Polynucleotide Injection for Enlarged Pores: Comparison of Intradermal Needle and Subdermal Cannula Techniques in a Randomized Split-Face Trial

Abstract

Background: Enlarged facial pores are a common cosmetic concern among Asians. Polynucleotides (PN) show potential for skin rejuvenation and pore reduction; however, the optimal delivery approach remains unclear. Objectives: To compare the efficacy, safety, and patient satisfaction of PN injections administered using two technique-based approaches: an intradermal needle technique (needle technique) and a subdermal cannula technique (cannula technique) for enlarged facial pores. Methods: A randomized, split-face, evaluator-blinded clinical trial was conducted in 30 participants. Each underwent three PN treatments at 4-week intervals, with the needle technique applied to one side and the cannula technique to the contralateral side. Quantitative assessments included pore volume, skin texture, sebum level, and hydration. Blinded dermatologists and participants performed visual evaluations. Results: The needle technique significantly reduced mean pore volume from 1.48 mm³ at baseline to 1.10, 0.93, and 0.88 mm³ at months 3, 4, and 5, respectively. The cannula technique demonstrated comparable reductions from 1.27 mm³ to 0.94 and 0.82 mm³ at months 4 and 5, with no significant difference between techniques. Skin texture improved by 15.45% and 12.89%, respectively. Hydration and sebum showed no significant changes. The needle technique was associated with higher pain scores and more frequent minor adverse events. Conclusions: Both techniques improved pore appearance and skin texture with comparable efficacy and acceptable safety. The needle technique showed a trend toward earlier improvement, whereas the cannula technique demonstrated greater tolerability. Findings reflect comparison of two clinical delivery approaches rather than isolated device effects. Trial Registration: This study was registered in Clinical Trials (TCTR20240716010), available at www.thaiclinicaltrials.org.