Efficacy and Effectiveness of High Molecular Weight Non-Cross-Linked Hyaluronic Acid Plus Succinic Acid Mesotherapy in Rosacea as Adjunct Therapy.

BACKGROUND: Rosacea is a highly prevalent dermatosis affecting 5% of the world's population. Its impact is not only physical but also psychological, as over 60% of patients with rosacea also suffer from depression, anxiety, and other psychological comorbidities. Currently, topical treatments yield low or unsatisfactory success rates, and rosacea complications such as disfigurement, burning sensation, and pain can greatly affect patients' well-being. Intra-dermotherapy with high molecular weight non-cross-linked hyaluronic acid plus succinic acid has shown anti-inflammatory, regenerative, and vascular modulatory effects. OBJECTIVES: To evaluate the efficacy and effectiveness of high molecular weight non-cross-linked hyaluronic acid (HMWNCHA) plus succinic acid (SA) mesotherapy in rosacea patients who are not responding to topical treatments. To determine the degree of improvement in general parameters such as erythema, telangiectasia, and skin laxity and hydration. To compare the cost of this treatment with that of laser therapy, a widely used modality. METHODS: We performed a non-randomized, controlled interventional study, and we evaluated the results after three sessions (once monthly) as the primary endpoint of this mesotherapy, using a product containing 1.1% of high molecular weight non-cross-linked hyaluronic acid plus 1.6% succinic acid (full face, 2 mL per session, administered using the papule technique) in a group of 20 male and female patients, aged 40-45 years, Fitzpatrick skin types I-III, without comorbidities. All patients were already undergoing topical treatment with Ivermectin 1%, Metronidazole 0.75%, and photoprotection, but without good results or clear improvement, quantified as a reduction in the Investigator's Global Assessment (IGA) severity score of at least 1 point. Erythema, hydration, and facial telangiectasia were evaluated at every session for proper quantification. Our study group was compared with a control group that only continued their topical treatment, and the study lasted 4 months, with a prospective follow-up at 6 months. RESULTS: Our results showed a reduction of 80% in the baseline erythema, an improvement of 30% in skin hydration, and a reduction of 20% in facial telangiectasia after three sessions, compared with patients who used only topical treatment. In addition, the costs were significantly lower than those of three sessions of laser therapy in a private healthcare setting. CONCLUSION: We demonstrated that using this acid combination in mesotherapy is an efficient, safe, and cost-effective adjunct therapy for patients already using a particular topical treatment.