The pursuit of healthy, youthful-looking skin has long centred on hydration. Serums, skin boosters and facial masks are designed to replenish moisture, helping skin appear smoother and plumper. But hydration is only one part of the picture.Beneath the skin’s surface lies the extracellular matrix (ECM), a gel-like 3D network of collagen, elastin and other biomolecules that surrounds and supports skin cells. As we age, this structural framework gradually deteriorates.“The ECM can be thought of as the skin’s natural support system,” said Dr Lam Bee Lan, medical director of Ageless Medical. “In younger skin, the ECM is dense, organised and continuously renewed. With ageing, and through cumulative exposure to ultraviolet radiation, pollution, smoking and other stresses, collagen becomes fragmented and reduced, elastic fibres become disorganised, and the skin’s water-binding and repair mechanisms become less efficient. The communication between skin cells and their surrounding matrix is also impaired.” The result, she noted, is thinner, drier and less resilient skin, with increasing laxity, wrinkles and slower recovery from injury.FROM REGENERATIVE MEDICINE TO AESTHETIC TREATMENTSECM-based biomaterials were first used in reconstructive surgery and wound management as biological scaffolds to support the body’s healing and tissue remodelling processes. Their application in aesthetic treatments is based on the principle that cells do not function in isolation but constantly interact with their surrounding matrix. “The ECM’s structure, composition and mechanical properties can influence how cells attach, migrate, communicate and participate in tissue repair,” said Dr Lam.A newer generation of skin boosters is applying regenerative medicine principles to target the ECM. One example is CellREDM, developed in South Korea. It is designed to deliver collagen, elastin, glycosaminoglycans (GAGs) and laminin into the dermis, the skin’s thick middle layer, with the aim of supporting the skin’s structural environment.CellREDM uses human acellular dermal matrix technology. Donated human dermal tissue undergoes medical-grade processing to remove living cells and cellular material while preserving collagen, elastin, GAGs and laminin, which are formulated into injectable microparticles. The tissue also undergoes stringent donor screening, processing and sterilisation to ensure safety and biocompatibility and to reduce the risk of immune reactions. MULTIPLE INGREDIENTS, MULTIPLE BENEFITSMost conventional skin boosters rely on hyaluronic acid and are used mainly to improve hydration. ECM-based boosters are built around a different biological concept: They contain multiple components that are naturally found in healthy skin.Each component plays a distinct role. Collagen provides much of the dermis’ structural support and tensile strength. Elastin helps skin stretch and return to its original shape. GAGs help regulate hydration, tissue cushioning and the organisation of the ECM itself. Hyaluronic acid is one member of the GAG family. Laminin sits at the junction between the epidermis and dermis, supporting cell attachment, tissue organisation, and communication between cells and the surrounding matrix. “Healthy skin is not made from one component. It is a highly organised biological system where different matrix molecules work together,” said Dr Lam. “A multi-component injectable like CellREDM may resemble the complexity of native tissue more closely than an isolated ingredient.”