Skin Priming

Skin priming is a relatively new, innovative concept in regenerative aesthetics that focuses on preparing the skin to optimize the effects of treatments aimed at rebuilding the extracellular matrix (ECM). The term and concept was first introduced by Elina Theodorakopoulou, Alec McCarthy, Shino Bay Aguilera, and Viviana Perico, who published on a combined treatment using calcium hydroxylapatite (CaHA) and an amino acid mesotherapy.¹ Treatments such as CaHA and Poly-L-Lactic Acid (PLLA) are known to stimulate collagen production, giving cells the cues needed to build new collagen networks. However, even with these cues, cells still require essential building blocks—such as amino acids, coenzymes, and other cofactors—to produce an abundant and robust supply of collagen. This is where skin priming comes into play.

Skin primers have been applied as a pretreatment or used concurrently with the primary procedure, such as by diluting CaHA with the primer itself. This approach helps ensure that the skin’s cells are adequately nourished, providing them with the necessary materials to fully capitalize on the regenerative signals sent by treatments like CaHA and PLLA. Think of the primer as the “fertilizer” and the regenerative treatment as the “planting the seeds”. Can plants grow without fertilizer? Definitely. Their growth can also be accelerated with and strengthened with fertilization, though.

As the field of regenerative aesthetics grows, so too does the use and body of evidence behind skin priming. To date, amino acid mesotherapies, exosomes, autologous adipose tissue, platelet rich plasma, and hyaluronic acids have been used as skin priming agents for various regenerative aesthetic treatments.^1-4 Whether applied before or during a procedure, skin priming may provide essential support that enables regenerative treatments to reach their full potential across a wide variety of patients. However, additional larger studies are needed to establish safety and efficacy of skin priming.

1. Theodorakopoulou E, McCarthy A, Perico V et al. Optimizing Skin Regenerative Response to Calcium Hydroxylapatite Microspheres Via Poly-Micronutrient Priming. J Drugs Dermatol. 2023;22:925-934.

2. Chernoff G. Combining topical dermal infused exosomes with injected calcium hydroxylapatite for enhanced tissue biostimulation. J Cosmet Dermatol 2023;22:15-27.

3. Melfa F, McCarthy A, Aguilera SB et al. Guided SEFFI and CaHA: A Retrospective Observational Study of an Innovative Protocol for Regenerative Aesthetics. J Clin Med. 2024;13:4381.

4. Khalifian S, McCarthy AD, Yoelin SG. Hyperdiluting Calcium Hydroxylapatite With Platelet-Rich Plasma and Hyaluronidase for Improving Neck Laxity and Wrinkle Severity. Cureus. 2024;16(7):e63969. doi: 10.7759/cureus.63969.