Demystifying Biostimulators
Dr. Jessica Halliley is an expert Aesthetic Doctor and Founder of Your Beauty Doctor, experienced NHS GP and one of the UK’s most respected voices in regenerative aesthetic medicine. She has a dual background in medical aesthetics and women’s health, and is a Key Opinion Leader and trainer for globally respected brands including Galderma, Sunekos and Ameela.
For many years, the world of aesthetics was dominated by HA dermal filler and botulinum toxin. While these procedures remain hugely popular, the demand for regenerative treatments continues to grow exponentially- with a wide range of biostimulators now on the market. Unlike traditional injectables, which focus on replacing volume or temporarily relaxing muscles, these tweakments encourage the body to heal, repair, and rejuvenate itself from within.
There are so many biostimulators now available, that both practitioners and patients alike can feel overwhelmed with where to start. So what exactly are they? How do they work, and why are they becoming such a hot topic in clinics worldwide?
What Are Biostimulators?
At their core, biostimulators are injectable (or sometimes topical) treatments designed to stimulate the body’s natural regenerative processes. Instead of simply masking signs of ageing, they work at a cellular level to:
Trigger autologous synthesis of collagen and elastin
Improve hydration and skin texture
Repair damage caused by oxidative stress, pollution, and UV light
Promote healthier, more resilient skin long-term
Patients love the natural-looking and progressive results, and practitioners are enjoying having a plethora of adjuncts to their traditional injectable portfolio.
So, let’s explore each of the main biostimulators currently taking the market by storm.
Polynucleotides
One of the most talked-about treatments in this field is polynucleotides, growing in popularity due to their powerful regenerative properties and potential to regulate gene expression. They are naturally occurring biopolymers from DNA and RNA, derived from salmon or trout spermatozoa.
How they work:
Polynucleotides act like a ‘rescue signal’ for tired or damaged skin cells. They stimulate fibroblasts—the cells responsible for producing collagen and elastin—while also exerting anti-inflammatory and antioxidant effects. Their hydrophilic nature also enhances hydration.
Clinical benefits:
Revitalises dull, tired skin
Reduces fine lines and wrinkles
Improves under-eye hollows and crepey texture (where fillers can sometimes look unnatural)
Helps skin recover after procedures like lasers, microneedling, or chemical peels
Treatment journey:
Polynucleotide treatments usually involve a course of 3 sessions spaced 2-4 weeks apart. The effects are gradual but long-lasting, with many patients noticing a healthier glow after the first session and continued improvements over several months. Generally a single maintenance is required 6 months after the initial block.
Exosomes
If polynucleotides are the foundation of regenerative injectables, exosomes are perhaps the most futuristic. Derived from stem cells, exosomes are tiny vesicles (imagine them as microscopic parcels) packed with growth factors, peptides, and genetic material. Their job is to deliver messages between cells, telling them how to behave, repair, and regenerate.
In Aesthetic Medicine, they are applied topically- usually post procedure. Their origin has remained a controversial topic. The use of exosomes derived from human mesenchymal stem cells is banned in the UK, so the market leaders here are plant and animal derived.
Exosomes represent the next step in skin regeneration. They not only stimulate collagen and elastin but also modulate inflammation, promote angiogenesis (new blood vessel formation), accelerate tissue remodelling and inhibit scar formation. This makes them particularly powerful in:
Skin rejuvenation (improving tone, texture, and luminosity)
Post-procedure recovery (shortening downtime after lasers or microneedling)
Managing pigmentation and redness
Hair restoration applications
Though still relatively new, the research around exosomes is growing rapidly, and many clinicians see them as a game-changer in regenerative medicine. However, there is still a lack of robust long-term safety data currently regarding their repeated use.
Calcium Hydroxylapatite (CaHA)
CaHA is a long-established dermal filler that also acts as a biostimulator. As well as providing immediate volume, it stimulates collagen production. Consisting of hydroxylapatite microspheres suspended in a carboxymethyl cellulose gel, it is commonly used to restore lost facial volume and improve wrinkles/folds. The carrier gel provides the immediate volume, then gradually gets absorbed, leaving the CaHA microspheres in place. These act as a biostimulatory scaffold, giving surrounding fibroblasts a framework to grow around. Over time, the CaHA microspheres are naturally broken down and metabolised by the body.
Its rejuvenating effects occur through several mechanisms, including stimulating cell growth, encouraging new collagen production, supporting angiogenesis and promoting the development of elastin and elastic fibres. It is able to trigger soft tissue regeneration with minimal adaptive immune cell recruitment.
CaHA can be prepared in different ways and is being increasingly combined with other regenerative treatments by practitioners, e.g. PRP or exosomes. However, it is worth noting these more innovative approaches are off-license, and more research is required to substantiate the efficacy of these novel combinations.
Poly-L-lactic acid (PLLA)
Poly-L-lactic acid is another injectable biostimulator known for gradual rejuvenation and collagen induction. The PLLA microparticles are encapsulated by macrophages generated by a localised immune response. Adipocyte progenitors transform into mature adipocytes, replenishing skin thickness. Macrophages shift into the regenerative phenotype without clinical inflammation, up regulating regenerative cytokines, and down regulating inflammatory cytokines. Senescent fibroblasts are woken back up- triggering type 1 collagen and elastin production, remodelling the extracellular matrix.
Why Biostimulators Are So Popular Now
The rise in demand for biostimulators reflects a shift in patient preferences. More than ever, we are seeking treatments that:
Look natural: Subtle, healthy improvements rather than drastic changes
Are preventative: Supporting skin health before ageing becomes advanced
Promote long-term skin quality: Not just a quick fix, but investing in future skin health and trusting the process.
Align with wellness trends: Patients see beauty and health as interconnected, and regenerative treatments fit neatly into this philosophy
In essence, today’s aesthetic patients don’t want to look different—they want to look like the best, healthiest version of themselves.
These treatments are highly customisable. From under-eye revitalisation with polynucleotides to full-face glow with exosomes, they can be tailored to each individual’s skin concerns and goals.
Biostimulators represent one of the most exciting innovations in modern aesthetics. They embody a more natural, regenerative, and long-term approach—a shift that mirrors broader trends in health, wellness, and beauty.
The message is clear: the future of aesthetics isn’t about transformation. It’s about regeneration.
