The Application Prospects of Agarose as a Novel Skin Filler: A Narrative Review

ABSTRACT Background Agarose is a naturally derived polysaccharide that forms thermoreversible hydrogels with tunable rheological properties, making it a potential alternative platform to conventional dermal fillers. However, evidence regarding its physicochemical basis, preclinical performance, clinical outcomes, and the developmental status of commercially available agarose‐based filler products remains scattered across the laboratory and clinical literature. This narrative review aims to synthesize current progress in agarose‐based dermal fillers, spanning intrinsic material properties, experimental findings, and reported clinical product performance, to inform future research directions and product development. Methods A literature search was performed in PubMed and Web of Science up to 31 February 2026. Keywords included agarose, hyaluronic acid (HA), calcium hydroxyapatite (CaHA), collagen, poly‐L‐lactic acid (PLLA), dermal fillers, rheology, biodegradation, and clinical outcomes. Eligible records included in vitro, ex vivo, in vivo, and clinical studies addressing agarose‐based filler formulation, structure–property relationships, degradation and clearance characteristics, biocompatibility, safety, and aesthetic effectiveness. Relevant comparative studies involving HA, CaHA, collagen, or PLLA were also included. Evidence was narratively summarized with emphasis on consistency, limitations, and translational relevance. Results Available evidence indicates that agarose hydrogels provide tunable viscoelasticity and cohesive gel behavior through concentration‐dependent network formation, thereby supporting injectability and shape retention when appropriately formulated. Reported preclinical and limited clinical data suggest acceptable local tolerability. However, the clinical evidence base remains small and heterogeneous, with insufficient standardized correlations between rheological properties and clinical outcomes, limited head‐to‐head comparisons with established fillers, and inadequate long‐term data on biodegradation and rare delayed adverse events. Conclusions Agarose represents a promising dermal filler platform supported by controllable rheological properties and generally favorable biocompatibility in existing studies. Future research should focus on standardized material characterization, controlled comparative clinical trials, and long‐term safety evaluation to better define its indications and comparative value. Trial Registration Chinese Clinical Trial Registry ChiCTR2100046013. Sponsor: Lanzhou Biotechnique Development Co. Ltd (888 Yanchang Road, Chengguan District, Lanzhou, Gansu, China). Information provided by Zhou Jia (Applicant) and Prof. Luo Shengkang (Principal Investigator, The Second People's Hospital of Guangdong Province). Ethics approval: No. 2021‐QXLCYJ‐003‐03 (The Second People's Hospital of Guangdong Province Drug Clinical Trials Ethics Committee, approved 2021‐04‐08). Last Update Posted: 2021‐12‐13