The appearance of youth and making skin biologically younger may not align. Popular aesthetic treatments like fillers, lasers, and microneedling visibly enhance the skin, but a recent review highlights a lack of substantial evidence for true biological “rejuvenation” or “regeneration.” Researchers examined 136 studies on these treatments to determine if they merely create a youthful look or genuinely renew aging tissue.
The study, available on Research Square, is yet to undergo peer review. It focused on common treatments such as fillers, lasers, platelet-rich plasma (PRP), ultrasound, microneedling, and radiofrequency, seeking evidence of changes in the skin’s underlying structure and function rather than just its appearance.
A 22-point system was utilized to evaluate if the studies explored broader modifications in the skin’s structural, functional, and cellular aspects, beyond just collagen increases.
The review exposed a significant gap in evidence. Of 34 studies assessed, 26, or 76.5 percent, were deemed to have “inadequate evidence.” These scores reflect the range of biological evidence for rejuvenation examined, not treatment effectiveness.
No study exceeded a score of 5 out of 22, with the “rejuvenation” category starting at 6 points. A study scoring 5 was conducted on cells in a lab, while the highest score for clinical studies with human participants was 4. This suggests that while treatments may have effects, the reviewed studies did not incorporate the necessary evidence to prove rejuvenation.
Much research has concentrated on collagen, a key component providing skin structure, which some treatments can boost. However, William Richard Webb, lead author and cell biologist at Innovation Aesthetics, states that increased collagen alone does not confirm skin regeneration. He likened this to making bread with only yeast as an ingredient.
While most studies focused on collagen, other potential rejuvenation indicators, such as tissue organization, altered skin function, and reversal of cellular aging changes, were less frequently investigated. Biological aging research can delve into cellular changes, gene activity, and chemical markers associated with biological age. Other studies have explored DNA changes and cellular replication abilities related to aging.
This does not imply aesthetic treatments lack benefits. Fillers can restore volume, some treatments increase collagen, and certain laser procedures enhance skin appearance and texture. However, the review questions whether such effects suffice to label a treatment “regenerative” or “rejuvenating.”
This debate isn’t new. A 2026 review argued for distinguishing regeneration in aesthetic medicine from temporary appearance changes, while another recent review noted varying evidence across treatments, calling for better-standardized research.
The review by Webb and his team also highlighted issues with some existing studies, such as small participant groups, lack of comparison groups, and reliance on subjective assessments. These shortcomings can undermine result certainty.
This distinction is crucial for consumer marketing of aesthetic treatments. “Marketing claims must mirror scientific evidence,” Webb told ScienceAlert. He emphasizes that when terms like “regeneration” or “rejuvenation” are used, consumers should understand what is proven and what is not.
Related: There Are 10 Signs of Faster Aging Hidden in Your Blood, Study Says
The new study has its limitations. The 22-point system was created by the research team and may not encompass every aspect of skin rejuvenation. Additionally, the review searched only three scientific databases, and some studies might have tracked unreported biological changes.
Ultimately, the findings draw a clear line: making skin appear younger is one thing, but proving it has become biologically younger requires far more robust evidence.
This study can be accessed as a preprint on Research Square.
This article was fact-checked by Rebecca Dyer and edited by Rebecca Dyer. While we pride ourselves on our process, we are only human. If you spot a mistake, please let us know.
