Effect of Single Facial Acupuncture on Dermal Structure and Appearance Satisfaction

Official title

Effects of Single-Session Facial Acupuncture on Dermal Structure and Aesthetic Satisfaction: A Randomized Controlled Trial Combining High-Frequency Ultrasound and Patient-Reported Outcomes

Overview

This study aims to investigate the effects of a single session of facial rejuvenation acupuncture on skin structure and personal satisfaction with facial appearance. As facial aging involves complex changes in muscles, skin, and soft tissues, facial acupuncture is considered a potential minimally invasive treatment to help restore balance and promote tissue repair. Researchers will enroll 60 healthy adults aged 30 to 60 who are concerned about facial aging. Participants will be randomly assigned to either an immediate intervention group or a waitlist control group. The intervention group will receive one session of facial acupuncture at the start of the study. The control group will continue their normal daily skincare routine for 6 weeks, after which they will receive the same single acupuncture treatment. All participants will be monitored weekly for 6 weeks. The research team will use non-invasive tools, including high-frequency skin ultrasound, 3D facial scanning, and a digital complexion analysis system, to objectively measure changes in skin thickness, facial volume, and wrinkles. Participants will also complete questionnaires at various time points to share their satisfaction with their appearance, self-confidence, and quality of life.

Detailed description

Facial aging is a complex, multi-layered process involving cranial bone resorption, fat pad redistribution, and biomechanical imbalances within the superficial musculo-aponeurotic system (SMAS) and facial expression muscles. While conventional aesthetic treatments like botulinum toxin, dermal fillers, and surgical facelifts are effective, they are associated with potential limitations such as expression stiffness, vascular risks, high costs, and extended recovery times. Consequently, Facial Rejuvenation Acupuncture (FRA) has emerged as a minimally invasive alternative designed to promote endogenous tissue repair with minimal downtime.

The potential physiological mechanisms of FRA include: regulating myofascial tension by targeting specific expression muscles to restore biomechanical balance; initiating a wound-healing cascade via micro-trauma to stimulate collagen synthesis; and enhancing local microcirculation through axon reflexes. Despite its growing clinical popularity, most existing research focuses on the cumulative effects of 5 to 10 sessions, leaving a significant gap in understanding the temporal dynamics of a single intervention. It remains unclear whether a single FRA session produces only a short-term "Cinderella effect" or initiates a sustained tissue remodeling process. Furthermore, previous studies have heavily relied on subjective assessments rather than objective quantification.

To address these gaps, this single-blind, randomized, waitlist-controlled trial aims to systematically evaluate the short-to-mid-term biological effects of a single FRA session over a 6-week period. Sixty eligible adults (aged 30-60) will be randomly allocated via sealed envelopes to an intervention group or a waitlist control group. The intervention group receives a single comprehensive FRA treatment at Week 0, targeting 20 specific anatomical structures across the neck, jaw, perioral, cheek, periorbital, and fascial regions to release ligament adhesions and adjust muscle tension. The control group maintains routine non-invasive skincare for 6 weeks before receiving a compensatory FRA treatment. To establish robust evidence, objective multi-modal imaging and assessments will be conducted weekly for all participants.

These tools include:

1.High-Frequency Skin Ultrasound (DUB Cutis): To measure changes in dermal thickness and assess collagen density via echogenicity.

2.3D Facial Scanning (Morpheus 3D): To quantify mid-to-lower face soft tissue volume changes and evaluate lifting effects via curved length measurements. 3.Digital Skin Analysis (VISIA): To objectively assess wrinkle depth, quantity, and overall skin surface texture.

In parallel with objective imaging, Patient-Reported Outcome Measures (PROMs) will track subjective changes in appearance satisfaction, self-confidence, and quality of life. Data collected across the 7 time points (Baseline to Week 6) will be analyzed using Linear Mixed Models (LMM) to evaluate the dynamic trends and interactions of the treatment effects over time.

Interventions

• Procedure Facial Rejuvenation Acupuncture (FRA)
  This intervention consists of a single, comprehensive session of Facial Rejuvenation Acupuncture (FRA). The procedure targets 20 specific anatomical structures across the neck, jaw, perioral, cheek, periorbital, and upper face regions. The acupuncturist uses specific needling techniques (e.g., flat, oblique, and deep insertions) to balance myofascial tension-relaxing hypertonic muscles (such as the corrugator and masseter) and stimulating hypotonic muscles (such as the zygomaticus major/minor).

Primary outcome measures

• Change in Dermal Thickness [Time frame: Baseline (Week 0) to Week 6]

Secondary outcome measures (7)

• Change in Facial Volume and Contour [Time frame: Baseline (Week 0) to Week 6]
• Change in Skin Density [Time frame: Baseline (Week 0) to Week 6]
• Change in Wrinkle Depth [Time frame: Baseline (Week 0) to Week 6]
• Change in Wrinkle Quantity [Time frame: Baseline (Week 0) to Week 6]
• Change in Patient-Reported Appearance Satisfaction [Time frame: Assessed using the FACE-Q Satisfaction with Appearance Scale. Higher scores indicate a better outcome (greater satisfaction with appearance).]
• Change in Skin Surface Smoothness [Time frame: Baseline (Week 0) to Week 6]
• Change in Quality of Life [Time frame: Baseline (Week 0) to Week 6]

Eligibility criteria

Inclusion criteria

• Adults aged 30 to 60 years old. Individuals concerned about facial aging issues.
• Individuals without severe chronic diseases.

Exclusion criteria

• Pregnant women.
• Individuals with coagulation disorders.
• Individuals with a keloid constitution or tendency for abnormal scarring.
• Individuals with acute or chronic facial hemiplegia/paralysis of any cause.
• Individuals who have undergone facial cosmetic surgery or cosmetic injections within the past 6 months.
• Individuals currently taking anticoagulant medications.
• Individuals with active skin infections.
• Individuals with a history of severe allergies.
• Individuals otherwise deemed unsuitable for facial acupuncture by the investigators.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Taiwan · 1 center

• Neihu Lixin TCM Clinic — Taipei

Publications

• Haghir H, Yazdanpanah MJ, Khadem-Rezaiyan M, Bidouei F, Azizi H. Effects of Face and Body Acupuncture on Glabellar Frown Lines in Women Aged 30-59: a Study Protocol for a Double-Arm Randomized Waitlist-Controlled Trial. J Acupunct Meridian Stud. 2024 Dec 31;17(6):221-228. doi: 10.51507/j.jams.2024.17.6.221. PMID 39722645
• Haghir H, Yazdanpanah MJ, Farahmand SK, Khadem-Rezaiyan M, Azizi H. Is Acupuncture Effective in Diminishing Frown Lines? Evidence From a Randomized Controlled Trial. J Cosmet Dermatol. 2025 Apr;24(4):e70144. doi: 10.1111/jocd.70144. PMID 40193060
• Rerksuppaphol L, Charoenpong T, Rerksuppaphol S. Randomized clinical trial of facial acupuncture with or without body acupuncture for treatment of melasma. Complement Ther Clin Pract. 2016 Feb;22:1-7. doi: 10.1016/j.ctcp.2015.10.004. Epub 2015 Oct 30. PMID 26850796
• Yun Y, Choi I. Effect of thread embedding acupuncture for facial wrinkles and laxity: a single-arm, prospective, open-label study. Integr Med Res. 2017 Dec;6(4):418-426. doi: 10.1016/j.imr.2017.09.002. Epub 2017 Sep 19. PMID 29296569

Identifiers

NCT: NCT07664280 · 115070-F

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗