Patients seeking hand rejuvenation to correct volume loss have few treatment options available. In 2015, calcium hydroxylapatite (Radiesse, Bioform Medical, Inc.) was approved by the U.S. Food and Drug Administration (FDA) for hand rejuvenation. In 2018 a second option was FDA approved: Restylane Lyft with Lidocaine (Galderma Laboratories).
Based on data from a small open-label study1 that showed promising results for hand rejuvenation with small-gel-particle hyaluronic acid, Amir Moradi, M.D., et al., conducted a study2 using large-gel-particle hyaluronic acid with 0.3% lidocaine (HAL; Restylane Lyft with Lidocaine; Galderma Laboratories) for correction of volume loss in the dorsal hand.
This prospective, multi-center, split-hand study examined the safety and efficacy of 20 mg/mL HAL to improve hand volume.
A total of 90 patients received HAL injections in one hand; for comparison, the other hand received no treatment. The primary endpoint was based on a minimum of 1 point of improvement on the Merz Hand Grading Scale (MHGS) in the hand treated with HAL.
Patients received treatments on day 0 in either the left or right hand in a randomized fashion, stratified by Fitzpatrick skin type. Each syringe contained 1 mL of gel.
Injections were administered to all patients on day 0 and then at the six-month mark, including an optional touch-up four weeks after the initial injection.
Patients received a mean injection volume of 2.1 mL for primary treatment and 1.1 mL for touch-up treatment (total volume range, 1 mL to 5 mL).
Results showed a consistently high proportion of patients noting improvement throughout the study, including continued improvement at six months to one year. MHGS assessment determined a significantly higher response rate in the hands treated with hyaluronic acid (85.9%), compared with those that received no treatment (21.2%). And blinded reviewers were consistently able to differentiate between the treated and untreated hands through week 24. These improvements were consistent over the course of the study, which supports the clinical utility of HAL for restoring volume.
According to the article, the study and medical writing services were funded by Galderma Research and Development, LLC.
1. Wilkerson EC, Goldberg DJ. Small-Particle Hyaluronic Acid Gel Treatment of Photoaged Hands. Dermatol Surg. 2018;44(1):68-74.
2. Moradi A, Allen S, Bank D, et al. A Prospective, Multicenter, Randomized, Evaluator-Blinded, Split-Hand Study to Evaluate the Effectiveness and Safety of Large-Gel-Particle Hyaluronic Acid with Lidocaine for the Correction of Volume Deficits in the Dorsal Hand. Plast Reconstr Surg. 2019;144(4):586e-596e.