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One study estimated that just in the U.S

According to peer-reviewed literature, unlike synthetic growth hormone replacement (recombinant HGH), secretagogues work with the body's existing feedback mechanisms, which may result in more physiologically natural GH pulsing patterns

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Sources : Caballero-Garca A, Noriega-Gonzlez DC, Roche E, Drobnic F, Crdova A

And you might be interested to know that the FDA generally considers claims to treat or remove wrinkles and increase the skins production of collagen to be drug claims, which require the agencys approval

Pharmacopeia, ensuring sterility, potency, and purity equivalent to FDA-approved Ozempic