Injectable skin boosters: which is the best for your clinic?

Aesthetic medicine is one of the most captivating specialties to work in, because not only are the majority of our patients healthy, but their conditions are often treatable without invasive medication or surgery.

I’ve been lucky enough to be involved in this amazing specialty for more than 12 years, during which time there have been many developments. My practice has evolved from the early days when I started out as an injector to providing my patients with a complete journey; looking after their skin, face, body and mind. We should be educating clients that we do not just treat lines and wrinkles, but are able to recondition skin, prevent damage and reverse photo-ageing to slow the ageing process across all skin and subdermal layers.

It has become part of my normal practice to hydrate skin. This can be achieved slowly with topical agents and collagen nutrient drinks like Skinade, or more rapidly using injectable hydrators. There are a huge array of injectable hydrating products available, ranging from very light dermal fillers to skin boosters and bio-remodellers. Over the years, these products have been developed, with some ranges adapting products to treat a wide portfolio of our patients’ concerns.

So, what are the benefits of the different skin boosters and hydrators available, how can we use these to improve skin quality and where else can they be used?

Dermal fillers

First on the market were the hydrating filler products; the lightest available, like Teosyal Redensity I, Belotero Soft, and Restylane Vital; and newer hydrating fillers like Teoxane RHA 1 and Viscoderm Hydrobooster from IBSA. With low-BDDE cross-linking and low cohesive rheology, these products do not hold form in the skin, therefore they do not lift or contour and remain in the horizontal plane.

These producrs are injected in superficial micro boluses spread equally across the treatment area, delivering hydration into the skin for an overall improvement in skin quality. These products are still used in many clinics and courses of treatment offer great results. All the premium dermal filler brands have a hydrating filler within their ranges.

Hydrating dermal fillers tend to last longer in the skin due to their BDDE; although minimal, it still helps these non-cohesive fillers last a bit longer than other skin boosting products.

Mesotherapy products

In recent years we have started to see more injectable mesotherapy products coming on the market. Some are used with micro-needling, plasma shower or micro bolus injections, as per hydrating fillers. The interesting thing about these ranges is the combinations of ingredients within the products; they are no longer just hyaluronic acid-based. One of the most comprehensive ranges with 14 products covering hydration through to the eye area, cellulite, hair and skin tightening is RRS by Aesthetic Derma.

Each has a specific amino acid or skin-whitening ingredient, while Silisorg contains DMAE for skin tightening. Using combinations is also possible, mixing a bespoke set of products for a tailormade personal treatment. These injectables are offered in courses of six or more sessions depending on the concern to be treated and the products used. There are also handy add-ons for the eye area which help upsell the treatment, as well as skincare to complement the treatment plan. RRS is distributed by Aesthetic Source and the company offers an excellent training day and ongoing support.

Mesotherapy products are delivered in courses of weekly or biweekly sessions for the best results. Treatment results are normally assessed after the course has been completed, with extra sessions optional to take the skin to the next level, reaching or surpassing the patient’s expectations.

Profhilo hydration and laxity treatment

Profhilo is an ultra-pure, high-dose hyaluronic acid bioremodeller that is injected into the skin, acting as a hyaluronic acid moisturising treatment.

Profhilo’s hydrating effect works as it stimulates collagen and elastin, attracting water into the dermis. Made with a patented technology called NAHYCOO, the result is a gel with prolonged stimulating activity on the dermal cells. The product also works to stimulate cell receptors to counteract skin laxity and restore firmness to the skin. With 32mg/ml HA and 64mg per treatment, Profhilo also contains one of the highest concentrations of HA on the market. Profhilo is made by IBSA Italia and distributed in the UK by HA-Derma. The main aesthetic pharmacies can also arrange training for you.

Most Profhilo skin treatments are delivered in a course of two sessions spaced three to six weeks apart to allow for maximum skin hydration and synergistic collagen stimulation. Further treatment may be advised for skin with more advanced sagging, photodamage and ageing. Short courses are ideal – more time effective and spread further apart from meso sessions. The results focus on tightening as well as hydration.

Where can skin-booster products be used?

Each product will come with preferred treatment indications and techniques, so it is always best to attend product training before starting to use new products on your patients. Your insurance will need proof of product training, too.

Skin boosters can be used to treat many different skin areas. The most common is the face, followed by the neck, décolletage and dorsum of the hands. However, they can also be used on difficult to treat areas, like tightening the skin under the chin (RRS), the upper inner arms, inner thighs, knees and abdomen. They are safe for all skin types, ages and genders.

Combination treatments

Hydrating dermal fillers can be used in combination with Profhilo, treatment-specific RRS or other mesotherapy products. The advantage of a combination protocol is that each product contributes its best attributes, resulting in premium treatment to suit the individual patient’s needs. For example, dermal filler has longevity, Profhilo has immediate hydration and skin tightening; while RRS can deliver much needed amino-acid complex DMAE, and its biorevitalisation is medium.

What's the future of skin boosters?

There is a very positive atmosphere within aesthetic clinics this year; we may currently be closed to patients but we have not stopped working for them.

When we reopen our doors and welcome our patients back once more, we will benefit from the support our distributors, training companies, conference organisers, and product representatives have been putting together for us. We’ll be armed with new knowledge to share with our patients and a few new techniques, too.

Product development never stops, and I predict we will see further advances in hydrating skin boosters to contain growth factors and stem-cell technology. The potential for results with growth factor injectables should be fantastic, enabling us to take PRP treatments to another level.

 Dr Anna Hemming is the founder of Thames Skin Clinic and The Cosmetic Skin Doctor. She has 22 years’ medical experience with surgical, anaesthetic, gynaecology and emergency department training. For the past 12 years she has immersed herself in aesthetic and regenerative medicine. A highly skilled injector, she treats a wide variety of photo-ageing concerns and skin problems, focused on subtle, natural rejuvenation to reveal younger, healthier and more beautiful skin.