Aesthetic Treatments May Make Skin Look Younger, But Not Biologically Younger

Looking younger is not necessarily the same as making ageing skin biologically younger.

Fillers, lasers, microneedling and other widely used aesthetic treatments can produce visible improvements in the skin. Yet a new review indicates there is remarkably little evidence that such effects constitute biological "rejuvenation" or "regeneration".

What the review examined in aesthetic treatments

Researchers assessed 136 publications covering popular aesthetic treatments, asking a straightforward question: do these procedures merely make skin appear younger, or do they truly renew ageing tissue?

The study, published on Research Square, has not yet undergone peer review.

The publications examined commonly used interventions, including fillers, lasers, platelet-rich plasma (PRP), ultrasound, microneedling and radiofrequency.

Instead of considering only whether skin appeared improved after treatment, the team searched for evidence of changes to its underlying structure and function.

They applied a 22-point framework that was intended to go beyond collagen increases, evaluating whether studies explored wider changes to the structure, function and cells of ageing skin.

The findings exposed a sizeable gap in the evidence.

Of the 34 primary studies that could be scored, 26 – or 76.5 percent – were placed in the category the researchers termed "inadequate evidence".

Crucially, these scores do not assess a treatment's effectiveness. Rather, they represent how many distinct forms of biological evidence for rejuvenation were examined.

No study achieved more than 5 out of 22. In the researchers' framework, 6 points is the threshold for the lowest category they label "rejuvenation".

The study awarded 5 points was carried out on cells in a laboratory, rather than on people. The highest score among clinical studies involving people was 4.

The researchers say this does not mean aesthetic treatments have no effects. Instead, it indicates that the studies reviewed did not assemble the breadth of biological evidence their framework demands to establish rejuvenation.

Why collagen alone cannot demonstrate skin regeneration

Much of the available research centred on one well-known substance: collagen.

Collagen gives skin strength and structure, and certain aesthetic treatments may stimulate its production. However, lead author and cell biologist William Richard Webb, of Innovation Aesthetics, says that increased collagen by itself is not proof that skin has regenerated.

"Claiming one part is conclusive without assessing all components is like trying to make bread, and the only ingredient you have is yeast," Webb told ScienceAlert.

The team found that most studies focused on collagen, while investigating other possible markers of biological rejuvenation much less frequently. These markers included the organisation of newly formed tissue, whether skin function changed and whether cellular alterations linked with ageing were reversed.

Scientists researching biological ageing can assess more than appearance, examining changes within cells. Earlier work involving human skin cells, for instance, has looked at shifts in gene activity and chemical markers linked to biological age.

Other skin-ageing research has examined age-related DNA changes and cells' capacity to multiply.

The seven biological domains used by the researchers to assess claims of true tissue regeneration and rejuvenation. (Webb et al., Research Square, 2026)

This does not mean aesthetic treatments offer no benefits. Fillers may restore volume, some procedures can boost collagen, and certain laser treatments can enhance the skin's appearance and texture.

The issue raised by the review is whether those outcomes are sufficient to describe a treatment as "regenerative" or biologically "rejuvenating."

This discussion predates the new study.

A 2026 review maintained that regeneration in aesthetic medicine should be separated from temporary visual changes, whereas another recent review found that evidence differs across treatments and that more robust standardised research is required.

Evidence and marketing claims for aesthetic treatments

Webb and his colleagues' review also highlighted shortcomings in the way some existing studies were performed.

Many used small participant groups, some did not include comparison groups, and others depended on subjective evaluations instead of objective measurements. Such constraints can reduce certainty in the findings.

The distinction is also important when aesthetic treatments are promoted to consumers.

"Marketing claims must mirror scientific evidence," Webb told ScienceAlert.

He says that if terms such as "regeneration" or "rejuvenation" are used, people should be able to see clearly what a treatment has genuinely been demonstrated to achieve – and what has yet to be proven.

Related: There Are 10 Signs of Faster Ageing Hidden in Your Blood, Study Says

The new study itself has limitations.

The research team created the 22-point system, and it may not encompass every component of skin rejuvenation.

The review also searched only three scientific databases, while some studies may have measured biological changes without reporting them.

For the moment, the findings underscore a simple distinction: proving that a treatment can make skin look younger is one thing.

Showing that ageing skin has genuinely become biologically younger requires a far higher standard of evidence.

This study is available as a preprint on Research Square.

This article was fact-checked by Rebecca Dyer and edited by Rebecca Dyer. While we take pride in our process, we are only human. If you spot an error, please let us know.