Abstract
PURPOSE: Microneedling achieves skin rejuvenation through controlled microinjury, while topical antioxidants may enhance its outcomes by neutralizing reactive oxygen species and promoting tissue repair. This study evaluated whether a topical antioxidant formulation containing vitamins C, E, and ferric acid enhances facial rejuvenation outcomes when combined with microneedling. PATIENTS AND METHODS: A 12-week, prospective, randomized, double-blinded, split-face trial was conducted in 31 adults with signs of facial aging. After subjects receiving microneedling treatments on both sides of the face, one side was randomly assigned to receive application of antioxidant serum while the other receiving placebo serum. Microneedling was performed at baseline and Week 4. Clinical efficacy throughout 12 weeks at four-week interval was assessed using the modified Griffith's scale, hemi-MASI, Global Aesthetic Improvement Scale (GAIS), and non-invasive skin biophysical measurements. RESULTS: At Week 12, the Microneedle + Antioxidant side demonstrated significantly greater improvements in modified Griffith's scale scores (23.9% vs 6.8%, p<0.001), hemi-MASI scores (31.2% vs 5.1%, p<0.001), and skin elasticity (39.0% vs 6.8%, p<0.001) compared to Microneedle + Placebo. GAIS assessment revealed 89.3% of antioxidant-treated sides achieved marked/near-total improvement versus 7.1% of placebo-treated sides. The antioxidant-treated sides also demonstrated superior improvements in skin elasticity (39.0% vs 6.8%, p<0.001) and melanin index (21.3% vs 3.4%, p<0.001). Only mild, transient side effects were reported. CONCLUSION: Combining topical antioxidant serum with microneedling provides superior outcomes for facial rejuvenation than microneedling alone. This combination protocol significantly improves clinical signs of photoaging, including skin elasticity, rhytides, and dyspigmentation, suggesting an optimized treatment protocol with minimal recovery time.