Understanding Polynucleotides
There's a growing category of injectable treatments in aesthetic medicine that work differently to everything that came before them. Not fillers, which add volume. Not Botox, which relaxes muscles. Not even skin boosters, which saturate the skin with hyaluronic acid. Polynucleotides do something more fundamental — they work at a cellular level to stimulate the skin's own regenerative processes, improving quality, resilience, and health from within.
It's this biological mechanism that has made polynucleotides one of the most talked-about developments in aesthetic medicine over the past few years — and one of the treatments generating the most consistent results in clinic.
What Are Polynucleotides?
Polynucleotides — often referred to as PDRN (polydeoxyribonucleotide) or PN — are long chains of nucleotides, the molecular building blocks that make up DNA and RNA. In aesthetic and regenerative medicine, they are derived from highly purified salmon or trout sperm DNA, which has a molecular structure remarkably similar to human DNA — making it highly biocompatible and well-tolerated by human tissue.
The purification process is extensive. The DNA is extracted, purified, and processed to remove any proteins or contaminants that could trigger an immune response, leaving behind only the polynucleotide chains themselves in a sterile, injectable form.
At Karwal Aesthetics, we use Plinest — one of the most established and clinically studied polynucleotide preparations available, produced in Italy and widely used across Europe and Asia for both medical and cosmetic applications.
How Do Polynucleotides Work?
This is where polynucleotides become genuinely interesting — because their mechanism of action is distinct from almost every other injectable treatment available.
Receptor Activation and Cellular Signalling
Polynucleotides work primarily by binding to adenosine receptors — receptors found on the surface of many cell types, including fibroblasts (the cells responsible for producing collagen and elastin), endothelial cells (which line blood vessels), and immune cells. When polynucleotides bind to these receptors, they trigger a cascade of cellular responses that collectively drive tissue regeneration and repair.
Fibroblast Stimulation
One of the most significant effects of polynucleotides is the direct stimulation of fibroblast activity. Fibroblasts are the workhorses of skin structure — they produce collagen, elastin, and hyaluronic acid, the three components most responsible for keeping skin firm, elastic, and hydrated. As we age, fibroblast activity declines progressively, and their output of these structural proteins diminishes. Polynucleotides reactivate fibroblasts, prompting them to increase production of new collagen and elastin — rebuilding the structural integrity of the skin from the ground up.
DNA Repair and Cell Proliferation
Polynucleotides also serve as a substrate for DNA synthesis — essentially providing cells with the raw materials they need to repair damaged DNA and proliferate. In skin that has been exposed to chronic UV radiation, pollution, or other environmental stressors, this DNA repair mechanism is particularly valuable. Cells that have been functioning below their potential due to accumulated DNA damage are given what they need to restore normal function.
Anti-inflammatory Action
Adenosine receptor activation has a well-documented anti-inflammatory effect, reducing the production of pro-inflammatory cytokines and creating a more favourable environment for tissue regeneration. This is one of the reasons polynucleotides are particularly effective in skin that has been chronically inflamed — whether from acne, rosacea, UV damage, or environmental stress — and why they produce improvements not just in texture and firmness but in overall skin health and resilience.
Angiogenesis: Improving Blood Supply
Polynucleotides stimulate the formation of new blood vessels in the treated tissue — a process called angiogenesis. Improved blood supply means better delivery of oxygen and nutrients to the cells, and more efficient removal of waste products. The result is tissue that functions more effectively at a cellular level, producing better quality collagen and recovering from daily environmental damage more efficiently.
Hydration at a Cellular Level
Unlike hyaluronic acid, which attracts and holds water by physical means, polynucleotides improve the skin's intrinsic ability to retain moisture by supporting the cells responsible for producing the skin's natural moisturising factors. The hydration improvement from polynucleotides is therefore not dependent on the continued presence of an injected product — it reflects a genuine improvement in the skin's own functioning.
What Can Polynucleotides Treat?
The biological mechanisms described above translate into a wide range of clinical applications. Polynucleotides are versatile, effective across multiple areas of the face and body, and suitable for a broad range of patients.
Skin Quality and Texture
This is the most common application and the one most patients seek treatment for. Polynucleotides improve the overall quality of the skin — its firmness, elasticity, texture, and radiance — by stimulating the underlying biological processes that maintain it. The improvement is not a surface effect but a genuine structural one, as new collagen and elastin are produced and the skin's architecture is progressively rebuilt.
Patients typically describe their skin as looking healthier, more alive, and more resilient — rather than simply fuller or smoother. It's a quality of improvement that's difficult to replicate with topical products alone, because it begins at the cellular level rather than the surface.
Fine Lines and Early Wrinkles
As collagen and elastin production improves, fine lines and early wrinkles become progressively less visible. The improvement is gradual and cumulative rather than immediate — reflecting the biological timeline of collagen synthesis rather than an instant physical change — which is also why results look natural.
Under-Eye and Periorbital Area
The skin around the eyes is the thinnest on the entire face, and the first to show the effects of ageing, fatigue, and environmental damage. Traditional volumising fillers are often too heavy for this delicate zone, and even lighter HA fillers require precise technique to avoid complications.
Polynucleotides are ideally suited to the periorbital area. By improving skin quality rather than adding volume, they address the crepiness, fine lines, and loss of elasticity that make the eye area look tired and aged — without the risks associated with volumising products in this sensitive zone. At Karwal Aesthetics, Plinest Eye — a formulation specifically developed for the periorbital region — is used for this indication.
Neck and Décolletage
These are areas that are frequently neglected and where the skin is often too delicate for more aggressive treatments. Polynucleotides improve firmness, reduce crepiness, and address the horizontal lines and textural changes that develop in the neck with age — producing meaningful improvements in an area that many patients have previously been told there is little that can be done for.
Hands
The backs of the hands are one of the most visible indicators of age, yet one of the most under-treated areas in aesthetic medicine. Polynucleotides improve the quality, hydration, and texture of the skin on the hands, reducing the thin, papery appearance that develops as collagen thins with age.
Scalp and Hair Health
One of the emerging and increasingly evidence-supported applications of polynucleotides is in hair loss and scalp health. Injected into the scalp, polynucleotides stimulate the follicular environment — improving blood supply, reducing inflammation, and creating the conditions for healthier hair growth. They are particularly useful in telogen effluvium (diffuse shedding triggered by stress or illness) and early androgenetic alopecia, where follicles are underperforming rather than permanently lost.
Post-Procedure Skin Recovery
Polynucleotides have a significant and underappreciated role in supporting skin recovery after medical and aesthetic procedures. Their anti-inflammatory properties, combined with their ability to stimulate tissue repair and improve local blood supply, make them a valuable addition to post-treatment protocols — accelerating healing and improving the quality of the final outcome.
Polynucleotides vs. Other Skin Treatments
Understanding where polynucleotides sit in relation to other injectable treatments helps to clarify when they are the right choice — and when a different approach, or a combination, would deliver better results.
Polynucleotides vs. Hyaluronic Acid Fillers
Fillers add volume by physically introducing a gel beneath the skin. They are excellent for restoring lost structure, lifting hollowed areas, and redefining facial contours. They do not, however, improve the quality of the skin itself.
Polynucleotides don't add volume. They improve the skin's intrinsic quality — its firmness, elasticity, and health — by stimulating biological regeneration. The two treatments address fundamentally different problems and work very well together as complementary elements of a comprehensive treatment plan.
Polynucleotides vs. Profhilo
Profhilo is a bio-remodelling treatment based on a high concentration of hyaluronic acid. It improves skin hydration and stimulates collagen production through bio-remodelling, and produces excellent results for overall skin quality and firmness — particularly for patients with mild to moderate laxity.
Polynucleotides work through a different mechanism — DNA-level cellular stimulation rather than HA bio-remodelling — and have additional anti-inflammatory and angiogenic effects that Profhilo does not. They are particularly well-suited to patients with chronic inflammation, significant sun damage, or concerns in delicate areas where HA products are less appropriate. In many cases, the two treatments complement each other effectively as part of a broader programme.
Polynucleotides vs. Sunekos
Sunekos combines hyaluronic acid with a patented amino acid complex to stimulate collagen and elastin through ECM regeneration. Like polynucleotides, it improves skin quality rather than adding volume, and it's particularly effective for fine lines, crepey skin, and delicate zones. At Karwal Aesthetics, Sunekos is our preferred skin booster for most patients — delivering strong results across a wide range of skin concerns. Polynucleotides are recommended where their specific mechanism — particularly the anti-inflammatory, DNA repair, and angiogenic effects — offers additional benefit, or where a targeted formulation like Plinest Eye is the most appropriate choice for the periorbital area.
The Treatment: What to Expect
Consultation
Every polynucleotide treatment at Karwal Aesthetics begins with a thorough consultation with Dr Arun Karwal. This covers your skin concerns, medical history, any previous treatments, and what you're hoping to achieve. Polynucleotides are not the right treatment for every concern, and the consultation ensures that if they are recommended, it's because they're genuinely the best option for your skin.
The Treatment Sessions
A standard course of polynucleotide treatment typically involves three to four sessions, spaced two to four weeks apart. Each session takes approximately 30 to 45 minutes. The product is administered via multiple small injections across the treatment area, using very fine needles or a cannula depending on the zone being treated. Topical anaesthetic can be applied beforehand if preferred.
After Treatment
There is no meaningful downtime. Mild redness, small injection marks, and occasional pinpoint bruising are normal in the 24 to 48 hours following treatment and resolve quickly. Normal activities can be resumed immediately, though we advise avoiding intense exercise, alcohol, and heat exposure for 24 hours.
When Will You See Results?
Results with polynucleotides develop gradually — reflecting the biological timeline of the processes being stimulated rather than an instant physical change. Most patients notice an improvement in skin radiance and hydration within the first two to three weeks. More significant improvements in texture, firmness, and fine lines become apparent over the following weeks and continue to develop for several months after the final session as collagen synthesis continues.
This gradual, progressive improvement is one of the reasons the results look so natural. The skin is changing because it is genuinely healthier — not because something has been introduced to mask a problem.
How Long Do Results Last?
Following a full treatment course, results typically last six to twelve months. Maintenance sessions every six months are recommended to sustain the improvement and continue supporting the biological processes that polynucleotides stimulate.
Who Is Polynucleotide Treatment Suited To?
Polynucleotides are suitable for a wide range of patients — from younger individuals seeking to protect and maintain their skin quality to older patients addressing more established concerns.
They are particularly well-suited to patients with skin that looks tired, dull, or depleted rather than specifically lined or volumised — the kind of skin change that doesn't respond fully to fillers or conventional skin boosters. They are also an excellent option for patients with sensitive or reactive skin, post-inflammatory conditions, or chronic UV damage, given their anti-inflammatory properties.
Treatment is not recommended during pregnancy or breastfeeding, for patients with active infections or inflammation in the treatment area, or for those with a known allergy to fish or fish products. Any relevant medical history will be discussed thoroughly at consultation.
Frequently Asked Questions
Are polynucleotides the same as PRP (platelet-rich plasma)? No. PRP is derived from your own blood and works primarily through the growth factors released by platelets. Polynucleotides are a separate category of treatment with a distinct mechanism — DNA-level cellular stimulation — and are derived from marine sources rather than the patient's own blood.
Is there any risk of allergic reaction? Because polynucleotides are derived from salmon or trout DNA, patients with a known fish allergy should discuss this at consultation. The purification process removes proteins that are typically responsible for allergic reactions, but the risk is not zero and should be assessed individually.
Can polynucleotides be combined with other treatments? Yes — and they frequently are. Polynucleotides work well alongside fillers, skin boosters, Profhilo, and medical-grade skincare as part of a comprehensive treatment plan. Dr Karwal will advise on the optimal combination and sequencing for your specific concerns.
How is it different from a skin booster? Skin boosters typically use hyaluronic acid to improve hydration and skin quality. Polynucleotides work through a completely different mechanism — stimulating cellular regeneration and repair at a DNA level — and produce a different quality of improvement that is complementary to, rather than interchangeable with, HA-based boosters.
Is the treatment painful? Discomfort is minimal. The needles used are very fine and the injections are superficial. Most patients find the treatment very manageable without anaesthetic, though topical cream is available if preferred.
If you'd like to find out whether polynucleotide treatment is right for your skin, book a consultation with Dr Arun Karwal at Karwal Aesthetics, Mayfair →
