Enhancing Skin Quality With a Sequential Treatment Using Two Hyaluronic Acid Dermal Fillers: A Prospective, Multicenter, Interventional Study.

Background: Skin quality affects facial attractiveness, which can significantly impact self-esteem and overall quality of life. The preferred fillers for enhancing skin quality are non-crosslinked or slightly crosslinked HA gels, such as RHA1 and R1, as they diffuse more easily into peripheral tissues.

Objectives: This study was designed to assess the performance and safety of RHA1 treatment for fine lines, such as smiling lines (SLs), including an exploratory arm assessing the performance of subsequent R1 treatments.

Methods: SKINQARE was a prospective, multicenter, low-interventional, open-label study. The primary outcome was Global Aesthetic Improvement Scale (GAIS) score recorded at two months post-injection with RHA1. Questionnaires were used to evaluate both subject and investigator satisfaction. Skin quality parameters were measured with standard equipment and the VISIA® CANFIELD imaging system. Safety assessment covered adverse events, injection site pain and common treatment responses (CTRs).

Results: The primary endpoint was met, with 92.7% of subjects exhibiting GAIS improvement two months after receiving RHA1 treatment for SLs. Subsequent treatment with R1 doubled the "very satisfied" rate compared to RHA1 alone at 6 months. Subjects also reported prolonged skin firmness, smoothness, and bounce, along with a refreshed feeling. No serious adverse events were reported during the study.

Conclusions: RHA1 was effective for skin beautification in all indications, including SLs, and subsequent R1 treatment improved performance. Both treatments were well tolerated. These findings highlight the potential benefits of using a combined treatment approach to improve skin quality.