Antonio Scarano1  · E. Qorri2  · A. Sbarbati3  · S. A. Gehrke4  · Alessio Frisone1  · D. Amuso3  · Sergio Rexhep Tari1

Received: 30 March 2024 / Accepted: 17 May 2024 / Published online: 24 June 2024

© The Author(s) 2024

Antonio Scarano

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E. Qorri

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A. Sbarbati

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S. A. Gehrke

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D. Amuso

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Sergio Rexhep Tari

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1 Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Strada Marcello Mucci 38/B, 66100 Chieti, Italy

2 Department of Dentistry, Faculty of Medical Sciences, Albanian University, 1001 Tirana, Albania

3 Department of Neurosciences, Biomedicine and Movement Sciences, Anatomy and Histology Section, School of Medicine, University of Verona, Verona, Italy

4 Department of Research, Bioface/PgO/UCAM, Montevideo, Uruguay

Abstract

Background Various techniques have been employed in aesthetic medicine to combat skin aging, in particular that of the facial region. Hyaluronic acid is utilized to enhance moisture levels and extracellular matrix molecules. This study aims to histologically assess the efects of low molecular weight hyaluronic acid fragments combined with amino acids (HAAM) on facial skin rejuvenation through intradermal microinjections.

Methods A total of twenty women, with an average age of 45 and ranging from 35 to 64 years old, participated in the study, including 8 in menopause and 12 in the childbearing age group. Mesotherapy was used to administer HAAM to the patients. Prior to and three months after the treatment, each patient underwent small circular punch biopsies. Ultrasound examinations were conducted using B-mode, capturing 2D images in longitudinal or transverse orientations with frequencies ranging from 5 to 13 Mega-hertz (MY LAB X8, ESAOTE, Genova, Italy). A total of 60 ultrasound examinations were taken, with 30 collected before treatment and 30 after treatment.

Results The histological analysis demonstrates an increase in fbroblast activity resulting in the production of Type III reticular collagen, as well as an increased number of blood vessels and epidermal thickness. However, the analysis of ultrasound data before and after treatment showed no statistical diference in skin thickness in malar area, chin and mandibular angle.

Conclusions Histological assessments indicate that subcutaneous infltration of HAAM has a substantial impact on the dermis of facial skin.

Keywords Hyaluronic acid · Hyaluronic acid fragments · Amino acid · Fibroblast · Skin aging · Ultrasound