It is a skin booster made of extracellular matrix, including all types of collagen, elastin and other dermal matrix components, to directly introduce (not just stimulate) biocompatible collagen and elastin into your skin.
A different approach to improving skin quality.
ECM skin boosters are injectable treatments made from Human Acellular Dermal Matrix (hADM) containing components of the extracellular matrix, including collagen, elastin and other structural proteins naturally found in skin.
Unlike conventional skin boosters that primarily hydrate the skin, or biostimulators that rely mainly on stimulating your own collagen production, ECM treatments aim to provide a biological scaffold within the skin, supporting the environment in which fibroblasts and other skin cells function.
At Freia Medical, we offer two ECM skin booster treatments, both based on hADM technology and designed to support the skin's extracellular matrix (ECM), the structural foundation that gives our skin its strength, elasticity, and resilience.
What are ECM Skin Boosters?
There are many kinds of skin boosters available today.
Some are primarily hyaluronic acid (HA)-based treatments, designed to improve hydration. Others are collagen biostimulators such as CaHA, PLLA, PDLLA, PDO and PCL, which encourage the skin to produce more collagen over time. Polynucleotide (PN) treatments are another category, focusing on skin repair and overall skin quality.
ECM skin boosters work differently.
Both R and C are based on Human Acellular Dermal Matrix (hADM). Through processing, cellular material is removed while extracellular matrix components are retained, producing micronised ECM particles that can be introduced into the skin. Rather than simply adding moisture or volume, the aim is to provide a scaffold-like environment that interacts with the surrounding tissue and supports tissue remodelling over time.
Understanding the Extracellular Matrix (ECM)
Your skin consists not only of cells, but also of the structural environment surrounding those cells.
This extracellular matrix contains substances including:
- Collagen
- Elastin
- Fibronectin
- Laminins
- Proteoglycans
- Glycosaminoglycans (GAGs)
Think of the ECM as the scaffold of the skin. It provides structural support and influences firmness, elasticity, hydration and overall skin quality. With ageing, UV exposure and environmental stress, this scaffold gradually deteriorates. Collagen decreases, elastin becomes fragmented, and the organisation of the dermis becomes less dense.
This may contribute to:
- Fine Lines and Wrinkles
- Loss of Elasticity
- Enlarged-looking Pores
- Thinner or Crepey Skin
- Rougher Texture
- Reduced Hydration
- Dullness and Loss of Radiance
How do ECM Skin Boosters work?
Both products contain hADM designed to act as an ECM scaffold within the treated tissue. Once introduced into the appropriate skin layer, these ECM particles interact with the surrounding tissue and may support fibroblast activity, collagen deposition and tissue remodelling.
The objective is therefore not simply to “fill” the skin. Treatment is directed towards improving the structural environment and overall quality of the skin.
Depending on the individual, treatment may help improve the appearance of:
- Skin Texture
- Skin Elasticity
- Fine Lines
- Enlarged Pores
- Dull or Crepey Skin
- Overall Skin Smoothness
- Hydration and Radiance
Results vary between patients and develop progressively as the skin responds and remodels.
What's the difference between R & C?
Both brands belong to the same broad category of hADM/ECM injectable treatments. They should therefore not be thought of as treatments with completely different biological mechanisms.
The differences relate more to factors such as particle characteristics, processing, supporting evidence, clinical track record, injectability and the doctor's preferred treatment protocol.
Feature | R | C |
|---|---|---|
Technology | hADM-derived ECM | hADM-derived ECM |
Key ECM Components | Collagen, Elastin, GAGs, and other ECM components. | Collagen, Elastin, GAGs, and other ECM components. |
Particle Size | R: approx. 100µm; R-Fine: approx. 50µm | Particles of ≤75µm |
Clinical Track Record | Earlier entrant into the injectable hADM market with a longer accumulated clinical track record | Newer entrant into the ECM injectable category |
Areas We May Consider | General skin quality; R-Fine may be considered for delicate or thin-skinned areas such as the under-eye. | General skin quality, hydration and areas where smooth, even distribution is desired. |
Selection | Based on skin condition, treatment area and doctor's assessment. | Based on skin condition, treatment area and doctor's assessment. |
There are currently no direct head-to-head clinical studies demonstrating that one of these products is universally superior to the other. Our doctors therefore select the product based on the patient's skin, treatment objectives, treatment area, and the patient’s preference.
Why does particle size matter?
Particle size affects how an ECM injectable behaves during and after injection.
Smaller, more uniform particles may:
- Allow smoother passage through finer needles
- Reduce injection resistance
- Allow finer and more even distribution within the skin
- Useful in delicate or thin-skinned areas
R has a particle size of approximately 100µm, while R-Fine is approximately 50µm and was developed for areas where finer distribution may be desirable, such as the under-eye region.
C uses uniform particles of ≤75µm, allowing injection through very fine 33-34G needles and smooth distribution within the skin.
Having said that, a smaller particle size does not eliminate the possibility of lumps, nodules or vascular complications. Injection depth, concentration, bolus size, anatomy and injection technique remain important, which is why ECM skin booster treatment should be individually planned and performed by a doctor.
Which ECM Skin Booster is right for me?
There is no single ECM Skin Booster that is best for every patient.
Our doctors would consider your:
- Skin Thickness and Quality
- Acne Tendency
- Treatment Area
- Fine Lines and Crepiness
- Hydration and Radiance concerns
- Desired Degree of Structural Support
- Previous Injectable Treatment(s)
- Expected Downtime
- Response to Previous Treatment(s)
For example, R-Fine may be considered for delicate areas such as the under-eye region, where its smaller 50µm particles permit finer distribution. For patients who are new to ECM Skin Boosters, have particularly reactive skin or are concerned about downtime, the doctor may also choose a more conservative protocol, including lower concentrations, smaller aliquots or wider spacing between treatments.
Product selection is ultimately made following a doctor's consultation rather than simply according to brand.
Treatment duration, associated pain, and downtime.
This treatment takes approximately 20 to 30 minutes, excluding pre-procedure numbing.
You may experience mild discomfort during the treatment. With the use of a topical anaesthetic/numbing cream and the aid of the professional, medical-grade Zimmer cooler, the procedure is generally very well tolerated by the majority. There can be pinprick marks with slightly raised bumps at the injection sites immediately post-treatment. These resolve naturally within 1-3 days post-treatment.
What to expect?
- Doctor's Consultation
- Cleansing of the area to be treated
- Application of Numbing Cream
- Treatment procedure
- Post-procedure Recovery Cream
- Home Care Advice
FAQs
Some patients notice improvements in hydration, smoothness and radiance relatively early after treatment, within 1-2 weeks. Structural improvements from ECM-supported tissue remodelling are expected to develop more gradually over the following weeks and months.
Published studies of particulate or micronised hADM have reported improvements in parameters including skin density, elasticity, wrinkle depth, pore area, hydration and skin barrier-related measurements. The degree and duration of improvement varies between individuals.
ECM Skin Boosters maintain their clinical effects for 6 months to over a year.
A course of three treatments spaced around one month apart may be recommended initially, depending on your skin condition and treatment objectives. Maintenance treatment can subsequently be individualised according to your response.
Routine steroids or antibiotics are not necessary for every ECM Skin Booster. Post-treatment medication should be based on your doctor's assessment and the way your skin responds. If significant redness, swelling, itching, tenderness or inflammation develops, your doctor may prescribe appropriate medication where clinically indicated.
Potentially, yes. Acne-prone or sensitive skin is not automatically unsuitable for ECM Skin Boosters. Because this treatment is directed towards supporting skin quality, barrier function and the dermal environment, it may still be considered in appropriately selected patients. However, patients with active infection, significant inflammatory acne, pustules or severely reactive skin require careful assessment before treatment.
Some patients may experience temporary acne-like flare-ups following injectable treatments, and these reactions may also relate to individual skin characteristics, injection-related inflammation, disruption of the skin barrier, skincare products or combination treatments. Our doctors may therefore adjust the concentration, injection volume, treatment spacing or accompanying treatments for acne-prone or sensitive skin.
Previous treatment with one hADM/ECM Skin Booster is not, by itself, a known contraindication to having another ECM Skin Booster subsequently. However, we generally prefer to space different ECM Skin Boosters appropriately. This allows the skin to settle and enables your doctor to assess the response to each treatment independently.
Only in selected patients, ECM Skin Boosters may form part of a wider skin rejuvenation programme incorporating treatments such as lasers, radiofrequency, ultrasound-based treatments or other injectables. However, treatments may need to be appropriately spaced to reduce excessive inflammation and allow your doctor to assess your response clearly.
Your doctor will recommend the appropriate sequence based on your skin and treatment objectives.
Temporary bruising, redness, swelling or small injection bumps may occur.
Following treatment:
- Gentle cleansing can usually resume later on the same day as advised by your doctor
- Makeup can generally be applied the following day
- Avoid irritating skincare products until the skin has settled
- Avoid saunas, steam rooms, and strenuous exercises for several days, or as advised by your doctor.
- Keep the skin adequately hydrated
- Contact the clinic if you develop persistent or worsening swelling, pain, redness or nodules.
ECM Skin Boosters may not be suitable for everyone. Your doctor will assess your medical history and skin before treatment.
Treatment may need to be avoided or postponed in patients with:
- Active local inflammation or infection at the treatment area
- History of keloids and hypertrophic scars
- Connective tissue diseases
- Active immunological disease
- Pregnancy or lactation
Potential treatment reactions include soreness, redness, swelling, bruising, papules and temporary inflammatory reactions. Less commonly, persistent lumps or nodules may occur.
As with other injectable particulate treatments, vascular compromise is a rare but potentially serious complication if material enters or compresses a blood vessel. Risk is influenced by anatomy, injection plane, pressure, volume and technique. For this reason, patient selection, anatomical knowledge and appropriate injection technique are essential.