To evaluate the efficacy and safety of monopolar radiofrequency treatment combined with SkinCeuticals A.G.E. Ultra Cream for facial rejuvenation
Facial aging is a multidimensional process that progresses with age, involving the synergistic degenerative changes of the skin, soft tissues, and skeletal structure. Its typical features include skin laxity, deepening of fine lines and wrinkles, rough texture, and dull complexion. Among these, the loss of collagen and elastin in the dermis is considered the core mechanism underlying reduced skin firmness and the formation of fine lines. Collagen loss is generally caused by a combination of intrinsic and extrinsic factors. Intrinsically, as age increases, the function of fibroblasts in the skin gradually declines, reducing their capacity to synthesize collagen, which leads to thinning of the dermis and decreased skin elasticity, manifesting as roughness and laxity. In addition, glycation plays a significant role in skin aging. Under a high-glucose environment, advanced glycation end products (AGEs) are prone to form in the skin, which stiffen the collagen structure, reduce elasticity, and impair repair capacity. AGEs further compromise fibroblast function, decreasing collagen production while increasing its degradation, ultimately exacerbating skin laxity and wrinkle formation . Among extrinsic factors, chronic ultraviolet exposure is a major accelerator of skin aging. Ultraviolet radiation induces oxidative damage and inflammatory responses in the skin, promoting collagen degradation while inhibiting its synthesis, thereby significantly accelerating the aging process. Under the combined influence of these factors, skin hydration and barrier function progressively decline, clinically presenting as uneven skin tone, reduced radiance, and accelerated aging. In terms of visual appearance, skin aging is mainly characterized by deepened wrinkles, decreased firmness, and increased laxity, particularly pronounced in the forehead, periorbital area, perioral region, and facial contour. These aging manifestations, marked by wrinkle formation and skin laxity, highlight the necessity of improving skin firmness and contour through medical aesthetic interventions, and further demonstrate the value of monopolar radiofrequency treatment in facial rejuvenation. Monopolar radiofrequency (i.e., Thermage®), as a non-invasive anti-aging technology, delivers radiofrequency energy to the dermis, causing immediate contraction of collagen fibers and stimulating fibroblasts to promote subsequent collagen neogenesis, thereby improving skin firmness, contour laxity, and fine lines. A substantial body of literature indicates that monopolar radiofrequency treatment produces stable and reproducible clinical outcomes in terms of facial tightening, tissue lifting, and improvement of superficial wrinkles, with a favorable safety profile, making it one of the most widely used skin anti-aging radiofrequency devices. However, although radiofrequency treatment can achieve collagen remodeling, its effects on the skin barrier, radiance, and deep AGEs are limited. Therefore, combining radiofrequency treatment with skincare products that possess anti-glycation, reparative, and collagen-promoting properties may further enhance facial rejuvenation outcomes. Currently, there is no unified, systematic clinical pathway for comprehensive skin management following non-invasive energy-based medical aesthetic procedures such as radiofrequency and focused ultrasound. To address this clinical need, SkinCeuticals has taken the lead in recent years in proposing the concept of "holistic skincare" and has formulated the Chinese Clinical Practice Expert Consensus on Peri-Procedural Holistic Skincare for Non-Invasive Energy-Based Medical Aesthetic Procedures. According to the consensus, holistic skincare refers to the systematic integration of functional skincare products into the skin management workflow during the peri-procedural period of non-invasive energy-based aesthetic treatments, covering the phases before treatment, immediately after treatment, and subsequent home maintenance. The expert consensus notes that while energy-based treatments such as radiofrequency improve skin firmness, they may also affect the skin barrier to some extent and are accompanied by oxidative, glycative, and inflammatory responses, making targeted skincare intervention necessary for comprehensive management. SkinCeuticals A.G.E. Ultra Cream, as a key component of the holistic skincare framework, is formulated around glycation-related aging pathways, covering multiple key dimensions including anti-glycation, promotion of multiple types of collagen production, and support of skin barrier stability. The flavonoid components and dipotassium glycyrrhizate in its compound anti-glycation concentrate help mitigate glycation effects, reduce collagen glycation damage, and block AGE formation pathways, thereby lowering the risk of collagen structural and functional deterioration. Meanwhile, ingredients such as pro-xylane solution, rhamnose, and Gentiana lutea root extract in the formula help support fibroblast activity and participate in the synthesis and tissue remodeling of key structural proteins including type IV, type VII, and type XVII collagen. This contributes to improving skin firmness while maintaining skin barrier stability and overall skin condition. Existing clinical studies have shown that SkinCeuticals A.G.E. Ultra Cream can effectively reduce facial wrinkles, improve skin elasticity, and ameliorate sagging manifestations, providing scientific evidence for comprehensive skin management following non-invasive energy-based aesthetic treatments. Based on the above mechanisms of skin aging and the characteristics of holistic skincare, this study adopts a combined intervention model of monopolar radiofrequency treatment plus SkinCeuticals A.G.E. Ultra Cream, incorporating both subjective efficacy indicators and skin physiological parameters to validate the efficacy and synergistic effects of SkinCeuticals A.G.E. Ultra Cream, thereby providing cutting-edge clinical evidence for the concept of holistic skincare.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
50
The left side of the face serves as the experimental side, and the right side serves as the control side. The experimental side uses SkinCeuticals A.G.E. Ultra Cream, while the control side uses a standard cream.
The left side of the face serves as the control side, and the right side serves as the experimental side. The experimental side uses SkinCeuticals A.G.E. Ultra Cream, while the control side uses a standard cream.
Beijing Artemis Medical Beauty Clinic
Beijing, Beijing Municipality, China
RECRUITINGInvestigator Global Aesthetic Improvement Scale (GAIS) assessment at 12 weeks post-treatment
The blinded evaluator will assess subjects using the Global Aesthetic Improvement Scale (GAIS). The scale contains two questions: 1. Global aesthetic improvement - left side, and 2. Global aesthetic improvement - right side. Each question is rated on a 5-level scale: Level 1 = Very marked improvement, Level 2 = Marked improvement, Level 3 = Somewhat improved, Level 4 = No change, and Level 5 = Worse than before. The minimum value is 1 per item, and the maximum value is 5 per item. A lower score indicates a better outcome, meaning higher scores represent a worse outcome.
Time frame: 12 weeks (±7 days) post-treatment
Global Aesthetic Improvement Scale (GAIS) assessment
The blinded evaluator will assess subjects using the Global Aesthetic Improvement Scale (GAIS). The scale contains two questions: 1. Global aesthetic improvement - left side, and 2. Global aesthetic improvement - right side. Each question is rated on a 5-level scale: Level 1 = Very marked improvement, Level 2 = Marked improvement, Level 3 = Somewhat improved, Level 4 = No change, and Level 5 = Worse than before. The minimum value is 1 per item, and the maximum value is 5 per item. A lower score indicates a better outcome, meaning higher scores represent a worse outcome.
Time frame: 1 week (±2 days) post-treatment, 2 weeks (±2 days) post-treatment, 4 weeks (±7 days) post-treatment, 8 weeks (±7 days) post-treatment
Patient satisfaction with treatment
The assessment uses a Subject Satisfaction Questionnaire. The questionnaire contains 5 identical questions to be evaluated separately for the left and right sides of the face. The 5 questions are: 1. Satisfaction with the overall skin care effects of the Thermage procedure. 2. Overall improvement in facial wrinkles after using the product. 3. Improvement in facial skin elasticity after using the product. 4. Improvement in facial skin plumpness after using the product. 5. Improvement in skin hydration after using the product. Each question is rated on a 5-level scale, with scores as follows: 1. point - Very Dissatisfied 2. points - Dissatisfied 3. points - Neutral / Average 4. points - Satisfied 5. points - Very Satisfied Higher Score Means: Better outcome (higher satisfaction)
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Time frame: 1 week (±2 days) post-treatment, 2 weeks (±2 days) post-treatment, 4 weeks (±7 days) post-treatment, 8 weeks (±7 days) post-treatment
Improvement in skin elasticity and firmness
The investigator will assess the skin on both sides of the face using the CK Skin Analyzer with a Cutometer probe; a single measurement will be taken
Time frame: Screening period, 1 week (±2 days) post-treatment, 2 weeks (±2 days) post-treatment, 4 weeks (±7 days) post-treatment, 8 weeks (±7 days) post-treatment, 12 weeks (±7 days) post-treatment
Improvement in transepidermal water loss
The investigator will assess transepidermal water loss on both sides of the face using the CK Skin Analyzer with a Vapometer probe. Measurements will be taken twice, and the average value will be used as the final result.
Time frame: Screening period, 1 week (±2 days) post-treatment, 2 weeks (±2 days) post-treatment, 4 weeks (±7 days) post-treatment, 8 weeks (±7 days) post-treatment, 12 weeks (±7 days) post-treatment
Improvement in skin hydration
The investigator will assess transepidermal water loss on both sides of the face using the CK Skin Analyzer with a moisture content probe. Measurements will be taken three times, and the average value will be used as the final result.
Time frame: Screening period, 1 week (±2 days) post-treatment, 2 weeks (±2 days) post-treatment, 4 weeks (±7 days) post-treatment, 8 weeks (±7 days) post-treatment, 12 weeks (±7 days) post-treatment
Improvement in skin glossiness
The investigator will assess skin glossiness on both sides of the face using the CK Skin Analyzer with a Glossymeter probe. Measurements will be taken three times, and the average value will be used as the final result.
Time frame: Screening period, 1 week (±2 days) post-treatment, 2 weeks (±2 days) post-treatment, 4 weeks (±7 days) post-treatment, 8 weeks (±7 days) post-treatment, 12 weeks (±7 days) post-treatment
Improvement in dermal thickness and density
The investigator will assess the thickness and density of both sides of the face using a skin ultrasound device; a single measurement will be taken.
Time frame: Screening period, 1 week (±2 days) post-treatment, 2 weeks (±2 days) post-treatment, 4 weeks (±7 days) post-treatment, 8 weeks (±7 days) post-treatment, 12 weeks (±7 days) post-treatment
Improvement in the number and volume of nasolabial folds
The investigator will assess the number and volume of wrinkles on both sides of the face nasolabial folds using the Antera 3D imaging system.
Time frame: Screening period, 1 week (±2 days) post-treatment, 2 weeks (±2 days) post-treatment, 4 weeks (±7 days) post-treatment, 8 weeks (±7 days) post-treatment, 12 weeks (±7 days) post-treatment
Improvement in jowl volume
The investigator will assess the jowl area on both sides of the face using the Antera 3D imaging system.
Time frame: Screening period, 1 week (±2 days) post-treatment, 2 weeks (±2 days) post-treatment, 4 weeks (±7 days) post-treatment, 8 weeks (±7 days) post-treatment, 12 weeks (±7 days) post-treatment
Area percentage of nasolabial folds, crow's feet, and marionette lines
The investigator will assess the area percentage of wrinkles at three sites on both sides of the face (crow's feet, nasolabial folds, and marionette lines) using the VISIA Skin Analysis System.
Time frame: Screening period, 1 week (±2 days) post-treatment, 2 weeks (±2 days) post-treatment, 4 weeks (±7 days) post-treatment, 8 weeks (±7 days) post-treatment, 12 weeks (±7 days) post-treatment
Improvement in skin AGEs
The investigator will assess the AGEs index on both sides of the face using the AGE Reader; a single measurement will be taken.The indicator measured by the AGE Reader is typically expressed in AU (Arbitrary Units) and reflects the accumulation level of Advanced Glycation End Products (AGEs) in skin tissue. AGEs are the products of non-enzymatic reactions between proteins or lipids and sugars. A lower value generally indicates less accumulation of AGEs, suggesting a better metabolic state, lower levels of oxidative stress and glycation reactions, and a relatively lower risk of skin aging.
Time frame: Screening period, 1 week (±2 days) post-treatment, 2 weeks (±2 days) post-treatment, 4 weeks (±7 days) post-treatment, 8 weeks (±7 days) post-treatment, 12 weeks (±7 days) post-treatment
Improvement in the number and volume of crow's feet
The investigator will assess the number and volume of wrinkles on both sides of the face crow's feet using the Antera 3D imaging system.
Time frame: Screening period, 1 week (±2 days) post-treatment, 2 weeks (±2 days) post-treatment, 4 weeks (±7 days) post-treatment, 8 weeks (±7 days) post-treatment, 12 weeks (±7 days) post-treatment
Improvement in the number and volume of marionette lines
The investigator will assess the number and volume of wrinkles on both sides of the face marionette lines using the Antera 3D imaging system.
Time frame: Screening period, 1 week (±2 days) post-treatment, 2 weeks (±2 days) post-treatment, 4 weeks (±7 days) post-treatment, 8 weeks (±7 days) post-treatment, 12 weeks (±7 days) post-treatment