Is there hope for the most chaotic medical aesthetics market?

With the approval on September 1, 2025, of another hyaluronic acid product for superficial dermal facial injections to temporarily improve adult skin dryness and dullness, a total of six compliant Class III “aqua shine injections” have been approved for market launch since the beginning of 2025.

As an entry-level injectable aesthetic treatment, aqua shine injections have long topped aesthetic clinics’ repurchase lists thanks to their basic benefits, such as hydration and moisturizing, broad applicability, and affordable price. However, market irregularities have followed closely behind. Because of their wide applicability, non-Class III products and off-label injections have proliferated, making aqua shine injections arguably the most chaotic product and market in the aesthetic medicine industry.

Now, with multiple products approved specifically for “aqua shine” indications and regulatory oversight intensifying, the path toward standardization and compliance in this field is finally seeing a breakthrough.

The root cause of the chaos in the hyaluronic acid injection market lies in the long-term mismatch between consumer demand and product supply.

In 2022, the National Medical Products Administration clearly stipulated in the Announcement on the Management Category of Medical Sodium Hyaluronate Products that medical sodium hyaluronate products injected into the dermis to improve skin condition through moisturizing and hydration are managed as Class III medical devices.

This policy marks for the first time that regulatory red lines for hydrating injections have been clearly defined, leading to a reduction in the long-standing market practice of using non-third-class medical device products (including Class II and Class I devices, as well as cosmetic-number products) for injections.

However, even after the introduction of the new regulations, by 2024, no Class III aqua shine injections approved specifically for “hydration and improving skin condition” had appeared on the market. During this period, the promotion of Class III hyaluronic acid products was indeed more vigorous, but off-label use remained an issue. The injected “aqua shine injections” were often hyaluronic acid products intended as an adjunct to prevent or reduce postoperative adhesions in abdominal (or pelvic) surgery, or products designed for injections in nasolabial folds, neck wrinkles, and similar areas.

“Water-light injection” is not an official name in registration documents. However, considering the indications described by regulatory authorities, the functional claims on aesthetic service platforms and by clinics, and public perception and demand for such injections, the industry’s colloquial term “aqua shine injection” closely aligns with the six hyaluronic acid products newly approved since 2025.

According to the National Medical Products Administration, since 2025, six aqua shine injections from five companies—Bloomage Biotech, Hyamed, Lepu Medical, GrandwellMed, and Fullerene—have been approved. The approved scope for all these products is consistent: for use in medical institutions, for superficial dermal injections on the face, temporarily improving adult skin dryness and dullness.

All six products use sodium hyaluronate as the main ingredient but differ in terms of added ingredients and packaging methods: some products include lidocaine to reduce pain for consumers, others add glycine, proline, etc. (such products are also known as "bio-revitalizers" in the industry) to achieve more comprehensive functions, while some adopt vials to provide medical aesthetic institutions with more flexible injection operation options.

The first Class III products explicitly approved for “improving skin dryness and dullness” have filled a longstanding gap in the market. The industry regards 2025 as the inaugural year of compliant aqua shine injections, marking a key turning point for the standardization and regulated development of the aqua shine injection market.

As compliant products are gradually introduced, the market landscape for hydrating injections is expected to be reshaped. On the one hand, "veterans" in the hyaluronic acid industry such as Bloomage Biotech are leveraging their brand heritage and channel advantages to explore new market growth amid the trend of compliant products squeezing out non-compliant ones; on the other hand, newcomers like Lepu Medical and GrandwellMed are entering the field with differentiated products and commercialization models in an attempt to disrupt the existing landscape.

Before 2025, excluding factors related to Class III medical device qualifications and indications, the more popular hyaluronic acid injection brands in the market include: Runbaiyan and Runzhi by Bloomage Biotech, Bicuishi by Changzhou Pharmaceutical Research Institute ("Changyao Institute" for short), Taihuo by Imeik, as well as Feiluojia and Dongguo. Nowadays, multiple old brands have expedited the registration and promotion of compliant hyaluronic acid products, striving to seize the first-mover advantage in this new phase.

For example, Bloomage Biotech released the "Runzhi 4S Aesthetic Plastics Hydrodynamic Treatment System" in June 2025 after obtaining approval for its compliant new products. This system combines two major hyaluronic acid needle products with other offerings, helping medical aesthetic institutions increase customer spending and repeat purchase rates through a "basic foundation + personalized stacking" model. The company also aims to bring new growth to its medical aesthetics business through these two new products.

Once popular in the market due to its price advantage, Dongguo Hydrating Injection has also actively transformed amidst the wave of regulatory compliance. In August 2025, Dongguo launched a new hydrating product that meets the Class III medical device standards with facial indications. This product adopts an OEM/ODM branding model (NMPA approval No. 20253131475, registered by GrandwellMed). Relying on the original brand influence and market foundation, the compliant new product can quickly enter medical aesthetic institutions, reducing the costs of market education and channel development.

For several new brands in the hyaluronic acid market, the commercialization pathways are mainly divided into two categories: self-owned brands and OEM models, each with their own advantages and disadvantages. Launching an entirely new proprietary brand into the market implies starting from scratch, requiring significant investment of time and financial resources, while gradually building recognition of the product among medical aesthetic institutions and consumers.

Unlike the self-owned brand model, GrandwellMed focuses on OEM/ODM manufacturing. Public information shows that, to date, GrandwellMed's hydrogel needle registration certificate has given rise to at least nine brands, including Dongguo mentioned earlier, as well as Ouyi, Xiluoyin, and Huaxiuse, among others. These products are mostly packaged in vials with a 3ml specification to meet the flexible reconstitution needs of medical aesthetics institutions, and also align with the single-injection dosage requirements of most consumers.

The OEM model has always been controversial. Consumers are not familiar with the background of "one license, multiple brands," and when facing a dazzling array of brands, they find it difficult to distinguish between good and bad. However, at the current stage, this model also brings certain positive effects to the market: on the one hand, it can quickly increase the market supply of compliant products; even some well-known brands can use this model to achieve rapid product replacement, accelerating the phase-out of non-compliant products. On the other hand, competition among multiple brands can also force product prices down, allowing consumers to obtain compliant products at a lower cost.

Notably, the market for hydrating injections has long shown a tendency toward low-price competition, and this trend has not changed in the short term even after the launch of compliant products. According to data from internet medical aesthetics platforms such as SoYoung and Meituan, the unit price of newly listed compliant hydrating injections is mostly below 1,000 yuan, with some institutions even using them as loss leaders to further drive down prices, with the lowest costs being only a few dozen yuan.

Amid the inevitable trend of price involution, some companies have also shifted their focus to other products or regional markets. In 2025, after the approval of "Yuekesi Swan Needle," a cross-linked hyaluronic acid sodium gel with lidocaine for neck wrinkle injections by Changyao Institute, it has become the company’s key promotional product. Changyao Institute is also actively expanding into overseas markets and obtained medical device registration certificates in Indonesia and Vietnam in 2025.

Looking at the hyaluronic acid injection market, some older brands have yet to release information related to medical device Class III hyaluronic acid injections. Is this due to product strategy adjustments or a shift in market positioning? It remains unclear for now. But one thing is certain. During the critical transition period between old and new products, companies that achieve product compliance while possessing mature market channels and efficient brand promotion capabilities are expected to capture a larger market share.

Currently, multiple hyaluronic acid injection products are still in the research and development or registration application stage.

In May 2025, the Sodium Hyaluronate Injectable Composite Solution developed by JenKem Technology has been accepted for registration. This product is a hydro-light needle based on polyethylene glycol modification technology. In June 2025, the Sodium Hyaluronate Composite Solution for Injection jointly developed by ReaLi Tide Biological Technology  and Nuomei Nuoheng was also accepted for registration.

Haohai Biological enhanced hyaluronic acid injectable has completed clinical trial grouping in 2025, and the injectable sodium hyaluronate composite solution has undergone registration inspection.

From the upstream supply perspective, there will be a greater variety of compliant hyaluronic acid products available in the future. However, due to the low efficacy threshold of basic hydrating products, high consumer price sensitivity, limited profit margins, and the potential to become a major area for price competition, therefore, Hydro-light with "Hydration+" functions will become a popular trend, enhancing the product's premium pricing ability through functional stacking.

"Collagen Hydrating Glow" is one of the typical composite hydrating glow products. Currently, although there are collagen injection filler products being promoted under the positioning of "collagen water light," compliant products have not yet covered indications similar to those of water light injections, such as "improving skin dryness and dull complexion." Currently, companies such as Huaxi Biology and Bareun Medical have already laid out plans for "collagen water light" aimed at improving skin condition.

Among them, "Collagen Fiber Filler-I" developed by Bairen Medical aims to improve overall skin condition and has been registered in 2024. It is expected to become the first domestically produced Class III medical collagen hyaluronic acid injection in China. In the first half of 2025, Bloomage Biotech's Class III medical collagen hyaluronic acid product, developed using its self-developed recombinant human collagen raw material, has entered the clinical trial stage.

However, the replacement of old products with compliant ones cannot be completed in a short period. Even today, searching for hydrating injections on Internet medical aesthetics platforms still reveals the presence of non-medical device grade products. Medical aesthetic institutions may also push the boundaries, using terms or procedures such as "needle-free hydration" or "topical hydration" to circumvent risks. The large-scale penetration of compliant products is largely driven by the regulatory authorities.

Recently, CCTV once again exposed the chaos in the hyaluronic acid injection market, and the Ministry of Public Security stated that it would take strong measures to crack down on criminal activities related to the medical aesthetics field. Subsequently, a well-known plastic surgery hospital in Guangdong had its "AAAAA Medical Aesthetics Hospital" rating revoked by the Chinese Association of Plastics and Aesthetics due to the unauthorized use of a Class II medical device for hyaluronic acid injections.

This may mean that non-compliant products will be cleared out at a faster rate moving forward.

For consumers, the popularity of compliant products means enhanced security, and there will be more cost-effective compliant options in the future. For enterprises, compliance is both a challenge and an opportunity. Companies that proactively invest in R&D, possess core technologies, and have channel advantages will dominate in the new round of competition; for the industry, the compliance of hyaluronic acid injections will also serve as a reference for other medical aesthetics subfields, promoting the standardized development of the entire medical aesthetics industry.