## 4 Discussion
The most pronounced differences in Corneometer results were noted in the group treated with lactobionic acid, where 80% of individuals showed improvement, compared to 59% in the carboxytherapy-only group and 64.3% in the group treated with ferulic and ascorbic acids. Skin viscoelasticity demonstrated the greatest improvement in participants receiving carboxytherapy combined with ferulic and ascorbic acids, with 92.9% of individuals showing positive outcomes. These findings underscore the potential efficacy of combining carboxytherapy with active ingredients tailored to specific skin needs, particularly in anti-aging and photoaging therapies where the synergistic effects of acids and carboxytherapy can be leveraged. Ferulic acid exhibits antioxidant and anti-inflammatory properties, enhances angiogenesis, accelerates healing, inhibits tyrosinase production, and improves hydration. Ascorbic acid promotes collagen synthesis, acts as an antioxidant, inhibits tyrosinase activity, and has moisturizing, anti-inflammatory, and exfoliating properties (when used at concentrations above 20%). This combination was chosen for participants with signs of photoaging and/or pigmented eye shadows. Ferulic acid, frequently utilized in chemical peels at concentrations ranging from 12% to 20%, is known for its multi-functional properties. These peels are gentle on the skin, do not cause visible exfoliation, and are suitable for year-round use. Ferulic acid acts as a suppressor of metalloproteinases (MMP-2 and MMP-9). Additionally, it absorbs UV radiation (290-320 nm), exhibits anti-inflammatory properties, and promotes skin regeneration and epithelialization. These attributes contribute to improved microcirculation and overall skin health [25; 26; 27; 28]. [PERSON] et al. evaluated the combination of ferulic acid and vitamin C on various skin parameters, including hydration, melanin levels, erythema intensity, and skin topography. Their study revealed a statistically significant improvement in hydration (\(p<0.0001\)) and observed initial positive changes in elasticity (R2 parameter) after eight weeks [29]. Additional research by [PERSON] demonstrated that ferulic acid enhances hydration in the stratum corneum, creating a smoother skin surface, as evidenced by Visioscan imaging [30]. [PERSON] et al. further confirmed that the topical application of ferulic acid supports the hydolipid barrier, reduces TEWL, and increases water content in both the epidermis and dermis [31]. In the context of our findings, the combination of carboxytherapy with ferulic acid and ascorbic acid demonstrated a significant improvement in skin viscoelasticity. In 92.9% of individuals treated with ferulic and ascorbic acid, an improvement in viscoelasticity was demonstrated (R6). Although differences in hydration between treatment groups were not statistically significant, carboxytherapy in combination with ferulic acid and ascorbic acid (14 patients) additionally contributed to a 64% of cases improvement in hydration within the treated area. The synergistic effect observed in our study underscores the utility of incorporating ferulic acid into combination treatments for improved anti-aging and skin-repair outcomes.