thanks to the accurate placement of the product into the dermis, high concentrations of active ingredients can act directly on target cells, such as fibroblasts or melanocytes. Depending on the composition, this can result in tissue revitalization or stimulation [25].

The effectiveness of mesotherapy arises from the synergy between pharmacological action of the injected compounds and the non-specific physical stimulation caused by microneedling [17]. Understanding these mechanisms is crucial for designing effective therapeutic protocols. This implies that the injection technique is just as important as the composition of the administered preparation.

The aim of the study was to objectively assess the impact of needle mesotherapy and microneedling on selected features of aging skin, including wrinkles, hyperpigmentation, firmness, and hydration levels. In addition, the study aimed to evaluate participants’ satisfaction with the treatment outcomes as well as their subjective experiences during the procedures.

2. Materials and Methods

The study involved 20 female participants aged 35–60 years (mean age: 48 ± 5 years) presenting with clinical signs of facial skin aging, such as loss of firmness, wrinkles, and pigmentation changes. Skin condition assessment and instrumental skin parameter measurements were conducted at the Collegium Medicum of Jan Długosz University in Częstochowa, following the approval of the University’s Research Ethics Committee (Decision No. KE-U/2/2024, dated 24 January 2024, and Decision No. KE-U/58/2025, dated 22 January 2025). Mesotherapy procedures were performed at the certified aesthetic medicine clinic Sensual Beauty in Tychy, as part of the clinic’s routine practice.

All participants were thoroughly informed about the nature of the study and signed written informed consent forms prior to their inclusion.

Inclusion criteria:

• Female participants aged 35–60 years;
• Overall good health;
• Visible signs of facial skin aging;
• No contraindications to mesotherapy;
• Willingness to participate and comply with study procedures.

Exclusion criteria:

• Pregnancy or breastfeeding;
• Active inflammatory or infectious skin conditions on the face;
• Autoimmune, neoplastic, or metabolic diseases;
• Undergoing aesthetic medicine procedures within the previous 6 months;
• Known allergies to the product;
• Tendency to scar formation or bleeding disorders.

2.1. Treatment Protocol

Each participant underwent a series of four procedures spaced 21 days apart. All treatment sessions for each participant were performed by the same investigator to maintain consistency in technique. Needle mesotherapy was performed on the right side of the face using manual intradermal injections with a 30 G needle, applying the microdepot technique at approximately 0.5 cm intervals across the entire treatment area. Microneedling mesotherapy was performed on the left side of the face using a Dr. Pen Ultima M-5 device equipped with cartridges containing 12 fine needles. The depth of penetration was adjusted up to 1 mm, and the procedure was carried out using a multiple fractional puncture technique. To eliminate variability in formulation, the same product—Elisir Lux, Swiss Scientific Lab GmbH—was used in all treatments. This allowed for an objective comparison of efficacy between the two application methods.

Elisir Lux, Swiss Scientific Lab GmbH is a Class III medical device (CE-marked), approved by the Istituto Superiore di Sanità. Each treatment session used a sterile 5 mL vial, ensuring dose standardization.

INCI composition of Elisir Lux, Swiss Scientific Lab GmbH: Hyaluronic Acid Sodium Salt, L-Serine, L-Alanine, L-Cysteine, L-Leucine, L-Lysine Hydrochloride, L-Proline, L-Valine, Glycine, Reduced Glutathione, Sodium Ascorbyl Phosphate, Phosphate Buffer System, Water for Injection.

Key active components:

• Fragmented hyaluronic acid (20–38 monomer units): stimulates fibroblast activity via CD44 receptors, enhancing type III collagen synthesis.
• Amino acid complex (L-serine, L-alanine, L-leucine, L-cysteine, L-proline, L-valine, L-lysine, glycine): improves hydration and elasticity, supports collagen and elastin synthesis, and provides antioxidant protection against skin aging.
• Reduced glutathione (tripeptide): detoxifying and antioxidant action, supports neutralization of free radicals.
• Stabilized vitamin C (sodium ascorbyl phosphate): converts to ascorbic acid upon contact with tissue; provides skin-brightening effects and reduces endothelial permeability.
• Phosphate buffer system: stabilizes product pH.

2.2. Skin Parameter Evaluation

Skin parameters were measured at three time points: before the treatment series (m0), one month after the first session (m1), and one month after the last session (m2). The following devices were used:

• Hydration—Corneometer^® CM 825, Courage + Khazaka Electronic GmbH, Germany.
• Sebum secretion—Sebumeter^® SM 815, Courage + Khazaka Electronic GmbH, Germany.
• Skin color—Mexameter^® MX 18, Courage + Khazaka Electronic GmbH, Germany.
• Skin pH—Skin-pH-Meter^®, Courage + Khazaka Electronic GmbH, Germany.

Measurements were taken symmetrically at four facial sites: forehead, cheeks, chin, and nose. All procedures were conducted in a controlled environment with consistent humidity (40–50%) and temperature (20–21 °C). To ensure objectivity, participants were instructed to cleanse their face thoroughly three hours prior to measurement and to refrain from applying any cosmetic products during that time. Measurements were performed in a cool, dimly lit room to minimize external influences, and participants remained in the room for at least 30 min before measurement to allow for acclimatization.

2.3. Clinical Photography

Standardized clinical photographs were taken at baseline, after one month, and after two months using a digital camera. Images were captured en face, as well as from the left and right oblique and profile views.

2.4. Treatment Procedure

Prior to each procedure, the skin was disinfected using an aqueous solution containing 40 ppm (0.004%) sodium hypochlorite, 40 ppm (0.004%) hypochlorous acid, and purified water. Following disinfection, mesotherapy was performed—needle mesotherapy on the right side of the face and microneedling on the left side. Subsequently, mesotherapy procedures were performed—needle mesotherapy on the right side of the face and microneedling on the left side.

Needle mesotherapy was performed using the microdepot technique, via intradermal injections at a depth of 1–1.5 mm, at an angle of 35–45°, depending on the facial area. A volume of 0.025 mL of the preparation was injected per point, totaling 2.5 mL for the half-face. A 0.30 × 4 mm/30 G needle was used for the procedure.

Microneedling mesotherapy was performed using the stamping technique (point by point), without gliding or circular motions. The needle depth was adjusted depending on the facial region:

• 0.5 mm on the cheeks and chin;
• 0.3 mm on the forehead;
• 0.25 mm around the jawline and lips;
• 0.2 mm in the periorbital area.

A total of 2.5 mL of the preparation was applied gradually over the entire treated area. The product was applied to the skin both before and immediately after microneedling. The procedure was continued until erythema was observed.

After each treatment, a soothing mask (Soothing and Calming Gel Mask, Norel) and a post-procedure cream (Cicabio Crème, Bioderma) were applied to the face. Participants were instructed to apply Cicabio Cream (Bioderma) twice daily, in the morning and evening, and to refrain from introducing any new cosmetic products during the study period.

During and immediately after the procedures, the following transient local skin reactions were observed:

• On the needle mesotherapy side, patients reported minor bleeding at injection sites, varying levels of pain, burning or pressure sensation during product administration, redness, and small hematomas.
• On the microneedling side, slight bleeding in the treated areas, moderate pain, burning sensation at the product application sites, and erythema were observed. One participant developed reactive erythema in the form of dermographism.
• The post-treatment skin reactions were short-lived and resolved in most cases within 30–60 min after the procedure.

The outcome analysis included:

• Changes in physiological skin parameters;
• Clinical assessment of treatment results;
• Participants’ subjective evaluations, including satisfaction;
• Pain perception during needle and microneedling mesotherapy.

The study was designed as a split-face model, which allowed for direct comparison of both techniques in the same individuals, eliminating inter-subject variability.

To assess pain intensity, participants completed the Numerical Rating Scale (NRS) after each session, and results were recorded in treatment observation sheets. The NRS is widely used, easy to understand for patients, and recommended by the Polish Pain Research Society as the most effective tool for evaluating pain intensity:

0—no pain;

1–3—mild pain;

4–6—moderate pain;

7–8—severe pain;

9–10—very severe pain (Polish Pain Research Society, 2018).

2.5. Statistical Analysis

Statistical analysis was performed using non-parametric tests, as the data did not meet the assumptions of normal distribution according to the Shapiro–Wilk test and quantile–quantile plots. To compare the results obtained at the three time points, a non-parametric repeated measures ANOVA (Friedman test) was applied. Statistical significance was set at p < 0.05.

3. Results

After completing a full series of four treatments performed every three weeks, a significant improvement was observed in all analyzed physiological parameters of the skin. Particularly noteworthy was the statistically significant increase in skin hydration following both microneedling (mean increase of 26% compared to baseline; p < 0.01) and needle mesotherapy (mean increase of 18%; p < 0.01) (

Table 1. Comparison of skin hydration mean values (±SD) between microneedling and needle mesotherapy across time points (M0, M1, M2).

Time Point	Facial Area	Microneedling (Mean ± SD)	Needle Mesotherapy (Mean ± SD)
M0	Forehead	50 ± 5	50 ± 5
	Cheek	58 ± 6	61 ± 6
	Chin	50 ± 17	51 ± 17
	Nose	29 ± 6	31 ± 22
M1	Forehead	62 ± 3	60 ± 3
	Cheek	70 ± 7	70 ± 7
	Chin	67 ± 6	64 ± 6
	Nose	44 ± 27	39 ± 27
M2	Forehead	67 ± 9	66 ± 9
	Cheek	72 ± 12	74 ± 12
	Chin	70 ± 10	71 ± 10
	Nose	53 ± 16	54 ± 16

).

A direct comparison of the two methods revealed significantly greater effectiveness of microneedling in improving skin hydration (p < 0.05).

With regard to sebum secretion, normalization of sebaceous gland activity was observed after microneedling treatment, especially in participants with oily skin (

Table 2. Comparison of sebum secretion (mean ± SD) between the left and right facial sides across time points (M0, M1, M2).

Time Point	Facial Area	Microneedling (Mean ± SD)	Needle Mesotherapy (Mean ± SD)
M0	Forehead	103 ± 58	108 ± 66
	Cheek	59 ± 44	74 ± 57
	Chin	114 ± 59	136 ± 67
	Nose	110 ± 84	129 ± 40
M1	Forehead	83 ± 50	102 ± 69
	Cheek	59 ± 50	53 ± 41
	Chin	96 ± 72	109 ± 78
	Nose	88 ± 88	112 ± 107
M2	Forehead	81 ± 46	106 ± 62
	Cheek	47 ± 73	99 ± 66
	Chin	88 ± 77	132 ± 70
	Nose	84 ± 93	126 ± 89

). In 70% of cases, sebum levels decreased to reference values. In contrast, the group treated with needle mesotherapy showed no significant changes in this parameter.

Skin pH demonstrated a moderate tendency toward normalization in both treatment groups, with more favorable changes observed after microneedling (

Table 3. Comparison of skin surface pH (mean ± SD) between microneedling and needle mesotherapy across time points (M0, M1, M2).

Time Point	Facial Area	Microneedling (Mean ± SD)	Needle Mesotherapy (Mean ± SD)
M0	Forehead	4.95 ± 0.55	4.97 ± 0.42
	Cheek	5.14 ± 0.43	5.18 ± 0.39
	Chin	5.17 ± 0.44	5.30 ± 0.27
	Nose	5.16 ± 0.27	5.20 ± 0.24
M1	Forehead	4.82 ± 0.41	4.79 ± 0.41
	Cheek	5.41 ± 0.13	5.29 ± 0.19
	Chin	5.42 ± 0.17	5.45 ± 0.21
	Nose	5.50 ± 0.27	5.46 ± 0.28
M2	Forehead	4.78 ± 0.40	4.69 ± 0.60
	Cheek	5.06 ± 0.29	5.16 ± 0.40
	Chin	5.35 ± 0.22	5.34 ± 0.29
	Nose	5.44 ± 0.20	5.37 ± 0.36

). The average pH value decreased from 5.8 to 5.5, falling within the physiological range for facial skin.

Regarding skin tone and erythema, a clear aesthetic improvement was noted (

Table 4. Comparison of melanin and hemoglobin content (mean ± SD) between microneedling and needle mesotherapy across time points (M0, M1, M2).

Time Point	Facial Area	Microneedling (Mean ± SD)		Needle Mesotherapy (Mean ± SD)
		Melanin Content	Hemoglobin Content	Melanin Content	Hemoglobin Content
M0	Forehead	76 ± 2	264 ± 1	91 ± 30	310 ± 99
	Cheek	75 ± 21	292 ± 74	91 ± 59	265 ± 102
	Chin	135 ± 39	370 ± 74	150 ± 36	344 ± 34
	Nose	61 ± 44	314 ± 82	93 ± 40	303 ± 58
M1	Forehead	90 ± 13	278 ± 75	100 ± 24	262 ± 58
	Cheek	92 ± 39	239 ± 52	89 ± 24	210 ± 71
	Chin	135 ± 53	362 ± 59	133 ± 19	349 ± 42
	Nose	67 ± 37	384 ± 7	82 ± 35	358 ± 39
M2	Forehead	90 ± 24	243 ± 42	83 ± 33	308 ± 62
	Cheek	86 ± 41	227 ± 40	86 ± 40	240 ± 76
	Chin	136 ± 45	353 ± 45	112 ± 45	405 ± 50
	Nose	68 ± 45	294 ± 29	70 ± 35	336 ± 94

). Microneedling led to a significant reduction in erythema and redness, with 85% of participants reporting improvement. On the other hand, needle mesotherapy was more effective in reducing overall melanin content, with an average decrease in pigmentation intensity of 21% following the treatment series.

Clinical observations confirmed positive changes in the skin’s appearance with both techniques. Standardized photographic documentation showed improvements in the smoothness of mimic wrinkles (particularly on the forehead and around the eyes), reduction in visible enlarged pores, increased elasticity and firmness of the skin, and overall improved skin tension. The facial skin treated with microneedling appeared slightly more radiant and smoother in visual assessment. Conversely, the side treated with needle mesotherapy showed more noticeable reduction in pigmentation spots and a more even skin tone (Figure 1).

Visual evaluation was performed independently by two cosmetologists who analyzed the participants’ photographs in a blinded manner, without knowing which technique was used (Figure 2). Both experts confirmed more pronounced improvements in skin tension, smoothness, and radiance after microneedling, and greater pigmentation reduction after needle mesotherapy.

Subjective assessments from the participants were collected using a standardized self-assessment questionnaire on skin condition and a satisfaction survey regarding treatment outcomes. On average, participants rated the improvement in their skin condition at 4.3 on a 5-point scale. The majority (95%) reported significant improvement in skin hydration, and 88% noticed a reduction in wrinkle visibility. Satisfaction with the overall treatment effects was high and comparable between both techniques, with an average score of 4.5/5 and no statistically significant difference between groups.

Pain perception, measured using the Numerical Rating Scale (NRS), revealed significant differences between the two techniques. Needle mesotherapy was perceived as more painful, with a mean score of 5.2/10. In contrast, microneedling resulted in a lower mean pain score of 3.1/10 (statistically significant difference; p < 0.01). The lower discomfort level associated with microneedling may be attributed to the even distribution of micro-punctures and shallower needle penetration.

Palpation assessment showed improved firmness, elasticity, and skin texture following both procedures. In 80% of participants, the evaluating specialist noted greater firmness and skin tension on the side treated with microneedling, which correlated with instrumental analysis results and clinical observations.

4. Discussion

The obtained results confirm the high effectiveness of both needle and microneedling mesotherapy in reducing visible signs of skin aging, with each technique demonstrating characteristic and distinct activity profiles [26]. In this study, a standardized preparation containing hyaluronic acid, glutathione, vitamin C, and an amino acid complex was used in both procedures, thereby eliminating variability in the composition of the applied substances as a potential factor influencing the outcomes. Fragmented hyaluronic acid enhances epidermal hydration and fibroblast activity, while amino acids contribute to extracellular matrix synthesis. In contrast, the deeper delivery achieved through needle mesotherapy may allow more effective action of glutathione and vitamin C on melanogenesis, leading to more pronounced pigmentation reduction.

Regarding physiological skin parameters, microneedling mesotherapy showed a clear advantage in improving hydration, regulating sebum secretion, and normalizing skin pH. The observed increase in tissue hydration following microneedling aligns with the findings of Markiewicz-Tomczyk et al. [27], who demonstrated that micro-injuries induce skin repair pathways leading to enhanced synthesis of glycosaminoglycans, including endogenous hyaluronic acid. The improvement in hydrolipid balance and acidification of the skin after the treatment series also indicates a restoration of the epidermal barrier function, which is crucial in preventing transepidermal water loss (TEWL) and delaying the aging process [28,29,30].

Needle mesotherapy proved more effective in reducing discoloration and pigmentation. This outcome may be attributed to the deeper deposition of active substances, such as stable vitamin C, into the dermis, which can lead to more pronounced modulation of the melanogenesis pathway [31,32,33]. In the present study, a decrease in melanin levels was observed in areas treated with intradermal injections. In contrast, regions treated with microneedling showed a slight increase in pigmentation, which could be related to superficial skin irritation, inadequate photoprotection, or post-inflammatory response.

Improved skin firmness and tension were observed with both techniques; however, greater improvements in elasticity were noted following microneedling. This effect may be linked to the stimulation of collagen remodeling mechanisms via micro-injury [34,35]. Microneedling mesotherapy activates the expression of COL1A1 and COL3A1 genes responsible for the synthesis of type I and III collagen and simultaneously promotes fibroblast proliferation and angiogenesis, thereby improving skin density and vascularization.

Microneedling was better tolerated in terms of pain, correlating with its less invasive and more superficial penetration. The NRS indicated an average of two points lower pain intensity compared to the needle technique. The sensations of pressure and burning during intradermal injections significantly decrease patient comfort. Notably, pain intensity diminished with each subsequent session, likely due to both skin adaptation and increased psychological acceptance of the procedure [36,37].

The high level of participant satisfaction, regardless of the technique used, indicates strong acceptance of mesotherapy as a method for improving skin quality. All subjects reported very high ratings for the treatment outcomes, and photographic documentation, along with clinical evaluation, confirmed that the results met their expectations. These findings underscore the importance of both procedural effectiveness and visibly perceived changes in motivating patients to undergo aesthetic treatments.

From a methodological perspective, the use of a split-face model is a strength of the study, as it enabled a direct comparison of the effectiveness of the two techniques within the same individual, eliminating the influence of inter-individual anatomical, hormonal, and environmental differences. This constitutes a valuable contribution to the existing literature, where standardized comparative studies using this model remain scarce. Furthermore, the use of a unified product allowed for the assessment of outcomes attributable solely to the application technique.

It is also worth noting that the application of a product containing fragmented hyaluronic acid and an amino acid complex contributed to increased hydration, pigmentation reduction, and skin tightening. The combination of hyaluronic acid and amino acids induces water retention in tissues and ECM bioregeneration through type IV collagen synthesis [38]. Additionally, in a subsequent study [39], was observed a significant increase in type III collagen in histological evaluations, indicating enhanced fibroblast activity. They also noted an increase in the number of blood vessels and basal layer cells, resulting in epidermal thickening.

A limitation of this study is the relatively short observation period (16 weeks) and the absence of long-term analysis of treatment durability. In the context of skin biorevitalization, further research should include 3- and 6-month follow-up periods to assess the longevity of the effects and the impact of cyclic treatment repetition. It should also be noted that home photoprotection among participants was not strictly monitored, which may have influenced post-treatment melanin levels on the microneedled side. The main limitation of the present study is the small sample size (n = 20), which may restrict the statistical power and limit generalizability of the results to a broader population. This study was not registered on clinicaltrials.gov, as it was designed as an academic comparative investigation rather than a clinical trial.

In summary, the results of this study confirm the effectiveness of both mesotherapy techniques in reducing signs of skin aging, while highlighting their complementary characteristics. Microneedling appears more effective in improving skin parameters and patient comfort, whereas the needle technique proves more beneficial in treating discolorations and achieving more intense revitalization effects. Therefore, technique selection should be individually tailored to the skin’s needs and patient expectations.

5. Conclusions

• Both needle mesotherapy and microneedling are effective methods for reducing the visible signs of facial skin aging, resulting in significant improvements in skin condition, firmness, and overall aesthetic appearance.
• Microneedling demonstrates greater effectiveness in improving physiological skin parameters, including hydration, sebum regulation, and pH normalization, making it the preferred method for dehydrated, reactive skin with an impaired epidermal barrier.
• Needle mesotherapy is more effective in reducing skin hyperpigmentation, which may be attributed to the deeper delivery of active ingredients, particularly vitamin C and amino acids with brightening properties.
• Microneedling is better tolerated in terms of pain perception, which may favor its use in patients with a low pain threshold or those new to aesthetic treatments.
• The high level of participant satisfaction with the outcomes of both therapies highlights the potential of mesotherapy as an anti-aging treatment and the importance of tailoring the technique to individual needs and indications.
• The intradermal delivery of products based on fragmented hyaluronic acid combined with an amino acid complex using different mesotherapy techniques stimulates fibroblasts, contributing to the aesthetic improvement of the treated skin.
• The split-face model is a valuable tool in comparative studies of aesthetic techniques, enabling direct evaluation of effects under controlled conditions.
• Further research is recommended with extended observation periods to assess the long-term durability of the results and to determine optimal treatment frequency and protocols.
• The present results represent short-term effects observed one month after treatment completion. Long-term studies are warranted to evaluate the persistence of these improvements.