Frost & Sullivan releases the 'Blue Book on the Current Development and Future Trends of the Medical Beauty Injection Product Industry' (with full text available for download)

Hyaluronic acid (English name: Hyaluronic acid, abbreviated as HA), also known as hyaluronan, is an indispensable high molecular weight polysaccharide within living organisms. Its molecular structure is mainly composed of alternating N-acetylglucosamine and D-glucuronic acid monomers. Molecular weight is an important parameter for hyaluronic acid, and it can be classified into high molecular weight hyaluronic acid (molecular weight ≥1×10⁶Da), low molecular weight hyaluronic acid (molecular weight between 1×10⁴–1×10⁶Da between them) and oligomeric hyaluronic acid (molecular weight ≤ 1×10⁴Additionally, depending on the cross-linking state, hyaluronic acid fillers are often classified as 'monophasic' and 'biphasic'.

Collagen, also known as collagen peptide, is a vitally important biopolymer that accounts for about 30% of the total protein content in the human body and is one of the most abundant types of proteins. Collagen constructs a strong scaffold system within the human body, supporting the basic structure of connective tissues such as skin, muscles, bones, tendons, and ligaments, while also deeply participating in various biological functions such as skin renewal, organ protection, and blood coagulation. It plays a central role in maintaining overall health and physiological functions.

Approximately 29 different types of collagen have been identified. Collagens can be classified into type I, type II, and type III collagen according to the order in which they were discovered; based on their function, collagen can be divided into fibrous collagen and non-fibrous collagen; depending on their source, collagen can be divided into recombinant collagen and animal-derived collagen.

Medical aesthetics regenerative injection products typically consist mainly of biomedical polymer materials. They are usually injected into the dermis and/or subcutaneous tissue in the form of microspheres. By stimulating the body's own collagen regeneration, they play a role in reshaping tightness, beautifying the skin, and anti-aging. Common regenerative materials used in medical aesthetics injections are synthetic polymers such as polylactic acid (PLA), polycaprolactone (PCL), polyvinyl alcohol (PVA), polymethyl methacrylate (PMMA), etc.

In medical aesthetics, regenerative injection products often use materials such as PLA and PCL in the form of microspheres that are injected into the skin. These microspheres can activate the activity of fibroblasts within the skin, thereby inducing the regeneration of collagen and elastic fibers, increasing skin density, and used to fill depressions, tighten the skin, and reduce wrinkles. The accompanying formation of new blood vessels helps improve blood circulation, overall enhance skin quality, and achieve facial rejuvenation effects. In addition, this microsphere structure also possesses excellent mechanical support properties. While stimulating regeneration, it can also immediately fill skin depressions, thus achieving aesthetic improvement in skin appearance.

The particle size of biodegradable medical aesthetic regenerative injection materials directly affects their stimulation effect on collagen regeneration. Studies have indicated that if the microsphere particle size is less than 20 μm, it is easily phagocytosed by macrophages and transformed into foreign body giant cells, which then degrade rapidly, leading to a rapid reduction in volume and weakening the regenerative and filling effects. On the contrary, if the microsphere diameter is too large, it may cause excessive stimulation and trigger adverse reactions such as inflammatory hyperplasia. The ideal regenerative state is to achieve a coordinated consistency between the regeneration speed of cells and proteins and the degradation rate of implants.

With the development of technology and deepening research, it is now possible to precisely control the particle size production of microspheres, ensuring that while causing minimal inflammatory hyperplasia, they effectively promote regeneration. It should be noted that the regenerative effect of medical aesthetic regeneration injection products is different from inflammatory hyperplasia; inflammation hyperplasia mainly manifests as the proliferation of connective tissue and specific cells, forming non-specific granulation tissue, which causes uneven sizes and surfaces at the lesion site.

Before 2021, China had not approved or launched any PLA-based skin fillers on the market. In 2021, Sanbo Ma's polylactic acid product Aiveland (a physiological regeneration product) and Aimep's lactic acid-ethylene glycol product Ruyadian Shengshi were successively approved and quickly received widespread social attention. According to Frost & Sullivan's analysis, the market scale of PLA products for medical aesthetics in China based on ex-factory prices reached 110 million yuan in 2021. In January 2024, Aimep's polysaccharide product Aipufei, represented by Jiangsu Wuzhong, was also successfully approved. According to Aimep's 2023 annual report data, the sales of its gel-based injection products, mainly Ruyadian Shengshi, increased by 81.43% compared to the same period last year.

Due to trends such as increasing consumer demand for minimally invasive anti-aging treatments, technological progress, expanded indications, improved consumer awareness and education levels, and gradual industry standardization, medical beauty regenerative injection products will continue to expand into new indication areas and maintain market growth.

Clostridium botulinum secretes a potent neurotoxin called botulinum toxin in anaerobic environments, which can cause specific neurological poisoning symptoms. Based on antigenic differences, botulinum toxin can be divided into seven types: A, B, C (C1, C2), D, E, F, and G. Among them, types A, B, E, and F are toxic to humans; types C and D are mainly associated with botulinum toxin poisoning in livestock and poultry; while type G toxin corresponds to the relatively rare type G Clostridium botulinum.

Currently, botulinum toxin type A is widely used in the field of medical aesthetics. It is one of the most neurotoxic proteins that is well understood by humans and can exert significant therapeutic effects within safe limits. Botulinum toxin type A currently available on the global market is combined with natural non-toxic proteins during preparation to form dimers, which ultimately exist in the form of a molecular weight of about 900 kD.

According to data analysis by Frost & Sullivan, in 2021, the market scale of botulinum toxin products in China reached RMB 4.6 billion, achieving a compound annual growth rate of 25.6% between 2017 and 2021. Benefiting from the continuous development of the injectable medical aesthetics service market and the recent approval of new types of botulinum toxin products, it is expected that the overall market scale of botulinum toxin products in China will further expand, reaching RMB 39 billion by 2030.

There are already five botulinum toxin products on the market in China, including Botox (produced by Allergen), Dysport (produced by Ipsen), Letybo (produced by Hugel), Hengli (produced by the Chinese Lanzhou Institute of Biological Products), and XEOMIN (produced by Merz from Germany) which was newly launched in February 2024. In addition, as of April 2024, several more botulinum toxin injections are in the application stage for marketing. Once these research and development products are approved for marketing, the market share of botulinum toxin products will further increase. The market scale of botulinum toxins in China is huge and growing rapidly.

The botulinum toxin industry is developing in parallel with integration and innovation, as well as standardization and marketization. Consumer acceptance has increased, indications are gradually expanding, and the future market space is vast. Future market demand will continue to grow, product penetration rates will gradually rise, and market competition will intensify. Companies are entering the market through multiple channels; domestic R&D efforts continue to strengthen, and market share is expected to increase; market supervision has been strengthened, and awareness of compliance and safety has increased; technology continues to innovate, and diversified applications are expanding.

Extracellular vesicles (EVs) are an important means of communication between cells and have the ability to transfer various substances (including proteins, nucleic acids, metabolites, and even entire organelles) between cells. Based on their size and biogenesis, EVs can be further divided into three categories: endogenous vesicles that are released into the extracellular space through fusion with the plasma membrane, known as exosomes, with a diameter of about 50-150nm; vesicles produced by budding and separation from the plasma membrane, called microvesicles, with a diameter of about 100-1,000nm; and apoptotic bodies released by apoptotic cells, with a diameter of about 1,000-5,000nm. Exosomes carry bioactive substances such as proteins, nucleic acids, and lipids. Depending on their source, exosomes can be mainly classified into natural exosomes, engineered exosomes, and synthetic exosomes.

In the field of skin anti-aging applications, research has shown that intercellular communication and material transport mediated by exosomes play an important role in maintaining tissue homeostasis and cellular function, and can also play a significant role in the pathophysiological process of chronic inflammatory skin diseases. Currently, exosomes are mainly used in wound recovery, scar repair, and skin anti-aging.

In November 2023, the exosome beauty company ELEVAI LABS issued 1.5 million shares at a price of $4 per share, successfully raising $6 million and becoming the 'first exosome anti-aging stock'. Its successful IPO can be seen as a testament to public confidence in exosome technology. In the future, with further research into mechanisms and safety, there will be more diverse forms of products approved for use.

The future market scale of exosome medical beauty injection products will continue to expand. With improved regulation, a complete industrial chain, and the emergence of innovative technologies, the range of medical beauty treatment combinations will be further expanded, as well as the scope of clinical applicability widened.

Aimeike Technology Development Co., Ltd., established in 2004, is an innovative leading enterprise engaged in the research, development, and transformation of biomedical materials and biopharmaceutical products. The company has successfully industrialized a series of skin fillers based on sodium hyaluronate, skin fillers based on polylactic acid, and polydioxanone facial implants, and is currently developing biopharmaceuticals such as recombinant proteins and peptides. Aimeike adheres to independent research and development, and many of its technologies and products have filled gaps in the domestic market, driving the technological upgrading of the industry.

Becton Dickinson (BD) is a global healthcare technology company that leads the world in health by improving medical discovery methods, diagnostic outcomes, and nursing quality. BD cares about and supports every frontline healthcare worker, committed to helping patients improve clinical treatment and medical staff improve clinical processes through research and development of innovative technologies, services, and solutions. BD's BD Hylok® pre-filled syringe new Luer-locking adapter (LLA) fixation technology can be applied to aesthetic injection products, helping to reduce risks such as needle extrusion.

Chengnuo Regenerative Medicine Technology (Beijing) Co., Ltd., jointly founded by scientists from China and the UK, is a national high-tech enterprise recognized for its excellence in specialized fields within Beijing's special economic zone, as well as a high-tech enterprise in Zhongguancun. The company takes reprogramming technology as its core and iPSC-induced pluripotent stem cell technology as its platform, taking the lead in industrializing and clinically transforming iPSC technology in China. Relying on its accumulated stem cell technology expertise, Chengnuo Medicine focuses on the export of exosomal upstream technology and the application of exosomal-delivered miRNAs in the field of skin anti-aging.

Shanghai Haohai Biotechnology Co., Ltd. (collectively referred to as 'Haohai Bio' with its subsidiaries) is a technology innovation enterprise that applies biomedical material technology and genetic engineering technology for the research, development, production, and sales of medical devices and pharmaceuticals. The company is committed to providing innovative medical products to the market through technological innovation and transformation, integration of domestic and international resources, and large-scale production, gradually achieving import substitution of related pharmaceutical products and becoming a leading enterprise in the field of biomedical materials. As of 2023, Haohai Bio has completed industry restructuring of biomedical materials represented by intraocular lenses, myopia prevention and control and refractive correction, ocular surface medications, medical sodium hyaluronate/sodium hyaluronate sulfate, and medical chitosan, and has industrialized the use of human epidermal growth factor (a new drug of Class I in China) as an innovative gene engineering drug, thereby achieving industry-leading advantages in four main business areas: ophthalmology, plastic surgery and wound care, orthopedics, and anti-adhesion and hemostasis.

Shandong Focus FuRuida Biotechnology Co., Ltd. (hereinafter referred to as Focus FuRuida), affiliated with Shandong Merchants FuRuida Pharmaceutical Co., Ltd., is an internationally renowned enterprise integrating R&D, production, and sales of sodium hyaluronate. FuRuida is the creator and leader in China's hyaluronic acid industry.

Jiangsu Wu Traditional Chinese Medicine Development Co., Ltd. was established in 1994, originally as a school-run enterprise of the general education system. It went public on the Shanghai Stock Exchange in 1999 and is hailed as "China's first general education stock," making it the first listed company in Wu County (now Wuzhong District) and the sixth in Suzhou City. Since its establishment, the company has continuously standardized and improved its governance structure, optimizing its main business through acquisitions and mergers as well as project investments. Currently, it is involved in multiple industries including medicine, medical aesthetics, and investment.

Jiangsu Jiangshan Juyuan Biotechnology Co., Ltd. is a high-tech enterprise focusing on the industrial design and application of bionic recombinant functional proteins. For 20 years, it has been dedicated to the research and development of recombinant collagen technology as well as the development and production of downstream products. At present, it has achieved a full industrial chain service system based on recombinant functional proteins, including gene design, strain construction, industrial design, ton-scale capacity expansion, downstream application research and development, safety and efficacy testing of downstream products. Juyuan Biotechnology is the first company to achieve large-scale fermentation production of recombinant type III collagen using Pichia pastoris and has become one of the world's largest recombinant collagen producers with an annual output of 20 tons of high-purity solid material.

Juzibio was established in 2000 and is a high-tech enterprise based on scientific and technological aesthetics. It is a pioneer and leader in China's professional skin care industry based on bioactive ingredients. Focusing on three major industrial directions: efficacy skincare products, medical devices, functional foods, and formula foods for special medical purposes. Juzibio takes its proprietary synthetic biology technology as the core to design and develop recombinant collagen, rare ginsenosides, and other bioactive ingredients. As of the end of 2023, it has 93 patents and patent applications. The company's recombinant collagen technology has received the first patent authorization in the industry in China and has won the National Technological Invention Award and the China Patent Gold Award in 2013 and 2016 respectively. Based on the synthetic biology technology platform, Juzibio has built a diverse and continuously expanding product portfolio for consumers in different application scenarios.

Meibai Biotech was established in July 2020. The company is centered around breakthrough ex vivo human cell expression technology and is committed to developing and producing groundbreaking medical products, currently having broken through 9 patent technologies. Meibai Biotech's headquarters are located in Beijing, with a production factory situated in Changsha covering an area of 2,200 square meters. Meibai Biotech has achieved large-scale production of human ECM extracellular matrix for the first time, creating the world's largest human ECM R&D and industrial base. It also possesses vaccine-level production processes and biopharmaceutical quality control standards.