(1) Background: The emergence of microneedle patch technology and its development as a transdermal drug delivery platform have shown proven results in improving skin texture and appearance. This study was conducted to determine the efficacy of the microneedle patch (MNP)- only cosmesis of undereye skin texture and wrinkles against patch cosmesis with diluted botulinum toxin-A. (2) Methods: A total of 23 Thai females volunteered for this prospective clinical trial. Each participant was treated according to a split-face design, with the application of diluted botulinum toxin-A through MNP technology to the right undereye and a normal saline MNP application to the left undereye. Test areas were recorded at baseline and 2, 4, 8, 12, and 16 weeks after the initial treatment. (3) Results: Botulinum toxin-A was successfully delivered to the skin by MNP technology. After the initial treatment, these novel transdermal drug delivery patches significantly improved infraorbital hollowness at week 8 and wrinkles at week 16. In addition, the skin surface was markedly enhanced, with no adverse effects observed during the trial. (4) Conclusions: Novel MNPs are an effective and safe technology for use in the management of undereye skin aging. Combination treatment with botulinum toxin-A-impregnated devices gave a higher patient satisfaction than MNPs alone.
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