Comparative Evaluation of High‐Frequency Microneedling Using a Layering Technique Versus Conventional Technique for Facial Rejuvenation

OBJECTIVE: To evaluate the effectiveness of high-frequency microneedling (HFM) using a layering technique versus conventional HFM for facial rejuvenation, with the Fitzpatrick Wrinkle and Laxity Classification Scale (FWCS) score at 3 months post-treatment as the primary endpoint. METHODS: A prospective non-randomized controlled study was conducted on 30 patients undergoing facial rejuvenation at Changzhou TCM Hospital (January-December 2024), who were divided into two groups (n = 15 each). The conventional group received standard HFM, while the layered group received HFM with needle length, power, and pulse width adjusted for superficial, middle, and deep skin layers. The primary endpoint was the Fitzpatrick Wrinkle and Laxity Classification Scale (FWCS) score at 3 months post-treatment. Secondary endpoints included FWCS scores at 1 and 2 months, VISIA-derived skin texture/pore scores, Global Aesthetic Improvement Scale (GAIS) scores, Cutometer skin rebound rate, and patient satisfaction. Assessments were performed pre-treatment and at 1, 2, and 3 months post-treatment. Statistical analyses were conducted using SPSS 22.0, with linear mixed-effects models for repeated measures, ordinal methods for GAIS, and Fisher's exact test for satisfaction. RESULTS: Pre-treatment FWCS scores showed no significant difference (p > 0.05). At 1 month, the layering group showed a significantly greater FWCS score reduction (2.53 vs. 1.34, p < 0.05). FWCS scores remained significantly lower in the layering group at 2 and 3 months (p < 0.05). Skin texture improvement was significantly better maintained in the layering group at 2 and 3 months (p < 0.05). Pore improvement was significantly better in the layering group only at 3 months (p < 0.05). GAIS scores indicated significantly superior rejuvenation effects in the layering group (p < 0.001). Patient satisfaction was significantly higher in the layering group (93.33% vs. 60.00%, p < 0.05). No serious adverse reactions occurred; transient redness and mild discomfort resolved quickly in both groups. CONCLUSION: The HFM layering technique demonstrates superior efficacy over conventional HFM for facial rejuvenation, with more significant and sustained improvements in wrinkles, skin texture, pores, and elasticity, as well as higher patient satisfaction. Both techniques are safe, though the layered approach is associated with slightly longer downtime.