Mesotherapy with HA and Choline Against Facial Skin Aging: An Open-Label Uncontrolled, Monocentric Study

Background: Facial aging involves soft and hard tissues with changes that can affect an individual's self-esteem and aesthetic appearance. Techniques used to counteract these changes include the use of solutions to be injected into the dermis, such as dermal matrix, vitamins, and antioxidants. B vitamins and choline are vital nutrition for humans and many other animals (vitamin B4), required to produce acetylcholine (ACh). It is considered a neurotransmitter universal methyl donator and of the major membrane constituent phosphatidylcholine (PC) and is crucial for the functioning of cell membranes, including those in skeletal muscle cells. The aim of this study is to evaluate the efficacy and safety of a fragment of HA amino acid and choline in a solution of phosphate buffer system used via mesotherapy. Specifically, state that the primary endpoint was the efficacy assessment using the Scientific Assessment Scale of Skin Quality (SASSQ), while secondary endpoints included safety assessments and patient-reported outcomes. Methods: Forty (40) subjects completed the study. In total, 40 subjects were screened and included in the study. The total duration of the study was 14 months. The first subject was included on 12 January 2019, and the last subject's last visit was on 14 March 2020. All patients received the SKIN Colin^® products by mesotherapy technique for 8 weeks, providing the treatment with the use of 0.5 cc syringes and 13 mm long, 30 G diameter needles. The solution was inoculated into the deep layer of the dermis of the face with a suitable amount of at least 0.2/0.3 mL in the cutaneous points four times every 15 days. Each subject had to be followed for 168 days after the last mesotherapy session. Only enrolled subjects received the HA and choline via mesotherapy. The primary efficacy endpoint was the absolute change in the Scientific Assessment Scale of Skin Quality from Baseline (Day 0) to Day 168. A reduction of at least one point in the SASSQ was considered to reach the endpoint goal. Results: The results of the present investigation show Scientific Assessment Scale of Skin Quality (SASSQ) mean at baseline was 2463 with a standard deviation of 0.36, while at day 168, the mean was 1303 with a standard deviation of 0.36. The difference was statistically significant (p < 0.0001). Also, the GAIS was improved after treatment with Skin Colin^®. The assessment of "satisfaction with treatment" was very high by the majority of subjects. Conclusions: In conclusion, our results suggest that a course of treatment with choline via mesotherapy results in an improvement of the Scientific Assessment Scale of Skin Quality. This data is very important for possible fields of application in the treatment of skin and muscle aging. However, the present study has limitations due to the small sample size and the lack of a control group.