Abstract
BACKGROUND: Horizontal neck wrinkles are a prevalent sign of aging, with emerging research highlighting the effectiveness of treatments such as acupotomy subcision (AS) and hyaluronic acid (HA) injections in rejuvenating aged skin. AIMS: This study aims to evaluate and compare the efficacy of three distinct treatment modalities for neck wrinkles: AS, HA injections, and a combination of both. The primary objective is to determine which treatment approach offers the most effective and satisfactory outcomes in terms of wrinkle reduction and skin rejuvenation. METHODS: In this randomized clinical trial, 30 female participants with neck Allergan Transverse Neck Lines Scale (ATNLS) scores ranging from 3 to 4 were randomly allocated into three treatment groups: AS, HA, and AS+HA. Each participant received treatment once a month for 3 months, followed by clinical assessments at 1 month and 6 months posttreatment. The assessments included ATNLS scores, Global Aesthetic Improvement Scores (GAIS), and analysis of skin elasticity and collagen levels. RESULTS: All treatment groups demonstrated improvements in ATNLS scores and GAIS after the final treatment. Notably, the AS+HA group showed a significantly higher number of participants reporting beneficial results at the 6-month follow-up. This group also exhibited a statistically significant increase in skin elasticity and collagen levels compared to the other groups. CONCLUSION: The combined approach of HA and acupotomy subcision is effective in treating horizontal neck wrinkles, leading to significant improvements in skin elasticity and collagen levels. This study suggests that the synergistic effect of AS and HA may enhance the overall efficacy of treatments for reducing neck wrinkles, providing a promising option for patients seeking noninvasive neck rejuvenation.