Topical Skin Boosters in Aesthetic Practice: Pharmacokinetic Challenges, Delivery Platforms, Evidence Gaps, and Future Directions

Although the term “topical skin booster” has gained significant traction in Korean aesthetic medicine, the category remains loosely defined and often disconnected from established principles of transdermal pharmacology. To address this ambiguity, we critically reviewed the mechanistic foundations and clinical evidence surrounding these formulations, using the 500 Da permeability heuristic as an initial physicochemical screening framework rather than an absolute cutoff. We assessed key delivery platforms, including microneedling, ablative fractional lasers, radiofrequency microneedling, and cold atmospheric plasma. The available evidence indicates that macromolecular actives such as hyaluronic acid and polydeoxyribonucleotides generally face substantial barriers to passive penetration, whereas small-molecule agents have a stronger physicochemical rationale for topical use. We propose a hypothesis-generating “signal-and-support” framework for biologically plausible multi-ingredient formulation design. The field remains constrained by inconsistent, claim-specific verification of cutaneous exposure and dermal delivery, particularly for macromolecular actives. More rigorous target-compartment pharmacokinetic and target-engagement studies are needed to distinguish mechanistic plausibility from verified dermal delivery and clinical benefit.