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Evaluating the Effects of Injected Calcium Hydroxylapatite on Changes in Human Skin Elastin and Proteoglycan Formation

González, Noelani, MD*; Goldberg, David J., MD, JD*,†

doi: 10.1097/DSS.0000000000001809
Original Article

BACKGROUND Previous studies have shown that calcium hydroxylapatite (CaHa) injected intradermally resulted in new collagen production at 6 months after injection, and a possible increase in elastin formation. In addition, a recent study showed the formation of new collagen, elastin, and angiogenesis after injection at 4 and 9 months.

OBJECTIVE To evaluate any changes in the presence of elastic fibers, proteoglycans, and elastin in photodamaged skin after injections with CaHa.

METHODS AND MATERIALS: Fifteen subjects underwent a punch biopsy of the right infra-auricular areas before and after injection of CaHa on day 180. Specimens were stained for elastic fibers, elastin, and proteoglycan presence.

RESULTS Quantitative analysis demonstrated a percent change in elastic fibers varying between 29% and 179% at 6 months in comparison with baseline. Subjects showed an increase in elastin between 12% and 66%. Subjects had positive mean percentage change in proteoglycans of 76.27% (t-test of 0.198).

CONCLUSION This is the first study to show that CaHa can increase proteoglycans and echoed previous studies showing it can also have an effect on elastin, which indicates it can induce remodeling of all aspects of the extracellular matrix. Much larger and longer studies are required to confirm its unique impact on collagen, elastin, and proteoglycans.

*Skin Laser and Surgery Specialists of NY and NJ, New York, NY;

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY

Address correspondence and reprint requests to: David J. Goldberg, MD, JD, Skin Laser and Surgery Specialists of NY and NJ, 20 Prospect Avenue, Hackensack, NJ 07601, or e-mail:

D.J. Goldberg received a research grant from Merz for this study.

The authors have indicated no significant interest with commercial supporters.

© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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