Noninvasive high-intensity focused ultrasound for skin brightening efficacy using a topical agent containing glutathione and hyaluronic acid

High-intensity focused ultrasound (HIFU) is well-documented for skin rejuvenation, lifting, and tightening. However, its synergistic effects with topical agents, enhanced by HIFU-induced vibration and heat, remain underexplored. To evaluate clinical and photographic outcomes of HIFU combined with a topical agent versus the topical agent alone. This non-randomized controlled trial involved 20 female volunteers (ages 30-55) divided into two groups. Group A ( = 10) received two HIFU sessions combined with a topical agent containing glutathione and hyaluronic acid. Group B ( = 10) received the topical agent alone. Outcomes were assessed using digital photography, patient satisfaction surveys, and the A-One Smart system for fine wrinkles, hyperpigmentation, and hydration. Skin brightening was evaluated with the Global Esthetic Improvement Scale (GAIS). Group A showed significant reductions in fine wrinkles (6.25 ± 2.00 mm to 3.10 ± 1.62 mm), improved hyperpigmentation (3.50 ± 0.80 to 2.10 ± 1.05), and increased hydration (28 ± 10 to 55 ± 11) (all 0.05), with only 30% reporting noticeable improvements. Combining HIFU with a topical agent significantly enhances skin quality and brightness without adverse effects.