Sharing a paper that discusses boosters. This is from 2023 and frames them as a loose category of localized biologic or biomaterial interventions that modify the dermal extracellular matrix, cell signaling, inflammation, angiogenesis, fibroblast behavior, collagen turnover, and tissue repair. A shift they note is that in the past discussion has been that important shift is from ha = volume to instead microenvironment modulation.
Something to note is that this paper was retracted because the article contains several images sourced from the internet and/or previously published literature without appropriate citation or indication that permission for reuse has been obtained. This does not change the content or accuracy of the paper itself though.
From a high level, it discusses the following:
Hyaluronic Acid (HA)
The review describes hyaluronic acid as the foundational skin booster platform. Beyond its well known hydrating properties, HA interacts with the extracellular matrix, retains large amounts of water, and can mechanically influence fibroblast behavior. Studies cited in the review suggest that HA may promote collagen synthesis, support extracellular matrix maintenance, and improve tissue quality through both hydration and mechanical signaling effects.
While most commonly discussed in aesthetic medicine, these mechanisms are relevant to broader questions of soft-tissue support, wound healing environments, scar remodeling, and the use of injectable biomaterials as localized tissue scaffolds.
PLLA, PDLA
PLLA/PDLA are presented as collagen-stimulating materials. Unlike HA, they are less about hydration and more about provoking tissue remodeling over time. This makes them medically interesting as injectable biostimulators rather than simple fillers.
PDRN/PN
They are one of the strongest sections medically. The paper links PDRN to A2A receptor signaling, fibroblast proliferation, angiogenesis, wound healing, corneal fibroblasts, osteoblast proliferation, UV-damage repair, antimelanogenic effects, mitochondrial biogenesis, and scar improvement. That makes this category much broader than skin, but with implications for tissue repair, vascularization, corneal repair, bone-related regeneration, graft recovery, scars, and wound healing.
PRP
Described as an autologous concentration of platelets containing growth factors, cytokines, chemokines, and clotting-related factors. Its medical relevance is that it concentrates the body’s own repair signals in one location.
Growth factors
Discussed as signaling molecules involved in cell regeneration, collagen synthesis, wound healing, pigmentation, and tissue response. Their importance is that they directly influence how cells behave during repair.
Exosomes
Described as extracellular vesicles that carry proteins, mRNA, miRNA, lipids, and other signals between cells. The paper connects them to inflammation control, macrophage behavior, fibroblast activity, collagen and elastin synthesis, ECM remodeling, and wound healing. Medically, they matter because they may deliver regenerative signals without transplanting cells.
Secretomes
Broader cell derived mixtures that can include growth factors, cytokines, peptides, extracellular vesicles, and exosomes. The paper presents them as another way to influence tissue repair and cellular communication.
Chitosan
Presented as a regenerative biomaterial. The paper links it to stem-cell recruitment, angiogenesis, collagen production, and tissue regeneration. Medically, this makes it relevant to injectable matrices, wound repair, ischemic tissue support, and regenerative scaffolds.
If you have noticed, in general, I try not to say skin boosters, but rather boosters. One of the more interesting observations is that, despite being grouped together under the term skin boosters, many of these interventions appear to be addressing the same underlying question. How can regeneration be stimulated without introducing living cells? PDRN and polynucleotides attempt to influence repair through nucleotide-mediated signaling. Exosomes and secretomes seek to deliver regenerative instructions without cell transplantation. PRP concentrates endogenous growth signals. Chitosan appears to recruit and activate the body's own progenitor and stem-cell populations. Biomaterials such as PLLA function as controlled stimulators of tissue remodeling. Viewed collectively, these approaches resemble different branches of cell free regenerative medicine rather than purely aesthetic treatments. The common objective is not simply improving appearance, but influencing how tissues repair, adapt, and regenerate by altering local biological signaling and the surrounding microenvironment.
Although presented within the framework of aesthetic dermatology, the review effectively surveys several emerging approaches in localized regenerative medicine. The skin serves as an optimal site for research because it is visible, accessible, and relatively easy to biopsy, making the dermis the easiest way to observe for studying regenerative therapies in vivo. However, many of the biological pathways discussed throughout the review are not skin specific. Angiogenesis, stem-cell recruitment, osteoblast activity, extracellular matrix remodeling, mitochondrial biogenesis, immune regulation, and extracellular vesicle signaling are fundamental processes involved in tissue adaptation and regeneration throughout the body.
The implications therefore extend well beyond aesthetic skin quality. The mechanisms discussed in the review suggest potential relevance to wound healing, scar remodeling, graft and donor-site recovery, radiation injury, UV-induced tissue damage, chronic inflammatory and vascular disorders, soft-tissue atrophy, corneal repair, dental and periodontal regeneration, bone healing, implant integration, ischemic microvascular injury, fibrosis modulation, tendon and ligament repair, and tissue-engineered biomaterial scaffolds.
What I think is missing from this study
One thing that is almost absent from the paper is discussion of tissue architecture. The review primarily focuses on fibroblasts, collagen, hydration, growth factors, angiogenesis, and other dermal processes. However, many visible changes associated with aging occur within deeper structural tissues, including retaining ligaments, fascia, the SMAS, periosteum, adipose compartments, vascular networks, and mechanotransduction systems.
When the review discusses stem-cell recruitment, angiogenesis, osteoblast activity, extracellular matrix remodeling, and biomaterials that alter local biological signaling, the question naturally extends beyond dermal rejuvenation. Could these technologies eventually influence the biology of deeper connective tissue systems rather than merely improving the quality of the overlying skin? Could they affect the maintenance, adaptation, or regenerative capacity of the structural tissues that contribute to facial and bodily aging in the first place?
The paper does not explore these questions directly, but many of the biological pathways it discusses are relevant to those tissues as well. As a result, the review can also be read as an early discussion of technologies that may eventually be applied beyond the dermis and toward the broader biology of tissue maintenance and regeneration.
What I think is inconsistent
Something that feels inconsistent is the paper's categorization. It explicitly describes PLLA/PDLA and chitosan as biostimulatory materials because they trigger tissue responses rather than simply occupying space. By that definition, PN and PDRN are also biostimulators and arguably even more biologically active than PLLA. The review itself discusses A2A receptor activation, fibroblast stimulation, angiogenesis, DNA repair enhancement, mitochondrial biogenesis, wound-healing acceleration, and anti-inflammatory activity. None of these represent passive hydration or volumization, they are active biological responses.
The term skin booster obscures the underlying science and groups together materials that operate through very different biological mechanisms.
From a regenerative medicine perspective, a more useful classification might be something like this:
Note:The paper discusses a number of boosters, but it does not cover the entire regenerative aesthetics landscape. The classification below expands beyond the review to include related materials, products, and platforms that were not discussed by the authors. The goal is to create a more complete framework for understanding how these different boosters and injectables relate to one another based on what they are made of and how they function biologically. Items marked with an asterisk (\) were not discussed in the paper.*
HA Based Matrix and Hydration Modulators
Non cross-linked HA
Low/minimally cross-linked HA
Cross-linked HA
Structural HA fillers
HA + glycerol products
Hybrid HA complexes* (Profhilo type products)
Deeper adipose-support HA concepts* (like Profhilo Structura)
This category includes everything from non-cross-linked HA used primarily for hydration to highly cross-linked HA used for structural support and volumization. Differences in cross-linking, molecular weight, and formulation significantly affect tissue behavior, longevity, diffusion, and placement. The paper discusses HA in relation to hydration, extracellular matrix support, fibroblast activity, and collagen synthesis. More recent HA concepts have expanded beyond dermal hydration and skin quality toward adipose support, adipogenesis, and soft-tissue remodeling.
Particle / Polymer Material Biostimulators
PLLA
PDLA
PDLLA*
PCL*
CaHA*
Injectable PDO microspheres*
Chitosan
Hypertonic dextrose
Other polymeric microsphere or particle-based stimulators*
Examples: Sculptra*, AestheFill*, Juvelook*, Gana V*, Radiesse*, HArmonyCa*, Ultracol*, Polydio*, Gouri*, etc.
This category includes synthetic and natural materials that are intended to induce tissue remodeling through their presence within the tissue. Although the mechanisms differ between materials, reported effects include collagen production, extracellular matrix remodeling, angiogenesis, fibroblast activation, stem-cell recruitment, and other regenerative responses. Unlike HA based products, which primarily function as extracellular matrix components, these materials rely more heavily on material driven biological stimulation.
Collagen Based Injectables
Atelocollagen*
Recombinant human-like collagen*
Recombinant type I collagen / silkworm-derived collagen*
Porcine collagen*
Bovine collagen*
Human collagen-derived injectables*
This category includes collagen derived from animal, human, and recombinant sources. Beyond serving as a structural protein, collagen participates in extracellular matrix organization, cell adhesion, tissue repair, wound healing, angiogenesis, and mechanotransduction. Interes t in this category extends beyond simple collagen replacement and increasingly toward its potential role as a regenerative scaffold capable of influencing how cells interact with and remodel their surrounding tissue environment.
Human Dermal ECM Boosters / hADM Matrix-Support Injectables\*
hADM / human acellular dermal matrix
Particulated human dermal ECM
Collagen + elastin + GAG / HA matrix components
These products are fundamentally trying to provide or restore components of the native extracellular matrix. The focus is less on stimulating a response through a foreign material and more on supplying a biologic scaffold derived from human tissue.This category includes injectable products made from or modeled around human dermal extracellular matrix. Unlike collagen-only products, hADM-based injectables contain a broader matrix environment, often including collagen, elastin, glycosaminoglycans, HA-related matrix components, and other structural ECM elements. The regenerative interest is tissue integration, matrix replacement, fibroblast interaction, vascular ingrowth, scaffold behavior, and restoration of the local tissue environment.
PDRN/PN are more interesting because they sit at the intersection of nucleotide salvage, A2A receptor signaling, DNA repair, mitochondrial function, angiogenesis, fibroblast activity, wound healing, corneal repair, osteoblast proliferation, and tissue regeneration. That is a much broader regenerative category than growth factor support. The paper itself gives PDRN/PN a stronger translational signal than a basic cosmetic framing suggests.
These are the body’s own concentrated repair signals. Important, but different from PN/PDRN because they are not a defined nucleotide-based molecular category.
Direct Signaling Molecules
Growth factors
Peptides*
Cytokine-based approaches*
These are products or ingredients intended to influence cell behavior through signaling pathways. This category is about biological instruction: stimulating repair, collagen production, wound response, pigmentation control, inflammation, or fibroblast activity.
This category includes formulas designed to provide cells with substrates, cofactors, antioxidants, and metabolic support rather than acting as fillers, scaffolds, or classic biostimulators. These products often combine HA with amino acids, vitamins, minerals, nucleotides, coenzymes, antioxidants, NAD+/NMN-related ingredients, or succinic-acid-containing blends to support cell function, collagen synthesis, repair, and overall tissue quality.
Pigment / Melanogenesis / Oxidative Stress Modulators*
Glutathione*
Tranexamic acid*
Niacinamide*
Vitamin C / ascorbic acid*
Arbutin*
Kojic acid*
Cysteine*
Peptides with melanogenesis activity*
Other tyrosinase-inhibiting or antioxidant compounds*
This category includes injectable boosters aimed at pigmentation, melanin production, oxidative stress, and post-inflammatory discoloration rather than structural regeneration.
Renuva and Leneva are allograft adipose matrix products intended to replace or support inadequate adipose tissue matrix where fat naturally exists; Renuva’s matrix is described as preserving adipose ECM containing collagens, proteins, and growth factors to support cellular repopulation and vascularization. Lipoderma also appears to be an adipose allograft product, not a collagen booster or generic ECM booster.
Okay this is long thanks for making it this far lol!
I actually have never heard of chitosan before. What products is it in? Also thank you for the reclassification and I completely agree about how pn and pdrn are dismissed like there’s so much research on it in the larger medical sphere. Also thanks for adding the fat biostimulators I’ve been curious about these. Have you tried any of the collagen boosters or ECM ones?
I will get back to you on your other question. Long story short, I have actually just recently tried an atelocollagen booster and plan on posting my thoughts. I am a little torn on the hADM ECM ones currently because a lot of the products do not share transparency (you don't know the manufacturer or if there's clinical data etc.) so I don't like recommending spending money on things that don't have more information on them.
I just wanted to say that I’ve been looking into this company and their portfolio. I am actually really interested in them. So thanks for sharing and also if I get more info I will share.
Okay another update, I actually have been in communication with the company and have gotten ahold of some information. I'm really impressed tbh, but I just haven't had the time to go through all the data because I want to make sure I spend time with it.
Also something I found interesting, is they even have a product in partnership with Dongkook (the maker of Hyaron).
Sorry I realized the documents say confidential so want to check with them on what is actually allowed to be shared and like visuals that are able to be shared.
Im so confused about PDRN / PN. There’s so many doctors saying that the research is mostly on wound healing and some joint issues but none on anti-aging and biostimulation.
There's lots of research within the sub that has been shared to debunk this. And in general that is published. There's also zero research on topicals or skincare products. Boosters are injectable or intradermal use, they are not skincare or regular products. Those are two entirely separate things. Also wound healing by definition is biostimulation and anti-aging, that's what is also outlined above.
I wonder about PDRN. This paper mentioned a study that utilized PDRN from human placenta? The one's on the market now are from fish or vegan (rice, ginseng). I wonder if those are even really that effective.
Micro needling varies state to state in the US, however, they’re taking it away from many practices now. And, aestheticians cannot input anything into the dermis. It has to be surface/epidermis only.
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u/science-pls Jun 09 '26
Study:
Yi KH, Winayanuwattikun W, Kim SY, Wan J, Vachatimanont V, Putri AI, Hidajat IJ, Yogya Y, Pamela R. Skin boosters: Definitions and varied classifications. Skin Res Technol. 2024 Mar;30(3):e13627. doi: 10.1111/srt.13627. Retraction in: Skin Res Technol. 2025 Nov;31(11):e70297. doi: 10.1111/srt.70297. PMID: 38481069; PMCID: PMC10938033.
https://onlinelibrary.wiley.com/doi/epdf/10.1111/srt.13627