Dermatologist Debriefs
Join no-nonsense Dermatologist Stefanie Williams as she debunks myths and shares her professional insights - separating facts from fiction in just a few minutes.
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Dermatologist Debriefs
Beyond Fillers: Exploring the Regenerative World of Skin Boosters
Ever wondered about the differences between Profilo, polynucleotides, Sunekos, and other skin boosters? Dr. Stefanie Williams cuts through the confusion with expert clarity in this informative episode.
Skin boosters represent a fundamentally different approach to injectable aesthetics compared to traditional fillers. While fillers remain in place to add volume or definition to specific areas, skin boosters are designed to spread throughout the skin, delivering deep hydration and stimulating your body's natural production of collagen and elastin. The result is improved overall skin quality, elasticity, and texture—without the risk of looking "done" or overfilled.
Dr. Stefanie walks us through the science behind four major categories of skin boosters outlining the distinct advantages, injection protocols, and ideal treatment areas. Whether you're concerned about dehydration, loss of firmness, or general skin quality, understanding these differences will help you make informed decisions about your aesthetic journey.
Dermatologist debriefs. Join no-nonsense dermatologist Dr Stephanie Williams as she debunks myths and shares her professional insights, separating facts from fiction in just a few minutes.
Speaker 2:I'm speaking about skin boosters and you may have heard of skin boosters like Profilo or polynucleotides or Sunicose, and the question I'm often asked in clinic is what is the difference between those? Are they all the same? Do they have different ingredients and what do they do? So that's what I'm going to answer today, but first I wanted to mention that although skin boosters are injected into the skin, so similar to fillers, they are very, very different from fillers. So fillers we use to plump up specific wrinkles or lines or to add volume, for example, to the mid face area. We may add volume in the cheekbone area or we may use fillers to contour the the jaw line. But skin boosters, in comparison, are injected to provide deep hydration and stimulate the production of matrix molecules like collagen and elastin. So they are supposed to spread all over rather than staying where we injected them, and they are then improving the skin elasticity and firmness and texture of the skin overall. So skin boosters are about skin quality overall and they are meant to spread out rather than filling specific depressions in the skin or adding definition in very specific areas or adding definition in very specific areas. So these injectable skin boosters are typical regenerative treatments. They help our skin to function better on a biological level and via that, they make it look better as well. And, as the case with the vast majority of regenerative treatments, it's usually not a one-off treatment, like a filler or Botox, for example, but a course of typically three or four sessions, which is then repeated, maybe after six or 12 months, to maintain the benefit. So let's start with these specific products I mentioned at the beginning and let's start with Profilo and other hyaluronic acid based skin boosters. So Profilo is an injectable, as I mentioned, containing a high concentration of different molecular size hyaluronic acid molecules, but it's, of course, not a filler, although fillers also contain HA. But in fillers the HA is typically chemically cross-linked and they are, for that reason, much more resistant to breakdown and they're much more viscous. And they're much more viscous and they can lift the skin and they stay where we put them. Profilo, in contrast, is thermally cross-linked, so they don't contain a chemical cross-linker like the fillers do, but the thermal cross-linking does enable a slower breakdown of the HA, to prolong its biostimulatory effect and the benefits, but at the same time remaining very soft and liquid and not lifting the skin like fillers do. So this HA is kind of standing between the heavily cross-linked fillers and the completely unlinked native HA. That's also called linear HA because it's not cross-linked and this linear or native HA has a very short half-life of only about 24 hours.
Speaker 2:So this is present, for example, in mesotherapy, where we use it as a kind of, in a way, lubricating agent to get in other beneficial active ingredients like minerals and vitamins and growth factors and so on minerals and vitamins and growth factors and so on. But the HA itself in these mesotherapy products is usually native and is broken down very quickly. But coming back to profilers, so profilers injected with a very fine needle into the dermis where our collagen and allostin live, and this happens at five quite specific points each side of the face, notably excluding the forehead. So unfortunately we can't treat the forehead with Profilo, which is a little bit of a shame, but it can be used in lots of other skin areas, including the neck and the chest and the hands as well. Hyaluronic acid can hold up to 1000 times in its own weight in water, making Profilo and other similar HA skin boosters super hydrators, so they really attract and hold water. And Profilo is, of course, just a brand name.
Speaker 2:There are several other HA-containing skin boosters on the market, but Profilo is probably the one that's most well-known to the general public. These HA-containing skin boosters are particularly effective for treating dehydrated, tired-looking skin, providing a subtle plumping and tightening effect without the risk of overfilling or puffiness. Typically, you have two or sometimes three sessions, usually four weeks apart. You will leave the clinic with 10 little bumps on your face, five on each side, but these will fully resolve over the next 24 hours or so because, as I mentioned, a skin booster is designed to spread out evenly over the skin and, in contrast to fillers, there is no risk of those bumps staying, as could be the case if you have fillers wrongly injected. And more recently we now have a variation of Profilo, which is the new product called Profilo Structura. It's a lovely product, slightly more viscous, which is injected with a cannula just below the dermis into the fat tissue, and this happens in the lateral face. So it gives you a nice lift and some plumpness in the lateral face. And the interesting thing about the Structura is that it helps to regenerate not only the dermis but also the fat tissue, which is normally pretty much ignored, although it's very important and it plays a very important role in the aging process of our skin. So that's Profilo skin. So that's profilo.
Speaker 2:Probably the second most well-known skin booster are the polynucleotides, and there are various brands offering polynucleotides, so I'm not specifically talking about one, because there's quite a few really good ones out now. So, in contrast to HA skin boosters like Profilo, polynucleotides contain purified DNA fragments. This is usually sourced from salmon and you may remember from biology class in school that DNA fragments are called nucleotides and poly simply means many, hence the name polynucleotides. Like HA skin boosters, they deeply hydrate the skin by holding on to water molecules, resulting in a plumper skin with improved texture and skin quality. Polynucleotides also activate fibroblasts, which are our skin's collagen factories, to produce more collagen and accelerate tissue repair and regeneration. So that part is similar to HA skin boosters. However, in addition, polynucleotides also have anti-inflammatory and antioxidant properties, reducing redness, calming irritation and protecting against environmental stresses and oxidative stress. They were originally developed for tissue and cartilage repair and are now more recently used in aesthetics, and their use is rapidly expanding. They're very much on vogue right now and they can be used in the under eye area as well, in contrast to Profilo, and they're even used on the scalp to aid hair rejuvenation.
Speaker 2:Polynucleotide skin boosters are typically administered in an initial course of two to four sessions, spaced about three or four weeks apart. That brings me to Sununecos, one of my favorite skin boosters, which has a different type of ingredient and mechanism of action. So Sunecos is an injectable skin booster containing amino acids. So you may remember that amino acids are the building blocks of proteins, blocks of proteins, and Sunicose combines six very specific amino acids, the building blocks of collagen and elastin, plus some hyaluronic acid for good measure. And these amino acids signal fibroblasts to ramp up production of new collagen and elastin, while the HA provides some immediate hydration. So the specific amino acid blend in Sunicose was developed after years of research to most effectively mimic the skin's own collagen and elastin synthesis pathways. So they are quite specific and they're not just any old amino acid blend in there. And the great thing about Zunikos is that it stimulates various different types of collagen, not just the typical collagen 1 and 3, in addition to also stimulating allostin, to also stimulating allostin and not many skin boosters do that, because you need very calm physiological tissue conditions to achieve that. And of course, the risk of allergic reactions to amino acids is extremely low as you contain these naturally in your body anyway, which is an advantage over, say, the polynucleotides, which are of marine origin.
Speaker 2:Sunicose can be injected all over the face, including below the eyes and even on the forehead Hallelujah. Treatment of neck, chest and hands is, of course, also possible, and I use two different types of Sunicors in clinic, so that's the Sunicors 1200 and the Sunicors Performa, and you will receive both of these during your first session and then only the performer in the following two or possibly three sessions. Pseudocost is injected in slightly shorter intervals, so it should be injected two weeks apart and, as I mentioned, you have three or occasionally four sessions in total, and then you repeat that as a maintenance treatment after about six or twelve months. Immediately after the sunicose injections, you will very likely experience a distinct flushing of the skin, but don't worry, that's completely expected and it will resolve really quickly within half an hour or so.
Speaker 2:And last but not least, we have PLLA based skin boosters. Plla stands for poly L lactic acid, which is a compound that we used to use, more concentrated, as more of a contouring and volumizing agent. You may have heard of the product Sculptra, but the new PLLA-based skin boosters are much more diluted, are much more diluted, you could say they are hyper dilute versions of polylactic acid and their main aim is really to stimulate collagen production rather than to add volume. And while there were quite a few reports of nodules after the concentrated PLLA injections, this does not seem to be the case with the hyperdilute versions, so they seem much safer in that respect.
Speaker 2:One of the great advantages of PLLA is that they provide very long-lasting improvements in plumpness and skin quality, provide very long lasting improvements in plumpness and skin quality, so the effects can last up to potentially two years or even more, which is very interesting. And these hyperdilute PLLA skin boosters can also be injected prior to a course of focused ultrasound, like our therapy, and they work really well in combination the PLLA augmenting the collagen stimulating effects of the focused ultrasound. So, in summary, while all four treatments rejuvenate the skin and improve skin quality, their main active ingredient and mechanism of action differ Profilo contains hyaluronic acid, polynucleotides contain DNA fragments, sunicose contains amino acids, acids, and PLLA contains a polymer of lactic acid. And, of course, your aesthetic doctor can advise which one of these is most suitable for your particular skin at this particular point of time. Thank you.