Microneedling Combined With Topical Poly-L-Lactic Acid and Hyaluronic Acid for Skin Elasticity and Hydration: A Pilot Comparative Study.

Background Microneedling is a minimally invasive skin rejuvenation technique that can improve photoaging-related skin texture, fine lines, and overall skin quality. This exploratory pilot study compared preliminary effects and short-term tolerability of microneedling combined with a topical poly-L-lactic acid-hyaluronic acid (PLLA-HA) formulation versus microneedling alone for skin quality and aesthetic appearance. Methods Thirty healthy participants (mean age ~38 years) received three treatment sessions of either microneedling alone (anatomically adjusted needle depth up to 2 mm) or microneedling plus topical PLLA-HA at two-week intervals. Skin biophysical measurements were recorded at baseline and weeks 2, 4, 6, 8, and 12 using the Cutometer for elasticity parameters (R2, R5, R7) and the Corneometer for hydration. Additional outcomes included 3D imaging with LifeViz® Mini Pro (QuantifiCare SA, Biot, France), FACE-Q™ Satisfaction with Outcome and FACE-Q™ Satisfaction with Skin, and Global Aesthetic Improvement Scale (GAIS) scores. Results Baseline-adjusted analyses favored the combination group for all elasticity parameters and hydration compared with microneedling alone. By week 12, 3D imaging revealed greater improvements in skin evenness, wrinkles, pore visibility, and image-derived oiliness. FACE-Q Satisfaction with Skin showed little change, whereas Satisfaction with Outcome favored the combination group at week 12 (mean difference, 30.6 points; 95% CI, 23.8-37.4); GAIS also favored the combination group. Adverse events were limited to two cases of mild, transient treatment-site erythema. Conclusion Microneedling combined with topical PLLA-HA is safe and more effective than microneedling alone, providing superior improvements in skin elasticity, hydration, and overall aesthetic appearance, supporting the benefit of combining mechanical and topical biostimulatory approaches in facial rejuvenation. This pilot study had a small sample size, and potential selection and assessment bias due to lack of randomization, allocation concealment, and assessor blinding. The 12-week follow-up period may not fully capture the long-term biostimulatory effects of PLLA. Hence, larger, well-controlled studies with extended follow-ups are warranted.