Skin regeneration-related mechanisms of Calcium Hydroxylapatite (CaHA): a systematic review

Mojgan Amiri; Renald Meçani; Christa D Niehot; Terri Phillips; Janina Kolb; Hua Daughtry; Taulant Muka

doi:10.3389/fmed.2023.1195934

Skin regeneration-related mechanisms of Calcium Hydroxylapatite (CaHA): a systematic review

Front Med (Lausanne). 2023 Jun 2:10:1195934. doi: 10.3389/fmed.2023.1195934. eCollection 2023.

Authors

Mojgan Amiri^{1

2}, Renald Meçani³, Christa D Niehot⁴, Terri Phillips⁵, Janina Kolb⁶, Hua Daughtry⁵, Taulant Muka^{2

7}

Affiliations

¹ Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands.
² Epistudia, Bern, Switzerland.
³ Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
⁴ Literature Searches Support, Dordrecht, Netherlands.
⁵ Merz North America, Inc., Raleigh, NC, United States.
⁶ Merz Aesthetics GmbH, Frankfurt, Germany.
⁷ Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.

Abstract

Introduction: Calcium Hydroxylapatite (CaHA) is a common dermal filler used in aesthetic medicine for volumizing and contouring. Understanding mechanisms of actions of CaHA can help improve our understanding of its clinical applications.

Methods: We performed a systematic review to summarize the skin-regeneration related mechanisms of CaHA. Five bibliographic databases were searched for English-language publications that evaluated CaHA in skin regeneration outcomes including neocollagenesis, cell proliferation and growth factors, angiogenesis, vascular dynamic and inflammatory markers, among others. Methodological rigor of included studies was assessed.

Results: Of 2,935 identified citations, 12 studies were included for final analysis. Collagen production was reported by nine studies, cell proliferation by four, elastic fibers and/or elastin by four, and three studies on angiogenesis, while limited studies were available on the other outcomes. Six were clinical/observational studies. Only seven studies had a control group. Overall, studies showed CaHA resulted in increased cell proliferation, increased collagen production and angiogenesis, as well as in higher elastic fiber and elastin formation. Limited and inconclusive evidence was available on the other mechanisms. The majority of the studies had methodological limitations.

Discussion: Current evidence is limited but indicates several mechanisms through which CaHA could lead to skin regeneration, volume enhancement, and contouring.

Systematic review registration: https://doi.org/10.17605/OSF.IO/WY49V.

Keywords: Calcium Hydroxylapatite (CaHA); angiogeneisis; elastic fiber; mechanism; skin regeneration.

Publication types

Systematic Review

Grants and funding

The authors declare that this study received funding from Merz North America, Inc. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication.