Hyaluronic acid plus mannitol treatment for improved skin hydration and elasticity

J Cosmet Dermatol. 2012 Jun;11(2):87-92. doi: 10.1111/j.1473-2165.2012.00608.x.


Background: Mesotherapy treatment of aging skin aims to replace depleting levels of minerals, vitamins, amino acids, and hyaluronic acid (HA).

Aim: To investigate the efficacy of 13.5 mg/g uncross-linked HA+0.9% mannitol (HA+mannitol) on skin hydration and elasticity.

Patients/methods: Four centers enrolled 34 women: Subgroup 1 comprised 27 subjects injected using a "depot" technique; Subgroup 2 comprised seven subjects injected using a "picotage" technique.

Results: A notable difference was seen between the two subgroups in outcome and subject satisfaction. In Subgroup 1, a significant improvement was seen in hydration, anisotropy, and skin roughness, but Subgroup 2 showed no significant improvements. Most physicians assessed HA+mannitol as "easy/very easy" to inject. Physician esthetic assessment in Subgroup 1 was "improved/very improved" for >90% of subjects at Day 60, and >80% according to subject assessment. 95% of subjects were delighted with treatment, and 85% would undergo repeat treatment and would recommend treatment to a friend. However, results for Subgroup 2 indicated 86% of subjects were unhappy with treatment and 83% would refuse to undergo repeat treatment.

Conclusions: HA+mannitol is effective for skin hydration, anisotropy, and roughness when treated using a depot technique.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Anisotropy
  • Body Water / drug effects*
  • Body Water / physiology
  • Dermatologic Agents / adverse effects
  • Dermatologic Agents / pharmacology*
  • Drug Combinations
  • Elasticity / drug effects*
  • Face
  • Female
  • Humans
  • Hyaluronic Acid / adverse effects
  • Hyaluronic Acid / pharmacology*
  • Injections, Intradermal
  • Mannitol / adverse effects
  • Mannitol / pharmacology*
  • Mesotherapy / adverse effects
  • Middle Aged
  • Prospective Studies
  • Skin Aging / drug effects
  • Skin Physiological Phenomena / drug effects*
  • Statistics, Nonparametric
  • Time Factors


  • Dermatologic Agents
  • Drug Combinations
  • Mannitol
  • Hyaluronic Acid