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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 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 interesting — because their mechanism of action is distinct from almost every other injectable treatment available.

Polynucleotides work primarily by binding to adenosine receptors — receptors found on the surface of many cell types, 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.

One of the most significant 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 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 integrity of the skin from the ground up.

Polynucleotides also serve as a substrate for DNA synthesis — essentially providing cells with the raw materials they need to repair damaged DNA and . In skin that has been exposed to chronic UV radiation, pollution, or other environmental stressors, this DNA repair mechanism is particularly . Cells that have been functioning below their potential due to accumulated DNA damage are given what they need to restore normal function.

Adenosine receptor 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.

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 more effectively at a cellular level, producing better quality collagen and from daily damage more efficiently.

Unlike hyaluronic acid, which attracts and holds water by 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.

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 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 .

Patients typically describe their skin as looking healthier, more alive, and more — 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.

As collagen and elastin production improves, fine lines and early wrinkles become progressively less . 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.

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 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, Eye — a formulation specifically developed for the periorbital region — is used for this indication.

These are areas that are frequently neglected and where the skin is often too for more aggressive . 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.

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.

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 for healthier hair growth. They are particularly useful in effluvium (diffuse shedding triggered by stress or illness) and early androgenetic alopecia, where follicles are underperforming rather than permanently lost.

have a and underappreciated role in supporting skin recovery after medical and aesthetic procedures. Their anti-inflammatory properties, combined with their to stimulate tissue repair and improve local blood supply, make them a valuable addition to post-treatment — 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.

Fillers add volume by physically introducing a gel beneath the skin. They are for restoring lost structure, lifting hollowed areas, and redefining facial contours. They do not, however, improve the quality of the skin itself.

don't add volume. They improve the skin's — 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.

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 — particularly for with mild to moderate laxity.

Polynucleotides work through a different mechanism — DNA-level cellular 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 areas where HA products are less appropriate. In many cases, the two treatments complement each other effectively as part of a broader programme.

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 where their mechanism — particularly the anti-inflammatory, DNA repair, and angiogenic effects — offers benefit, or where a targeted formulation like Plinest Eye is the most appropriate choice for the periorbital area.

The Treatment: What to Expect

Every polynucleotide treatment at Karwal 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. 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.

A standard course of treatment typically involves three to four sessions, spaced two to four weeks apart. Each session takes approximately 30 to 45 minutes. The is administered via small injections across the treatment area, using very fine needles or a cannula depending on the zone being treated. anaesthetic can be applied beforehand if preferred.

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.

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 . The skin is changing because it is genuinely healthier — not because something has been introduced to mask a problem.

Following a full treatment course, results typically last six to twelve months. Maintenance sessions every six months are to sustain the improvement and continue supporting the biological processes that polynucleotides stimulate.

Who Is Polynucleotide Treatment Suited To?

Polynucleotides are 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 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 to fish or fish products. Any medical history will be discussed thoroughly at .

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 — cellular stimulation — and are derived from marine sources rather than the patient's own blood.

Is there any risk of allergic reaction? polynucleotides are derived from salmon or trout DNA, patients with a known fish should discuss this at consultation. The purification process removes proteins that are typically for 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