A Prospective Study Comparing the Efficacy of Hyaluronic Acid and Collagen in the Treatment of Nasolabial Folds.

BACKGROUND: Hyaluronic acid (HA) is established as the gold standard for nasolabial folds (NLFs) correction. However, its use is frequently associated with transient edema and potential migration. These limitations have spurred investigation into collagen-based fillers as viable alternatives characterized by comparable efficacy and a favorable safety profile. OBJECTIVE: This prospective randomized controlled trial aimed to evaluate the comparative effectiveness of HA and collagen fillers in NLFs augmentation. METHODS: Between January 2022 and December 2023, 100 patients with moderate to severe NLFs (Wrinkle Severity Rating Scale Grades 2-4) were enrolled and randomly allocated to receive either collagen (n = 50) or HA (n = 50) injections. Treatment protocols employed tailored injection doses according to baseline NLFs severity and indentation depth. Global Aesthetic Improvement Scale (GAIS) evaluation of standardized photographs was performed to assess outcomes at baseline, 3 months, and 6 months. RESULTS: Baseline characteristics showed no intergroup disparities. Both materials produced similar improvements in NLFs reduction initially and at 3 months. At 6 months, HA maintained significantly greater improvements in NLF dimensions compared with collagen. GAIS scores indicated superior immediate and 3-month aesthetic outcomes with collagen, while HA showed better aesthetic maintenance at 6 months. CONCLUSION: This study demonstrated comparable short-term efficacy between collagen and HA for NLFs correction. These findings suggest collagen may be a practical alternative for patients seeking rapid correction with minimal downtime, while HA remains superior for long-term correction. Treatment selection should therefore be individualized based on patient preference for immediate improvement or longevity. TRIAL REGISTRATION: Clinical Trial Registry: ChiCTR2500106800.