LC-OCT in Aesthetic Dermatology: Applications in Skin Aging, Cosmetic Product Assessment, and Aesthetic Procedures—A Narrative Review

Line-field confocal optical coherence tomography (LC-OCT) is a non-invasive optical imaging technique that combines cellular resolution with vertical, horizontal, and three-dimensional visualization of living skin. These features are attractive in aesthetic dermatology, where conventional clinical photography and biophysical measurements primarily assess visible changes and selected skin properties but provide limited information on tissue architecture. This narrative review examines the emerging use of LC-OCT to characterize skin aging, assess cosmetic and topical products, and monitor aesthetic procedures. Published studies demonstrate that LC-OCT, particularly when coupled with automated segmentation and artificial intelligence, can quantify epidermal organization, dermal–epidermal junction morphology, cellular features, pigment distribution, and superficial dermal fiber patterns. Early interventional work has applied these endpoints to brightening products, anti-aging formulations, sunscreens, and topical drugs. Procedural studies have visualized tissue responses after microdermabrasion, hydradermabrasion, chemical peeling, hair-removal lasers, fractional laser treatments, plasma radiofrequency, botulinum toxin, microwave thermolysis, and dermal filler injection. LC-OCT may therefore complement clinical outcomes by providing repeatable, in vivo microscopic endpoints and longitudinal imaging without biopsy. However, most studies remain exploratory, with small samples, short follow-up, heterogeneous acquisition protocols, and limited external validation. LC-OCT should currently be considered an advanced research and treatment-monitoring tool rather than a validated surrogate for clinical benefit. Multicenter studies, standardized acquisition protocols and blinded analyses will be required before routine adoption in aesthetic trials and practice.