The Gold Standard in Anti-Ageing In-Clinic Skin Treatments

Strength of Evidence: High

Botulinum toxin type A is the most extensively studied in-clinic anti-ageing treatment worldwide, with a large body of high-quality, placebo-controlled RCTs.

Evidence overview

Randomised, double-blind clinical trials consistently demonstrate that botulinum toxin:

• Significantly reduces dynamic wrinkle severity compared with placebo

• Produces predictable, reproducible improvements across facial regions

• Demonstrates a well-characterised safety profile when administered by an appropriately trained medical professional.

These findings have been replicated internationally across large patient populations, making botulinum toxin one of the most evidence-secure aesthetic interventions available.

Our Pharmacist’s Interpretation:

Botulinum toxin represents a gold-standard treatment for dynamic facial ageing, offering predictable outcomes supported by the strongest RCT evidence base in aesthetic medicine.

Strength of Evidence: High

Hyaluronic acid (HA) dermal fillers are supported by multiple randomised, evaluator-blinded, and split-face trials assessing volume restoration and static wrinkle reduction.

Evidence overview

Clinical trials demonstrate that HA fillers:

• Improve wrinkle severity and volume loss compared with baseline and comparators

• Produce immediate and sustained aesthetic improvement

• Show acceptable safety profiles when delivered by medically trained clinicians

While placebo-controlled designs are limited by ethical considerations, split-face RCTs provide robust comparative evidence.

Our Pharmacist’s Interpretation:

HA fillers are strongly supported for structural ageing and volume loss, though outcomes are highly technique-dependent and require advanced anatomical expertise.

Strength of Evidence: High (device-dependent)

Fractional laser resurfacing, including ablative and non-ablative technologies, is supported by multiple RCTs and meta-analyses for skin rejuvenation and collagen remodelling.

Evidence overview

High-quality studies show that fractional lasers:

• Improve skin texture, fine lines, and acne scarring

• Stimulate dermal collagen remodelling

• Produce durable results with appropriate patient selection

Ablative lasers demonstrate stronger effects but greater downtime, while non-ablative lasers offer gentler recovery with cumulative benefit.

Our Pharmacist’s Interpretation:

Fractional laser treatments are among the most evidence-supported options for structural skin change beyond injectables, particularly for texture and scarring.

The following treatments are widely used in aesthetic practice but do not consistently meet the same RCT threshold as the gold-standard treatments above.

1) Microneedling

Strength of Evidence: Moderate to High

Microneedling has a growing RCT base, particularly for acne scarring and skin texture.

Evidence overview

RCTs demonstrate that microneedling:

• Improves acne scarring and skin texture compared with baseline

• Stimulates collagen production via controlled dermal injury

Outcomes depend heavily on device type, needle depth, and treatment protocol.

Our Pharmacist’s Interpretation:

Microneedling is one of the better-supported regenerative procedures, especially for texture and scarring, but results are less predictable than lasers or injectables.

2) Trichloroacetic Acid (TCA) Chemical Peels

Strength of Evidence: Moderate

TCA peels have long-standing clinical use, with evidence supporting improvements in photoaging and pigmentation.

Evidence overview

Clinical studies suggest TCA peels:

• Improve skin tone and surface irregularities

• Can enhance photoaged skin appearance

However, protocols vary widely, and outcomes are operator-dependent.

Our Pharmacist’s Interpretation:

TCA peels are established and effective in selected patients but lack the standardisation and predictability seen with gold-standard modalities.

3) Profhilo and Profhilo Structura

Strength of Evidence: Low to Moderate

Profhilo products are stabilised hyaluronic acid complexes positioned for skin quality and hydration rather than volume replacement.

Evidence overview

Published studies are generally:

• Small-scale

• Often non-blinded or observational

• Focused on hydration and elasticity metrics

Large, independent RCTs remain limited.

Our Pharmacist’s Interpretation:

Profhilo may support skin hydration and perceived quality, but current evidence does not place it alongside gold-standard anti-ageing interventions.

4) Polynucleotides

Strength of Evidence: Low (Emerging)

Polynucleotide-based injectables are marketed for regenerative and skin quality benefits.

Evidence overview

Current human studies are:

• Small

• Methodologically heterogeneous

• Limited in long-term outcome data

Our Pharmacist’s Interpretation:

Polynucleotides remain an emerging treatment with promising biological rationale but insufficient high-quality RCT evidence to support strong anti-ageing claims.

5) Exosomes and Conditioned Media (Including via Microneedling)

Strength of Evidence: Low (Adjunct only)

Products described as “exosomes” or conditioned media are increasingly used post-procedure.

Evidence overview

At present:

• Robust, blinded RCTs are lacking

• Most data are observational or manufacturer-led

• Regulatory classifications vary internationally

Our Pharmacist’s Interpretation:

These products may support recovery and short-term skin quality but should be positioned as adjunctive rather than core anti-ageing treatments.

Gold-standard RCT-supported treatments:

• Botulinum toxin (dynamic wrinkles)

• Hyaluronic acid fillers (volume and structure)

• Fractional laser resurfacing (texture and collagen remodelling)

Moderate evidence treatments:

• Microneedling

• TCA chemical peels

Emerging or adjunctive treatments:

• Profhilo and Profhilo Structura

• Polynucleotides

• Exosomes and conditioned media

Overall Scientific Summary

When assessed using the highest-quality available clinical evidence:

• Injectables and energy-based devices remain the most reliably supported anti-ageing interventions

• Regenerative and skin-quality treatments show promise but lack equivalent RCT maturity

• Optimal anti-ageing outcomes require pathway-specific treatment selection, not trend-driven intervention

At OptiOptu, your treatment recommendations are based on clinical evidence, safety, and biological plausibility, ensuring you receive interventions that are both effective and scientifically proven.