Growth Factors as a Cornerstone in Cost-Effective Regenerative Medicine

After 25 years practicing aesthetic and anti-aging medicine with a parallel career in health economics, I continue to see the immense value of regenerative interventions that are not only clinically effective but also economically sustainable. Among these, recombinant growth factors stand out.

This article explores the biologic foundations and practical applications of growth factors in clinical aesthetics—how they relate to cellular aging, how they restore intercellular communication, and why they represent a cost-effective alternative to more complex or expensive regenerative options such as stem cells or exosomes.

EPIGENETIC ORGINS OF TISSUE SPECIALIZATION AND AGING

To understand the power of growth factors, we must begin at the start of life, with epigenetic reprogramming. The first totipotent cell formed by the union of sperm and egg carries no epigenetic marks from its parents. This clean slate is crucial: during the first 9 months of life, nearly 60% to 65% of the genome becomes epigenetically marked, and these marks define the identity and function of our future tissues.

The DNA sequence is identical in all cells of the body, but their expression patterns differ due to these epigenetic modifications. This is how we develop bone cells, skin cells, and neurons from the same genetic material.

However, with age, epigenetic regulation deteriorates, and stem cell populations decline. This is accompanied by a reduction in the secretion of growth factors, which are critical for maintaining tissue structure, communication, and function. In this context, I define aging as a progressive loss in the ability to produce growth factors.

AGING, CELLULAR COMMUNICATION, AND THE ECM

Various hallmarks of aging have been identified in recent years, but one is particularly relevant to my practice: the loss of intercellular communication. Aging can be viewed as a disease driven by the loss of biological information exchange.

This communication largely occurs within the extracellular matrix (ECM). Biosignals such as hormones, neurotransmitters, exosomes, and growth factors all reside or act within the ECM. Their signaling operates through autocrine, paracrine, and intracrine pathways. Among these, the paracrine action—where signals affect neighboring cells—is especially relevant in tissue repair and regeneration.

When the ECM is disrupted, as it is during aging or disease, these signals become disorganized or diminished. This impairs tissue maintenance, protein synthesis, and cellular resilience.

WHY GROWTH FACTORS MATTER MORE THAN EVER

In practical terms, growth factors are among the most specific and targeted biosignals we can use.^1-5 They stimulate protein synthesis, promote tissue regeneration, and—unlike stem cells or exosomes—can be selected and engineered for precise tissue effects.

For instance:

• Bone marrow-derived growth factors tend to be anti-inflammatory.⁶
• Platelet-rich plasma (PRP) or fat-derived growth factors tend to be pro-inflammatory, reflecting their source’s biologic role in wound response.⁷
• Recombinant (bioengineered) growth factors offer high purity, stability, and specificity, and can be nanoencapsulated for controlled delivery.⁸

In my practice, I use a recombinant growth factor system called SkinGenuity that includes specific formulations for skin, hair, vaginal tissue, and eyelashes. Each contains 10 to 11 growth factors, including platelet-derived growth factor (PDGF), carefully selected to match the tissue’s repair needs.

PHYSICAL VS BIOLOGICAL BIOSTIMULATION

Biostimulation can be mechanical (eg, heat, lasers, microneedling, poly-L-lactic acid) or biological (eg, exosomes, stem cells, growth factors). I routinely combine microneedling with topical recombinant growth factors to synergistically stimulate dermal repair. Microneedling induces a controlled injury, triggering wound healing and vascular remodeling. When growth factors are applied afterward, the response is amplified.

Some may believe microneedling simply allows for better product absorption, but its regenerative impact is independent and enhanced when paired with appropriate biological signals.

CLINICAL EXPERIENCE AND PROTOCOL DESIGN

Over the past 5 years, I have applied this protocol to at least 20 patients each month, especially for postsurgical scarring and photoaging. Here are 3 examples:

1. Female, 32 years old, post–breast reduction scar (Figures 1 and 2)

• Volume: 1 vial (2 mL)
• Depth: 1 to 1.5 mm
• Passes: 4
• Sessions: 4
• Result: Visible flattening and texture normalization after 6 to 7 months

Figures 1 and 2. 

Figures 1 and 2. Before and after photographs of a 32-year-old patient’s post-breast reduction scarring treated with microneedling and topical recombinant growth factors. (Photos courtesy of Juan Carlos Arenas, MD)

2. Female, 55 years old, facial rejuvenation also with neurotoxin and filler (Figures 3 and 4)

• Volume: 1 vial (2 mL)
• Depth: 0.25 to 0.75 mm
• Passes: 4
• Sessions: 4
• Result: Improved dermal density, wrinkle reduction, and facial harmony

Figures 3 and 4. 

Figures 3 and 4. Before and after photographs of a 55-year-old patient’s facial rejuvenation. (Photos courtesy of Juan Carlos Arenas, MD)

3. Female, 65 years old, facial rejuvenation (Figures 5 and 6)

• Volume: 1 vial (2 mL)
• Depth: 0.25 to 0.75 mm
• Passes: 4
• Sessions: 4
• Result: Subtle, sustained rejuvenation of skin tone and firmness

Figures 5 and 6. 

Figures 5 and 6. Before and after photographs of a 65-year-old patient’s facial rejuvenation with neurotoxin, filler, microneedling, and topical recombinant growth factor. (Photos courtesy of Juan Carlos Arenas, MD)

These cases confirm the durability and reproducibility of results using recombinant growth factors as part of a cost-efficient regenerative plan.

A NEW DELIVERY PARADIGM

One of my newer strategies involves daily administration of growth factors via cream. Our cells receive signals—nutrients, water, hormones—every day, so why should growth factors be any different?

In one case, I treated a woman in her 80s with vulvar lichen sclerosus, a chronic, incurable inflammatory condition. Traditional treatments such as steroids and antihistamines had failed. I prescribed a topical growth factor cream applied 4 times daily.

Within days, the patient reported dramatic itch relief. Within 3 weeks, her skin showed visible regeneration. This outcome supports the idea that consistent, localized growth factor application may represent a breakthrough for inflammatory dermatoses.

COST-EFFECTIVENESS IN MIDDLE-INCOME HEALTH SYSTEMS

Practicing in a country with universal health coverage and constrained resources has shaped my perspective. Interventions must be not only be safe and effective but also cost-effective.

Compared with stem cells and exosomes, recombinant growth factors often are available at less than half the cost. This makes them an attractive option in both aesthetic and therapeutic applications.

Moreover, the mechanisms of action for stem cells and exosomes remain incompletely understood, while recombinant growth factors offer clearer pharmacodynamics, more consistent outcomes, and lower regulatory barriers. 

RESTORING AND RE-ESTABLISHING

In aesthetic and regenerative medicine, we are not merely treating surface features; we are restoring cellular function, re-establishing communication networks, and supporting the body’s innate repair mechanisms. Growth factors, particularly in recombinant form, offer a scientifically grounded, economically viable, and clinically effective method to stimulate tissue repair, restore intercellular signaling, and slow aging-related degeneration.

Other biologics can be useful in certain situations, but in my daily practice, growth factors often offer the best balance among precision, performance, and price. 

Editor’s note: This article is based on a presentation delivered at the 2025 Genesis: Innovations in Aesthetic Regenerative Medicine Meeting.

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