Polynucleotides are injectable DNA fragments, most commonly salmon-derived, used as bioregenerators in aesthetic medicine. The peer-reviewed evidence supports collagen stimulation, improved skin elasticity, and a low adverse-event profile. They are not traditional fillers. They sit alongside skin boosters as a regenerative tool with a different clinical rationale.
What polynucleotides actually are
Polynucleotides are short and long-chain fragments of purified DNA, isolated from natural sources such as salmon trout sperm. The most studied product class is referred to in the literature as PN-HPT, polynucleotides at high purification technology. Two related compounds also appear in the dermatology literature: PDRN (polydeoxyribonucleotide), which uses shorter DNA fragments, and PN proper, which uses longer chains.
Mechanistically, the published systematic review describes a sustained interaction with the extracellular matrix. The fragments act on fibroblasts, encouraging collagen production and tissue self-repair. The viscoelasticity of the longer DNA chains gives the products a temporary structural quality, but the goal is biological remodelling, not volume replacement.
The 2026 evidence read
Two pieces of literature anchor the current read.
The first is the systematic review by Lee et al., which pooled multiple clinical studies and reported statistically significant improvements in skin texture, elasticity, hydration, fine lines and pore size. The review also flagged a consistently low rate of adverse events across the studies it included.
The second is the practice survey and review by Park and colleagues, which sampled cosmetic physicians on real-world use and outcomes. The headline finding: most respondents reported a perceived effectiveness consistent with the controlled-trial evidence, particularly for skin booster–style applications and pore reduction.
Both reviews converge on the same picture. The evidence base is stronger than it looked three years ago, but most studies are small and short-duration. There is a place for polynucleotides in clinical practice, with the caveat that the long-term evidence is still being built.
How polynucleotides differ from hyaluronic acid fillers
The conflation of polynucleotides with HA fillers is one of the most common misreadings in clinic conversations.
- HA fillers restore volume immediately through a viscous gel.
- Polynucleotides work over weeks by encouraging endogenous collagen production. Visible change is gradual.
- HA fillers dissolve over months; polynucleotides do not need dissolving, the DNA fragments are metabolised.
- HA fillers are reversed with hyaluronidase if a complication occurs. Polynucleotides have no analogous reversal agent.
For practitioners, the consent conversation is fundamentally different. The patient is not buying volume. They are buying biological remodelling, on a longer time horizon, without the same off-ramp.
Indications with the strongest published support
Across the reviewed literature, the indications with the most consistent evidence are:
- Periorbital and perioral fine lines, the skin-quality indications where small, repeatable changes are most visible.
- Atrophic acne scars, when used alongside microneedling or laser as a priming or co-injection strategy.
- Striae albae (mature stretch marks), improvement in elasticity and texture across multiple small studies.
- Iatrogenic fat atrophy, case-series-level evidence for facial volume rehabilitation.
- Pore size and skin texture, surveyed cosmetic physicians reported this as a strong perceived indication.
Indications where the evidence is weaker or absent include hand rejuvenation, hair regrowth and intimate dermatology, areas where polynucleotides are sometimes marketed but where the published support has not yet caught up.
Safety profile and adverse events
The reviews are consistent on the safety profile. Reported events are predominantly local, bruising, mild erythema, transient nodules, and resolve without intervention. Serious adverse events are rare in the published literature.
That is not a clinical guarantee. It is a statement about what the literature has captured. As with any injectable, the responsibility for managing rare events sits with the practitioner, the consent process, and the documentation. The JCCP's competence framework covers the procedural standards expected in UK practice.
Where this sits in UK practice
Polynucleotide products are CE/UKCA marked as medical devices, not licensed medicines. That places them firmly under the MHRA for any regulatory action concerning the device itself, and under your professional regulator (NMC, GMC or GDC) for the clinical decisions you make around their use.
When the licensing scheme under the Health and Care Act 2022 brings injectables into the local-authority licensing tier, polynucleotides are likely to fall within scope. That has not been formally confirmed at the time of writing, the procedure list is still being defined, but it would be unusual for a deep-injection product class to sit outside the scheme.
If you offer polynucleotides in clinic, the documentation work that pays back is the same work that pays back for any injectable: scope of practice on file, consent records that match the actual conversation, and a competence record aligned to the CPSA framework.
For the structured walk-through of where polynucleotides, and every other injectable category, fit inside a defensible UK practice, the RAG Pathway is the four-week programme designed to land practitioners aligned with JCCP, CPSA, MHRA and the licensing scheme expectations before the regulations tighten.
FAQ
Are polynucleotides licensed medicines in the UK?
No. The products available in UK clinics are CE/UKCA-marked medical devices, not licensed medicines. That puts MHRA in charge of the device approval and post-market surveillance, with your professional regulator covering the clinical use.
Do polynucleotides work like hyaluronic acid fillers?
No. They are not volumising fillers. They stimulate collagen production over weeks, with the goal of biological remodelling rather than immediate volume replacement. The peer-reviewed reviews consistently describe them as bioregenerators or skin boosters, not fillers.
What does the systematic review evidence say about effectiveness?
The 2024 systematic review pooled multiple clinical studies and reported statistically significant improvements in skin texture, elasticity, hydration, fine lines and pore size, with a consistently low adverse-event profile. The studies were generally small and short-duration; long-term evidence is still being built.
Are polynucleotides safe?
The published evidence reports a favourable safety profile, with adverse events predominantly local and self-limiting. As with any injectable, that statistical profile does not replace the practitioner's responsibility for consent, documentation, and management of rare events.
Will polynucleotides come under the UK aesthetics licensing scheme?
Most likely yes, given they are deep-injection procedures, but the procedure list under the secondary legislation is still being defined as of 2026. Treat the scheme as imminent for any injectable category and structure documentation accordingly.
Can polynucleotides be reversed?
There is no reversal agent equivalent to hyaluronidase for polynucleotides. The DNA fragments are metabolised over time. This makes the consent conversation materially different from that for hyaluronic acid fillers.