Skin Booster Injections: What Are They, and Who Are They For?

What is a skin booster injection?

Skin booster injections are procedures in which the product is placed into the skin or just beneath it, either as many small points or spread with a thin cannula. The aim is not to add volume to a particular area but to support the overall quality of the skin: hydration, elasticity, smoothness and radiance.

“Skin booster” is not a medical definition but rather an umbrella name used in marketing. For this reason, products with different contents, mechanisms of action and levels of evidence may be sold under the same name. It is important to ask what will be injected by its contents, not by its name.

What product groups are there?

• Hydrating injections containing hyaluronic acid: these contain non-cross-linked or lightly cross-linked hyaluronic acid. Cross-linking is the chemical bonding that makes the molecule last longer in the body; because there is little of it in these products, the gel is more fluid and does not add volume. This group is the most studied of the skin booster injections.
• Biostimulators: substances that aim to stimulate the body's own collagen production. Substances such as poly-L-lactic acid or diluted calcium hydroxylapatite may be used for this purpose. Their effects come slowly, and they cannot be dissolved with hyaluronidase.
• Polynucleotides (popularly called “salmon DNA”): products obtained from fish-derived DNA fragments. There are few studies, mostly small; the evidence is limited.
• Exosomes: products said to be obtained from very small vesicles secreted by cells. The evidence for aesthetic use is very limited; products may differ greatly in contents, source and quality.
• Vitamin, amino acid and similar mixtures: this topic is covered separately in our guide ‘Mesotherapy: What Is It, What Is It Used For, and What Does the Evidence Say?’.

How does it differ from filler?

Volumising hyaluronic acid fillers are a denser gel with more cross-linking and are injected to add shape or volume to a particular point. Skin booster hyaluronic acid products, by contrast, are more fluid and are spread as a thin layer over a wide area of skin. For this reason they are not suitable for purposes such as filling the cheeks, enlarging the lips or defining the jawline.

What is it used for?

• Supporting hydration and radiance in skin that looks dry, dull and tired
• Softening the appearance of fine, superficial lines
• Improving skin texture in areas such as the face, neck, décolletage and backs of the hands
• Additional support alongside other methods for some superficial acne scars (the effect varies from person to person)

Which product group is used, in which area and for how many sessions depends on the condition of your skin. This decision is made after an examination and a physician's assessment.

Who might it be suitable for?

It may be considered for adults in good general health who are bothered by mild changes in skin quality and have realistic expectations. The change expected from these procedures is usually subtle; it is often described as “the skin looking more rested and hydrated”. It is not expected to be enough on its own for marked sagging or deep wrinkles.

Who is it not suitable for, and what should you watch out for?

• Pregnancy and breastfeeding (safety data for this period are insufficient)
• Active infection, a cold sore, a flare of acne or an open wound in the treatment area
• A history of allergy to the product's ingredients, to local anaesthetic or (for polynucleotides) to fish-derived substances
• A bleeding disorder or use of blood-thinning medication (do not stop your medication on your own; talk to your physician)
• Uncontrolled autoimmune disease or treatments that suppress the immune system
• A tendency to scar easily or to form raised scars (keloids)
• A product of unknown contents having previously been injected into the same area

Tell your physician about all the medicines, herbal products and strong skin-care products you use, and about any past aesthetic treatments.

What does the evidence say?

Systematic reviews examining the effect of injected hyaluronic acid on skin quality show that there are studies reporting improvements in measures such as hydration, elasticity and radiance. However, a significant proportion of these studies are small and short-term, and the reviews stress the need for larger, well-designed studies. In short, the evidence is promising but moderate.

A systematic review on polynucleotides states that there are few studies, of low to moderate quality, and that there is no consensus on the most appropriate way to use them. For exosome products, there is no strong clinical evidence for aesthetic use. The U.S. Food and Drug Administration (FDA) has issued a public warning because of reports of serious side effects associated with unapproved exosome products. Claims made about these products on social media are not supported by scientific data.

Who should perform it, and where?

These procedures should be carried out by a trained physician who knows skin and facial anatomy and can manage possible complications, in a licensed healthcare facility that follows hygiene rules. Because products containing hyaluronic acid also carry a risk of vascular occlusion, although rare, it is important that the necessary medicines and equipment are available where the treatment is given.

The product used must be licensed, genuine and within its expiry date. Injectable products bought online, of unknown contents or offered as “suitable for home use” can cause serious infection and tissue damage.

Preparing for the procedure

• At the consultation, discuss your expectations for your skin and your past treatments.
• Ask about the contents of the product to be used, its product group and how many sessions are planned.
• Get information about medicines and supplements that may increase the risk of bruising; do not stop your prescription medicines yourself.
• If you have a history of cold sores, tell your physician.
• Because small bumps at the injection points may last a few days, do not schedule the procedure just before an important event.
• Read the consent form without rushing.

The day of the procedure, step by step

1. The physician assesses your skin and decides the treatment areas together with you; a photographic record is usually taken.
2. The skin is cleansed and wiped with an antiseptic solution.
3. If needed, a numbing cream is applied and left for a while; some products also contain a small amount of local anaesthetic.
4. The product is injected into the skin with a fine needle as many small points or spread with a cannula.
5. During the treatment the physician watches the colour of your skin; if you feel sudden, severe or unusual pain, say so immediately.
6. At the end of the procedure the area is cleaned; you are given aftercare advice and information on how to reach the physician if there is a problem.

After the procedure: the first 24 hours and the first week

Immediately after the procedure, small bumps, redness and tenderness at the injection points are expected. These bumps mostly disappear within a few hours to a few days. Not pressing on or massaging the area, and postponing make-up for as long as the physician advises, are generally recommended.

In the first days you may be asked to avoid intense exercise, saunas, Turkish baths and strong sun. With biostimulator products, some physicians may recommend massaging the area for a certain period; because this advice varies by product, follow only your own physician's instructions.

Expected side effects

• Small bumps at the injection points
• Redness and tenderness
• Bruising
• Mild swelling
• Itching or a feeling of tightness

These symptoms usually ease within a few days. Steadily increasing pain, discolouration, discharge or fever, however, are outside the expected course.

Other possible problems

• Nodules: small lumps you can feel. These may appear weeks or months later, particularly with biostimulator products, and can be harder to treat.
• Infection: the risk increases in settings where hygiene rules are not followed or with products of unknown origin.
• Bluish appearance: hyaluronic acid placed too superficially may look bluish, especially in thin skin.
• Allergic or delayed inflammatory reactions.
• Vascular occlusion: a rare but serious risk; for details, see our guide ‘When Is It an Emergency After Filler? Vascular Occlusion and Other Warning Signs’.

When is the result seen, and how long does it last?

With hydrating injections containing hyaluronic acid, the change is usually noticed as the sessions progress and within a few weeks. With biostimulators, because the effect depends on the body producing its own collagen, it appears more slowly, over weeks to months.

How long the effect lasts depends on the product, the person's skin structure, age, sun exposure and lifestyle. The effect of no product group is permanent; most protocols plan repeat treatments at set intervals. For polynucleotide and exosome products, there are almost no reliable data on how long the effect lasts.

Realistic expectations: what can skin booster injections not do?

• They do not replace lost volume or shape facial contours.
• They do not lift marked sagging.
• On their own, they do not correct deep wrinkles caused by facial expressions.
• On their own, they do not remove pigmentation, melasma or sun damage.
• They are no substitute for sun protection, regular skin care and avoiding smoking.
• A new or “trendy” product is not necessarily more effective; it is important to ask about the level of evidence.

Alternatives

This page is for general information. The method that suits you can only be determined through an examination and a physician's assessment.