title: Changes in skin physiology and clinical appearance after microdroplet placement of hyaluronic acid in aging hands.
abstract: BACKGROUND
  Up to now rejuvenating treatment of the hands has been challenging and results often disappointing.
  
  
  OBJECTIVE
  To determine whether hyaluronic acid (HA) microdroplet placement into the dorsal hands has an impact on skin physiology and clinical appearance and whether there is any difference between stabilized HA (S-HA) and nonstabilized HA (NS-HA).
  
  
  METHODS
  The intra-individual comparison in 15 volunteers involved injection sessions at week 0, 4, and 8 with random assignment of left and right hand to either S-HA or NS-HA. Skin physiology parameters cutaneous elasticity, surface roughness, hydration, and transepidermal water loss (TEWL) were measured in vivo at weeks 0 (before treatment), 4 (before subsequent treatment), 12, and 24. Clinical hand assessment was carried out at weeks 0 and 12 by a blinded dermatologist.
  
  
  RESULTS
  Intradermal injection of S-HA generated significant improvement in skin elasticity and surface roughness at week 12 compared to baseline. On the hands treated with NS-HA, there was a trend for improvement (not significant). While there was no significant difference in hydration and TEWL between both hands before treatment, at week 12 hands treated with S-HA displayed a significantly higher hydration level and lower TEWL compared to NS-HA treatment. Clinically S-HA proved to be significantly superior to NS-HA. At week 24 the observed effects started to return back toward baseline, with S-HA treatment still offering better results compared to the NS-HA.
  
  
  CONCLUSIONS
  Skin revitalization with injectable HA can improve clinical appearance and skin physiology parameters on the back of the hands. It has been shown that S-HA has better effects when compared with NS-HA.
authors.affiliation: Cosmetic Science Group, School of Management and Science, University of the Arts London, London, UK. dr.williams@eudelo.com
authors.forename: Stefanie
authors.initials: S
authors.lastname: Williams
authors.forename: Slobodanka
authors.initials: S
authors.lastname: Tamburic
authors.forename: Henriette
authors.initials: H
authors.lastname: Stensvik
authors.forename: Mateja
authors.initials: M
authors.lastname: Weber
mesh_terms: D000328:Adult; D004355:Drug Stability; D004548:Elasticity; D004817:Epidermis / Q000187:drug effects / Q000502:physiology; D005260:Female; D006225:Hand; D006801:Humans; D006820:Hyaluronic Acid / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D015595:Skin Aging / Q000187:drug effects / Q000502:physiology*; D012879:Skin Physiological Phenomena / Q000187:drug effects*; D014870:Water Loss, Insensible / Q000187:drug effects
chemical_list: D006820:Hyaluronic Acid