Move over Profhilo, there’s a hot new skin booster in town. So what are polynucleotides, should you have them - and what's the deal with the salmon sperm?

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Polynucleotides may sound like a bit of a mouthful, but that hasn’t stopped them being the most talked about tweakment right now, embraced at record speed by pretty much every aesthetic doctor we know (and us!) And the fact that the procedure involves injecting salmon sperm into the face is, not surprisingly, grabbing headlines.

This week London aesthetician Dr David Jack spoke about the benefits of polynucleotides on Instagram, in response to an episode of The Newlyweds, the podcast fronted by Made In Chelsea stars Jamie Laing and his wife Sophie Habboo. The latter mentioned she had facial swelling and bruising, after a bad reaction to a  polynucleotides treatment (not, it must be said, with Dr Jack). Despite this mishap, Jack sings it praises. "It's a regenerative treatment that involves injecting fragments of DNA derived from salmon," he explained. "The DNA from these cells have a very strong stimulation and repair effect on the skin." So, as gross as it sounds, that salmon sperm can help boost collagen production and improve hyperpigmentation.

While you’ll see polynucleotides taking top billing on treatment menus, you won’t see any obvious signs on people’s faces. There’s mostly no downtime (poor Sophie is an anomaly) and the result is healthier, more youthful skin. These injectable collagen rever-uppers firm and brighten skin and plump out wrinkles without creating a ‘frozen’ or ‘filled’ look. And pretty much everyone can have them.

Polynucleotides are similar to the popular skin booster Profhilo (and its fellow game-changing skin boosters) in that they inject super-powered skincare without changing the shape of or movement in your face. With polynucleotides, you go one better than Profhilo thanks to extra regenerative powers. They are a ‘healthy ageing’ treatment for those who want their skin to ‘act’ younger or to help heal conditions such as eczema (they started life in the medical world).

“They make skin look radiant, youthful and strong without changing your appearance in a weird, ‘filled’ way,” says cosmetic physician Dr Paris Acharya, who we went to see for a course of three treatments.

Too good to be true? Actually, no! Read on…

GTGs Victoria Woodhall immediately after polynucleotide treatment with Dr Paris Acharya.

What are polynucleotides?

Polynucleotides come as an injectable serum derived from the DNA of salmon or trout sperm (very similar to human DNA). They are proteins that act like messenger molecules. “We call them ‘biostimulators’: they kick-start skin regeneration to repair and replace the damage that comes with ageing,” says cosmetic physician Dr Sarah Tonks.

They communicate with our cells to increase its number of fibroblasts, the cells that produce everything we need for bouncy, stretchy skin: collagen, elastin and hyaluronic acid. These, in turn, then get churned out in greater amounts. On top of that, polynucleotides are anti-oxidant and anti-inflammatory, protecting from internal and external damage.

Some doctors describe them as ‘medicine for the skin’ and they are, in more ways than one: “Polynucleotides were originally medicinally used for inflammatory skin conditions such as severe eczema and psoriasis,” says Acharya. They’ve been used in tissue and cartilage regenerative medicine for 40 years and are backed by more than 90 clinical publications, so they’re pretty reliable ‘good guys’ when it comes to treating your skin.

What’s the difference between polynucleotides and Profhilo?

Profhilo  is said to kick-start collagen regeneration but it does so only in a minimal and roundabout way. It mainly deeply hydrates - and well-hydrated skin is more effective at producing its own collagen.

The fact is, Profhilo and its hyaluronic acid-based ilk, including Teoxane Redensity 1, Belotero Revive, and Volite, are brilliant at keeping skin healthy and plump by continuously trapping moisture in the skin, but they don’t actively thicken and densify it. Nor do they help scavenge damaging free radicals. Polynucleotides do all that, while also helping skin feel more hydrated.

Where can you have polynucleotides applied?

Basically anywhere, which is another thing that sets polynucleotides apart from hyaluronic acid skin boosters. The latter are generally not meant for the bonier parts of the face or body, but polynucleotides can be used all over the face and neck, including the jawline and cheekbones, as well as around the eyes and lips, to regenerate knees, elbows and décolletage, to minimise scars, and even on the scalp and eyebrows to improve hair quality and vulva to increase hydration and lubrication.

What are the benefits of polynucleotides?

They improve elasticity, soften wrinkles, crepiness, scars and brown spots and tighten pores, and on the body minimise crinkly skin and stretch marks. They have a significant hydrating effect through the generation of more of your own hyaluronic acid and they calm inflammation, making skin look and feel healthier.

Here are some ways that doctors use polynucleotides

1. For skin sagging

“They are wonderful for restoring firmness, tone and elasticity,” says oculoplastic surgeon Dr Elizabeth Hawkes. Very few things have an effect on skin’s elastin generation, so doctors specifically prize this benefit. “I have had amazing results with my patients regenerating sagging, dehydrated skin,” says Hawkes.

2. For plumping

“In Asia, polynucleotides jabs are routinely teamed with hyaluronic acid injections to both smooth skin and infuse it with moisture,” says Tonks. The Mastelli Plinest brand is the only make that has products that combine both HA and polynucleotides in one injectable; this blend, called ‘Newest’, is what Dr Acharya used on GTG’s Victoria Woodhall, who describes the results as “like Profhilo but better, this provides all the skin bounciness with added regeneration. After three treatments the lines around my mouth were noticeably softened and I looked much more refreshed.”

3. Improving skin texture

By the same token, many doctors use polynucleotides in combination with conventional fillers all over the face to re-shape features while improving skin texture.

4. To treat inflammatory skin conditions

Because polynucleotides bring down inflammation in the skin, they can bring down rosacea-induced redness as well as, as we have seen, other inflammatory skin conditions such as psoriasis, eczema and even, says Acharya, acne.

5. To strengthen your skin ahead of other treatments or surgery
They can be used to improve skin condition and fortify tissues ahead of surgery or aggressive energy-based treatments like Morpheus 8:  "From a surgical perspective, you could definitely include polynucleotides within the treatment plan,” says aesthetic surgeon Dr Glyn Estebanez of Prima Aesthetics. “Anything to improve collagen and the tone of the skin is always beneficial.”

Polynucleotides and energy-based treatments can also be combined to enhance the final results: “I would offer polynucleotides as a stand-alone treatment for mild under eye crepiness but depending on each patient, we can combine them with skin-tightening treatments such as Thermage for more dramatic results.”

6. Polynucleotides eyes: treating dark circles

Because it thickens the skin, polynucleotides are very popular for making dark undereye circles less obvious, while Estebanez likes to use polynucleotides around the eyes in combination with Botox: “Botox works on the expression lines while polynucleotides soften static lines and crepiness around the eyes,” he says.

Which polynucleotides do what?

There are multiple makes of polynucleotides (Nucleofill, Ameela, PhilArt, Rejuran Healer, Pluryal Silk and Densify and Mastelli Plinest are all examples), but despite some marketing claims, they all have pretty much all of the listed benefits in equal measure. Mastelli Plinest Newest is the only one with an added HA component.

Many brands do offer different product densities or strengths for different areas: “Essentially, most brands have a selection of polynucleotide products specifically designed for the treatment area they’re focused on,” says Dr Estebanez. “Some come in a thicker consistency for treating the lower and midface whilst others are specifically designed for, for example, the extremely delicate tissues of the peri-orbital area.”

Why are polynucleotides for the eye area so popular?

For eyes, polynucleotides are a game changer.

“For eyes, this is a truly brightening and dark circle-reducing treatment, because it reduces pigmentation as well as hollows” says Hawkes. “It makes patients look less tired, with some of mine saying they no longer use under-eye concealer. I’ve also had great success reducing crow’s feet with Ameela Eyes.”

Yes, traditional tear trough fillers can plump out sunken eyes and make dark circles less obvious, but they don’t suit a lot of people. “If the lymph drainage around your eyes isn’t great, any hyaluronic acid filler or booster can cause puffiness,” says Hawkes. If you have under-eye bags or lack of elasticity in the area you also aren’t good a good candidate for fillers.

“Treating this area has historically been difficult,” adds Estebanez. “Using under-eye filler in patients who don’t lack volume risks risk making the patient look overfilled. Bio-stimulating fillers such as Sculptra and HarmonyCa are also too thick for the eye area. But polynucleotides such as Ameela restore the skin quality here without any distortion.”

He even injects above the eye and around the tail of the brow, where wrinkles can form that are normally hard to treat.

Are polynucleotides an alternative to lip fillers?

Polynucleotides haven’t got a plumping effect and are not injected into the actual lip so they’re not an equivalent to lip fillers, but doctors love to use them in the perioral (around the mouth) area for other reasons.

“They are excellent for rejuvenation of the lip area, improving overall skin texture and quality,” says Estebanez. “Polynucleotides allow us to improve smoker’s lines without overfilling and distorting the lip appearance.”

HA-based skin boosters can help to improve crepiness here, but it is mainly through their plumping, water-binding effect. With polynucleotides, on the other hand, the benefits come from the collagen stimulation which effectively reduces the wrinkling long-term.

Who can’t have polynucleotides?

They’re not suitable for pregnant women and for those with active herpes. As they are fish-derived, vegans and vegetarians will want to steer clear, as well as those with a fish allergy.

How many polynucleotide treatments do you need and what do polynucleotides cost?

You’ll pay roughly between £350 and £700 per round of treatment (it depends on the size of the treated area and the location of your clinic), and you’ll need two to three sessions spaced two weeks apart.

What do polynucleotides treatments involve?

You can either have them as multiple microdroplet injections or with a cannula, that requires only a limited amount (one to three or so) of punctures. Doctors will tailor and personalise the treatment. An appointment takes around 45 minutes.

If you're having them via injection, the jabs have a nasty sting but it’s all over soon. Your doctor may or may not apply anaesthetic cream – you can request it if you like.  “The recommended protocol is to use micro-droplets of product across the treatment area,” says consultant physician Professor Syed Haq. But there is no set number and pattern of jabs as with Profhilo; I had a full-face  Philart treatment with Dr Haq some time ago that involved about 20 jabs, but some doctor would use more.

Victoria had a cannula instead. “This minimises bruising and eliminates the little bumps you get all over your face when hand-injecting,” says Dr Acharya. “Those can last up to four days, so for that reason, many people choose the cannula option.”

For a cannula, you’ll need a tiny anaesthetic injection where it’s inserted. This can be a little painful although the cannula insertion itself is then practically painless because you are numb.

What is the downtime after a polynucleotides treatment?

You can exercise and wear makeup the next day. Overall, downtime and risks beyond potential bruising and bumpy swelling are minimal (with no bumps for the cannula option) as long as you see a highly qualified doctor. They will ensure no disreputable brands of polynucleotides are used, plus why would you let any non-medical professional stick a syringe in your face?

When do you see the results of polynucleotides, and how long do they last?

Where other skin boosters can take around three months before you see results come through, polynucleotides make skin glowier and healthier in the space of about six weeks, while many people see some results after the first session. Those continue to improve over three months, with final results lasting six to nine months before you need a top-up.

Polynucleotides with Dr Paris Acharya at Waterhouse Young Clinic in London costs £600, or £1600 for 3 treatments.