Skin Rejuvenation with Hyaluronic Acid and Sirtuin-1 Activa-tors (Nicotinamide Adenine Dinucleotide and Resveratrol): A Comparative Clinical Study of Microneedling and Injection Delivery

Abstract

Skin aging results from both intrinsic and extrinsic factors, leading to a decline in hydration, elasticity, and the structural integrity of the skin. A novel skinca-re formulation has been developed to address these changes using five syner-gistic components: dual molecular weight hyaluronic acid (HA), Nicotinamide Adenine Dinucleotide (NAD⁺), liposomal resveratrol, biomimetic peptides, and mannitol. These actives collectively target hydration, oxidative stress, col-lagen synthesis, and mitochondrial function. Central to the formulation is the activation of Sirtuin-1 (SIRT1), a longevity-associated gene involved in DNA repair and cellular resilience (1), enhanced through the synergistic action of NAD⁺ and resveratrol. This clinical study was randomized and evaluated the efficacy of the formulation delivered through two methods: micronee-dling, consistent with the product’s authorized cosmetic use, and a five-point injection technique, representing an off-label application, in a total of 20 pa-tients. The off-label administration was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and received prior approval from an ethics committee. Parameters assessed include hydration, elasticity, wrinkle reduction, and patient satisfaction. Results showed a 55% increase in hydration and a 42% improvement in elasticity for the injection group, compared to 38% and 25%, respectively, for the microneedling group. Injection allows deeper and more targeted delivery of active compounds into the dermal-subdermal junction, which may enhance bioavailability and the-rapeutic effects compared to the more superficial diffusion associated with microneedling.