Fractional microneedle radiofrequency with the application of vitamin C, E, and ferulic acid serum for neck skin rejuvenation: a prospective, double-blinded, split-neck, placebo-controlled trial

Abstract

Purpose To evaluate the efficacy of fractional microneedle radiofrequency (FMR) combined with topical antioxidant serum (vitamin C, E, and ferulic acid) compared to FMR alone for neck rejuvenation. Materials and methods This prospective, randomized, double-blind, split-neck trial included 31 participants aged 30-65 years with visible signs of neck aging. Subjects underwent two FMR treatments at 4-week intervals. Immediately post-treatment, participants applied antioxidant serum to one randomly assigned side of the neck and placebo to the contralateral side daily. Efficacy was assessed by Fitzpatrick Wrinkle and Elastosis Scale, Global Esthetic Improvement Scale (GAIS), and biophysical skin parameters. Histological analyses evaluated elastin production and markers of senescence. Results At week 12, the antioxidant-treated neck side showed significantly greater reductions in wrinkle severity (29.9% vs. 18.0%; p < 0.001), increased elasticity (12.9% vs. 2.3%; p < 0.001), and higher GAIS improvement (87.5% vs. 14.3%). Histologically, antioxidant-treated areas exhibited increased elastin and reduced cellular senescence markers (p16 and gamma-H2A.X). Conclusions Combining FMR with topical antioxidant serum substantially enhances neck skin rejuvenation, demonstrating superior clinical and histological outcomes. This approach effectively addresses neck aging, highlighting antioxidants as valuable adjunctive therapies.