Abstract
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 noncrosslinked or slightly crosslinked hyaluronic acid gels, such as RHA1 and R1, because 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 2 months postinjection with RHA1. Questionnaires were used to evaluate both patient and investigator satisfaction. Skin quality parameters were measured with standard equipment and the VISIA CANFIELD imaging system. Safety assessment covered adverse events (AEs), injection site pain, and common treatment responses. RESULTS: The primary endpoint was met, with 92.7% of patients exhibiting GAIS improvement 2 months after receiving RHA1 treatment for SLs. Subsequent treatment with R1 doubled the "very satisfied" rate compared with RHA1 alone at 6 months. Patients also reported prolonged skin firmness, smoothness, and bounce, along with a refreshed feeling. No serious AEs 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. LEVEL OF EVIDENCE: 3: (Therapeutic).