Polynucleotides — who they're for, and who I'd send away

Polynucleotides are probably the most under-explained treatment in UK aesthetics. They have grown rapidly in the last few years — for good reason — but the marketing has often outrun the clinical conversation. Patients arrive asking for them with no clear idea of whether they're the right answer, often because they've seen them mentioned somewhere as the new alternative to filler.

Here is who I think they actually suit, and who I think should be having a different conversation.

What polynucleotides do (briefly — the longer version is on the treatment page)

Polynucleotides are fragments of purified DNA — typically extracted from a salmon source — that, when injected into the skin, signal fibroblasts to behave more like younger cells. The result is improved skin quality, increased hydration, smoother texture, and a particular benefit in delicate areas where other treatments aren't well-suited.

They are not a filler. They do not add volume. They restore the skin's regenerative behaviour.

The patients polynucleotides genuinely suit

The under-eye patient. This is where polynucleotides have had the biggest impact, in my view. The under-eye area is too delicate for filler in most cases — the skin is thin, the anatomy is unforgiving, and badly-placed under-eye filler is one of the hardest mistakes to fix. Polynucleotides work brilliantly here. They thicken and improve the skin quality without adding volume, softening dark circles caused by skin thinning, smoothing fine crepiness, and reducing the hollow appearance that thinning skin contributes to.

The post-isotretinoin patient. Patients recovering from a course of oral retinoid treatment for acne often have skin that's dry, thinned, with a compromised barrier. Polynucleotides accelerate the recovery — restoring hydration, supporting fibroblast function, and reducing the lingering dryness.

The patient who has had volume done and now needs skin quality. This is increasingly common. Patients who pursued filler-led work in their thirties arrive in their forties realising the structural shape is in place but the skin itself looks tired. Polynucleotides address that gap.

The patient with stubborn fine lines around the mouth or eyes. The perioral and periorbital areas often resist anti-wrinkle alone — the skin quality has degraded enough that muscle relaxation isn't enough. Polynucleotides restore the underlying skin behaviour.

The patient with mature skin and significant atrophy. In skin that has thinned visibly with age, polynucleotides offer a regenerative response that purely volume-based treatments can't provide.

Who I'd send to a different treatment

Patients with primary volume loss. If the cheeks have flattened, the jawline has lost definition, or the face has lost foundational structure, polynucleotides are not the answer. That's a filler conversation, possibly a HarmonyCA or biostimulator conversation, possibly a comprehensive structural plan. Polynucleotides will improve the skin quality of those areas, but they won't restore the architecture.

Patients whose primary concern is hydration alone. For straightforward hydration and improved luminosity in skin that hasn't significantly atrophied, Profhilo is usually a more efficient choice. Polynucleotides earn their place when the skin needs more than hydration — when there's a regenerative need beyond the surface.

Patients with active skin disease. Significant rosacea flare, active acne, dermatitis, eczema in the treatment area — these need to be controlled before polynucleotide work begins.

First-time clients with no homecare regimen. Polynucleotides work hardest when the skin has been prepared. Asking the injection alone to do the work that should also be happening topically is asking too much. I'd want a patient on a structured medical-grade homecare protocol for at least four to six weeks before we proceed.

The course question

Polynucleotides usually need a course — typically two or three sessions, two to four weeks apart, depending on the area and the indication. A single session produces a meaningful response; a course produces lasting change. Maintenance is usually six-monthly. The under-eye protocol is often slightly different — sometimes three sessions, two weeks apart, depending on the formulation.

Where they fit in the REGEN Method

Polynucleotides sit at the heart of the Generate pillar — alongside Profhilo, PRP, and microneedling. Each does something the others can't do as well, and the right combination for a specific patient is what produces the best long-term result. For some patients, polynucleotides come first and Profhilo follows. For others, the reverse. For others again, the two are sequenced together. That is a consultation decision.

The honest closing

If you've been told polynucleotides are the answer for everything, they aren't. If you've been told they're the same as Profhilo, they aren't. If you've been told they're a substitute for filler, they aren't. They are a specific tool for a specific kind of skin need — and when correctly indicated, they're one of the most quietly powerful treatments we offer.

Whether they're the right answer for your skin specifically depends on what your skin actually needs. That's a Reveal Consultation conversation.

— Dr Chris, Founder and Medical Director, REGEN Clinic

Want the full clinical detail and pricing? Visit the Polynucleotides treatment page.