Combined microneedling and PRX PLUS for multidimensional skin quality improvement: A pilot prospective pragmatic study

Background Microneedling and PRX PLUS formulations are established strategies for enhancing multidimensional skin quality, yet their combined use has not been systematically investigated. This pilot prospective real-world study evaluated the clinical effectiveness, patient-reported outcomes, and tolerability of a combined microneedling and skin booster protocol. Methods A prospective single-arm pilot study was conducted in an outpatient aesthetic practice, enrolling 15 women with signs of photoaging. All participants received three full-face treatment sessions at 21-day intervals. Assessments at baseline (T0) and 15 days after the final session (T1) included high-resolution imaging (VISIA® and Visioscope) to quantify key skin parameters, the validated FLO-11 questionnaire for patient-reported outcomes, and visual analogue scales for immediate tolerability. Results The combined protocol was associated significant improvements across multiple skin-quality domains. VISIA analyses demonstrated notable reductions in texture irregularities (–26.2%, p=0.001), texture score (–25.8%, p=0.001), UV spots (–9.5%, p=0.027), pigmented spots (–14.1%, p=0.001), and redness (–32.6%, p=0.008). Visioscope findings further confirmed reductions in spots (–41.7%, p=0.001), pore visibility (–17.1%, p=0.001), sebum levels (–40.0%, p=0.005), and wrinkle severity (–12.4%, p=0.006). Patient-reported outcomes indicated improved skin smoothness (p=0.014), a less “stressed” appearance (p=0.015), and greater satisfaction with overall facial aesthetics (p=0.038). Tolerability was favorable, with only mild-to-moderate discomfort and no clinically relevant adverse events. Conclusion This exploratory pilot study suggests that microneedling combined with PRX PLUS may be associated with early, multidimensional improvements in skin quality with favorable tolerability and patient satisfaction. However, given the small sample size and multiple endpoints assessed, all findings should be considered hypothesis-generating.