Guide To Skin Boosters

Skin boosters are an interesting category of treatments. They are not dermal fillers and nor are they Botox. They sit in the space between topical skincare and traditional injectables. Their job is to improve skin quality from inside the dermis in order to provide hydration, elasticity, fine texture and brightening. Some skin boosters can even give a little structural support to the skin.

The category has grown fast over the last five years beyond the initial offerings of Profhilo and Restylane skin boosters. Polynucleotides (PDRN) are now one of the most asked for aesthetic treatments in the USA and Europe. Exosomes have also captured huge public interest despite a complicated UK regulatory picture. Whilst Sculptra and Radiesse have undergone rebranding from volumisers into skin regenerating treatments. Beyond synthetic injectables, treatments that use your own blood like platelet-rich plasma (PRP) continue to mature in their evidence base and popularity, particularly for hair loss. This guide profiles the main skin boosters available, best uses, safety and availability in the UK. We’ll also review alternative or supportive topical skincare treatments.

Please note, although we no longer offer in-person injectable treatments, we’ve kept this content updated as we believe the public deserve clear, evidence-led information without commercial bias.

What are Skin Boosters?

At their core, skin boosters are injectable treatments which seek to improve skin quality. They do not provide structural support to contour and restore facial volume like dermal fillers. Nor can they relax muscles to freeze dynamic lines like Botox. Most skin boosters work in the dermis to stimulate fibroblast cells to make them increase collagen and elastin. This improves skin texture, firmness, elasticity and hydration. Some also signal tissue repair through other mechanisms like increasing blood vessels. Broadly speaking, the current generation of skin boosters fall into three categories:

• Hyaluronic acid hydrators: These deliver hyaluronic acid into the dermis where it binds water and gives an immediate plumping and smoothing effect, with a smaller secondary effect on collagen and elastin. Juvéderm Volite, Restylane Skinboosters and Teosyal Redensity I are popular examples of this.
• Biostimulators: This type triggers your own skin to produce new collagen and elastin over weeks to months. Profhilo (a stabilised hyaluronic acid that bioremodels the dermis), Sculptra (poly-L-lactic acid) and Radiesse (calcium hydroxylapatite) are all established options.
• Regenerative injectables: These use signalling molecules to reduce inflammation, increase blood supply and promote skin repair. Growth factors in PRP, DNA fragments in PDRN and cell-derived vesicles in exosomes sit in this group.

As you can see, some skin boosters can fall into more than one category due to their multi-actions. What ties them all though is that, unlike traditional dermal fillers, you won’t see an instant change from any of these treatments. Results usually emerge over weeks to months as the skin regenerates. Additionally, most skin boosters need a course of two to four sessions with maintenance every six to twelve months.

Profhilo Skin Booster

Profhilo® is probably the skin booster most UK patients are familiar with in no small part thanks to an impressive marketing campaign. It is a highly concentrated injectable hyaluronic acid (32mg/ml) stabilised using a patented heat-based process (NAHYCO Hybrid Technology). This links high and low molecular weight hyaluronic acid (HA) chains without traditional cross-linkers like BDDE.

Once injected, Profhilo spreads through the dermis rather than staying at the injection point. It hydrates the skin immediately and over four weeks bioremodels the dermis layer by stimulating collagen and elastin production. The result is firmer, smoother and more elastic skin with visible improvement in crepiness and laxity. As such, Profhilo skin boosters are best for:

• Thin, crepey or dry skin with mild to moderate laxity.
• Mid and lower face sagging in the cheeks, jawline area and neck.
• Patients in their 40s and above whose main concern is skin quality rather than volume loss.

That said, Profhilo will not fill deep wrinkles, nose to mouth lines or jowls. Nor will it restore significant lost volume in the cheeks or temples. For a complete approach to tackle these, it is best to pair Profhilo with Botox and dermal fillers. It also does not replace for a daily anti-ageing skincare routine.

The standard treatment schedule is two sessions four weeks apart with maintenance every six to nine months. Particularly dry or aged skin may benefit from a third session at three months. Initial hydration is visible within five to seven days and peak collagen improvement is at six to eight weeks after the second treatment. Profhilo has a reasonable evidence base for safety and effectiveness in skin quality improvement, including biopsy studies showing increased collagen and elastin production after treatment. Side effects are generally mild (transient redness, small bruises at the injection points).

Juvéderm Volite, Teosyal Redensity I & Restylane Skinboosters

Volite®, Redensity I and Restylane skin boosters are the main alternatives to Profhilo. These products use cross-linked hyaluronic acid in microdroplet injections that spread across the treated area. The cross-linking gives a slower release of hydration and a longer duration of effect than non-stabilised HA.

The main practical difference from Profhilo is that delivery of Volite and the other skin boosters is usually through numerous small microdroplet injections rather than the five large bolus injections per side for Profhilo. Redensity I and Restylane skin boosters usually require 3 sessions 2-4 weeks apart initially vs Volite which normally requires one session. Like Profhilo, all these treatments need a maintenance every 6-12 months depending on the product. As a general rule, Volite and other similar skin boosters are best for:

• Patients in their 30s and early 40s with mild skin quality decline.
• Forehead where Profhilo is less commonly used.
• Single-session protocols (Volite only) when multiple visits within 2-6 weeks aren’t practical.

Sculptra (poly-L-lactic acid)

Sculptra® has been around since 1999 when it was originally licensed in Europe for HIV-associated facial lipoatrophy. This is the hollowing in particular around the temples and sunken cheeks occurs with certain HIV medications. However, over the last few years there’s been a successful rebranding effort to position Sculptra as a true regenerative biostimulator rather than just a volumiser. It has also become popular in the wider aesthetics community, beyond it’s original use, for anti-ageing purposes. The active ingredient in Sculptra is poly-L-lactic acid (PLLA) which is a synthetic biodegradable polymer. It comes from the same family as dissolvable surgical sutures which are used to close wounds.

The way Sculptra works is that the injection of PLLA microparticles into the deep dermis triggers a controllable inflammatory response. This then activates fibroblast cells which then lay down new collagen over weeks and months to gradually rebuild the skin’s structural framework. Studies show that Sculptra can add back measurable structural collagen and not just surface hydration. Due to this function, Sculptra is generally popular for:

• Combined structural volume loss and skin quality decline (typically late 40s and above).
• Patients wanting long-lasting collagen production (up to two years) rather than repeated short-term treatments.
• Cheeks, temples, jawline contour and increasingly the body (e.g. buttocks, knees and upper arms for skin laxity).

However, despite it’s collagen building effects, Sculptra will not give immediate results. The change in skin quality is gradual over months. Whilst it can add volume, this is not similar to dermal fillers. It is also not effective for common skin ageing concerns like hyperpigmentation, pores and texture. Crucially, unlike hyaluronic acid, you can’t dissolve PLLA. This means that you can not immediately reverse side effects like nodules. Treatment usually involves two to four sessions four weeks apart. Results develop over three to six months and last up to two years. Maintenance is also necessary every 18 to 24 months to retain results.

Radiesse (Calcium Hydroxylapatite)

Radiesse® contains calcium hydroxylapatite (CaHA) microspheres suspended in a gel carrier. It works as both an immediate modest volumiser and a biostimulator. This is because the gel gives instant filling effect whilst the CaHA microspheres trigger fibroblast activity and collagen production over months. Radiesse is also often diluted when injecting into a large area of the body. This dilution makes it behave more like a skin booster than a filler. The main uses of Radiesse are for treating:

• Skin laxity in larger areas including the neck, décolletage, arms and knees.
• Mature skin with combined volume loss and surface laxity.
• Hand rejuvenation where Radiesse has a long track record.

Even without dilution, Radiesse will not give the same instant lift or volume as hyaluronic acid dermal fillers. Like Sculptra, you also can’t dissolve calcium hydroxylapatite which means you can’t immediately reverse side effects like lumps. Most protocols use one or two sessions of Radiesse depending on indication and dilution. Results last 12 to 18 months.

Platelet-Rich Plasma (PRP)

PRP differs from the other injectable skin boosters because it uses your own blood. The way it works is that a small sample is drawn usually from the arm like with any normal blood test. This blood is then spun down in a centrifuge to concentrate the platelets and separate the plasma. This plasma is then injected back into the skin or scalp. The growth factors released by the activated platelets in the plasma stimulate fibroblasts, control inflammation, encourage blood vessel formation and speed up tissue repair. For this reason, PRP is becoming increasingly popular for:

• Hair loss and particularly early to moderate androgenetic alopecia where PRP has growing evidence.
• Under eye hollowing where many injectors tend to avoid fillers due to vascular occlusion and inflammation risk.
• Patients who prefer an autologous treatment over a synthetic or animal-derived product.

Because PRP is prepared from the patient’s own blood at the point of care, it sits outside most medicines regulation. There is no MHRA marketing authorisation involved because nothing is being manufactured and supplied as a medicine. The downside to this is that quality and platelet concentration vary enormously between systems and providers as standardisation of protocols remains weak. Most skin protocols involve three sessions four to six weeks apart with annual or biannual maintenance. For hair loss, four to six initial sessions are more typical.

Polynucleotides (PN) & Polydeoxyribonucleotides (PDRN)

Polynucleotides (PN) and polydeoxyribonucleotide (PDRN) are the fastest-growing members of the skin booster family. They are closely related and the terms are often used interchangeably, though there is a technical distinction. Polynucleotides are the broader class of long-chain DNA fragments whilst PDRN is a specific highly purified subset. Usually PDRN has lower molecular weight and is more standardised in concentration. Both PN and PDRN are derived from purified salmon or trout sperm DNA and work in the same way. Once injected into the skin, they activate the adenosine A2A receptor on fibroblasts. This then boosts collagen production which reduces inflammation and promotes skin regeneration. Both PN or PDRN injectables are popular choices for:

• Skin quality improvement without volume effects.
• Sensitive or thin skin as PDRN has anti-inflammatory properties that some other boosters lack.
• Eye area particularly fine lines and tear trough instead of dermal filler injection which carries significant risks.
• Acne scars and post-inflammatory skin as there is reasonable evidence for improvement.
• People who want an alternative or complementary treatment to Profhilo.

The evidence base is growing but still mixed for PN and PDRN. Whilst the current research data supports their skin rejuvenation benefits, most studies are small. As such, the standardisation of protocols and doses is still missing. The most widely used branded products in the UK are Rejuran®, Nucleofill® and Plinest®. These are all regulated as CE-marked medical devices rather than as medicines. Standard protocol is three sessions two to three weeks apart with maintenance every six to nine months. Results tend to emerge gradually over four to eight weeks after each session.

Exosomes

Exosomes are nanoscale vesicles released by plant and human cells. They carry signalling molecules including proteins, lipids, growth factors and nucleic acids. Exosomes have garnered huge interest in regenerative medicine because they appear to coordinate complex tissue repair signals that can help improve skin and hair health.

Despite these promising qualities, in the UK, exosomes are not authorised for use in the UK due to safety concerns. These mainly centre around the difficulty in separating exosomes from viruses and the potential risk of growth factor delivery to undiagnosed skin cancers. This means that injecting any type of exosomes for cosmetic reasons is not lawful in UK. However, plant-derived exosomes are legally sold as skincare and can be used legally in topical serums or creams. However, evidence for penetration deep into the skin and effect when applied topically is limited.

Who Skin Boosters Work Best for (& Who They Don’t)

Skin boosters work best for patients with mild to moderate skin quality decline who are realistic about what an injectable can do. They’re particularly effective for:

• Thin, crepey or dehydrated skin in the mid to lower face.
• People who have already optimised their topical skincare routine and want incremental improvement.
• Mild to moderate skin laxity in those not yet ready for surgical intervention.
• Eye skin quality where PDRN and PRP are popular.
• Combining with other treatments like Botox, dermal fillers and topical retinoids as part of a complete anti-ageing skin treatment.

Despite their possible benefits, skin boosters are not for everyone. They are less likely to give meaningful results for:

• Deep volume loss which may be better suited to dermal filler or fat grafting.
• Significant skin laxity in older patients where surgical lifting or laser may be more appropriate.
• Acne, melasma, hyperpigmentation or scars which need prescription skincare, laser therapy, microneedling or minor surgery.
• People who haven’t done the basics such as a daily skincare routine with sunscreen and getting adequate sleep, nutrition and hydration. No booster will outdo consistent skincare and healthy living.

Skin Boosters vs Skincare

This is the part most patients (and quite a few clinics) get wrong. Skin boosters and prescription topical treatments are not alternatives. They work at different layers of the skin with different mechanisms and the strongest clinical outcomes come from using them together rather than choosing between them. A booster like Profhilo or PDRN works in the dermis, signalling fibroblasts to behave like younger fibroblasts. Prescription topicals like tretinoin work at the epidermis (cell turnover, surface texture, fine lines, hyperpigmentation) and drive collagen production in the dermis. Vitamin C protects against the oxidative damage that degrades collagen. Niacinamide improves barrier function and reduces inflammation. Hydroquinone and tranexamic acid address pigmentation that injectables can’t touch.

That’s why a course of skin boosters laid on top of inadequate topical skincare gives a fraction of the benefit that the same boosters give in well-looked after skin. The fibroblasts you’re trying to stimulate work better in a healthy dermis. Similarly, the collagen they make survives longer when oxidative stress is controlled. Moreover, surface hyperpigmentation, fine lines, pores and texture almost always respond better to topical treatments. The optimal sequence for starting boosters is fairly straightforward:

• Optimise your topical skincare routine first: Retinoids like retinal or Tretinoin for cell turnover and collagen, vitamin C for antioxidant protection and daily sunscreen. Three to six months on a properly designed skincare routine can give visible skin quality improvement before you spend anything on injectables.
• Address active skin concerns next: Melasma, acne, stubborn hyperpigmentation or rosacea need treating properly first. Boosters won’t fix them and in some cases if there are side effects they can make things worse.
• Thoughtfully add in boosters: Once the surface and active disease processes are under control, choose the skin booster that can best target your specific skin concerns or goals. Remember most need a course of treatment over a set period of time and maintenance. So don’t start if you are not able to commit.
• Continue topical skincare between booster sessions: New collagen and elastin need an environment that doesn’t actively degrade them. A daily routine containing sun protection, retinoids and antioxidants will enhance and extend the length of results.

At City Skin Clinic, we are passionate about personalised skincare. We offer safe and effective custom skincare treatments using ingredients like tretinoin, hydroquinone, azelaic acid and tranexamic acid where appropriate through our online skin clinic. Our doctors treat a range of conditions such as acne, hyperpigmentation, melasma and skin ageing. To start your personalised skincare plan, book a virtual video consultation or use our online consultation form. The journey towards great skin starts here.

Please note that City Skin Clinic no longer offers in-person or injectable treatments. We are now an exclusively online skincare and hair loss clinic. However, we have kept this guide available because we believe people deserve clear, evidence based information about all of their options. For injectable treatments, please consult a GMC-registered doctor or appropriately qualified practitioner working in a clinical environment.

This article is for informational purposes and does not constitute medical advice. Treatments described should only be performed by a licensed medical doctor or appropriately qualified medical professional after a full consultation. Regulatory and licensing status of products and treatments may change. If you are considering any of the treatments discussed here, ask your practitioner about the regulatory pathway under which they are offered, the evidence base, and the specific risks for your skin and medical history.