Polynucleotides explained: the practitioner's guide

Polynucleotides have moved quickly from conference talking point to standard menu item, and most clinics adding them are fielding the same patient questions: what are they, how are they different from filler, and why does it take a course. This guide gives you a clear account you can use in consultation, plus the protocol, patient-selection and record-keeping detail that matters on the practitioner side. If your patients are searching for the term before they book, this is the explanation they should arrive with.

What polynucleotides are

Polynucleotides are injectable preparations of purified DNA fragments, most commonly derived from salmon or trout, processed so that the genetic information is removed and what remains is a biocompatible chain of nucleotides. Injected into the skin, they are positioned as regenerative rather than volumising: the aim is to improve the quality of the tissue itself, supporting fibroblast activity, hydration and skin elasticity over a course of treatment.

The honest framing for patients is that polynucleotides are a skin-quality treatment. They do not freeze movement, fill a line or reshape a feature. Patients tend to report improvements in texture, firmness, crepiness and the general condition of the skin, with the under-eye area, face, neck and hands the most commonly treated zones. Results build gradually across a course rather than appearing on the day.

How they differ from filler and skin boosters

The three categories are easiest to separate by what each is trying to do.

Dermal filler adds volume. It is a structural treatment: restoring a cheek, defining a jawline, filling a deep fold. The product remains in the tissue and the result is visible immediately.

Skin boosters add hydration. These are typically soft hyaluronic acid preparations injected superficially to improve moisture, glow and fine crepiness. They condition the skin rather than reshape it.

Polynucleotides aim at regeneration. Rather than adding volume or water-binding material, the intention is to stimulate the skin’s own repair processes, so the change patients see is in the quality and behaviour of their tissue. The trade-off is patience: there is little to see immediately, and the result is judged weeks after the course finishes.

In practice the categories overlap and are often sequenced together, for example polynucleotides to improve tissue quality before filler is used for structure. The consultation job is to match the patient’s actual concern to the right category, because a patient who wants volume will be disappointed by polynucleotides, and a patient with thin, crepey under-eye skin may be poorly served by filler alone.

Typical protocols

Most manufacturers recommend a course of two to three sessions, spaced around two to four weeks apart, with maintenance sessions thereafter at intervals that suit the patient and the product. Injection technique varies by product and area: under-eye treatment is commonly delivered with a cannula or fine-needle serial puncture, while face, neck and hand protocols often use multiple small intradermal deposits.

Protocols differ meaningfully between brands, so check the manufacturer’s guidance for the specific product you use, including dilution where relevant, recommended session spacing and the areas the product is indicated for. Build your pricing and booking structure around the course rather than the single session, because a patient who attends once and stops is unlikely to see the result the product is capable of, and that becomes your review problem rather than theirs.

Who they suit

Good candidates are patients whose concern is skin quality rather than shape: dull or tired-looking skin, fine crepiness, early laxity, thin under-eye skin, sun-damaged necks and hands. They suit patients who are realistic about gradual improvement and willing to commit to a course, and they are a useful option for patients who are hesitant about filler or for whom filler is not the right answer anatomically.

They are not suitable for patients who are pregnant or breastfeeding, who have an active skin infection in the area, or, for salmon-derived products, who have a known fish allergy. Screen for this explicitly rather than relying on the patient to volunteer it. Patients with unrealistic expectations of a one-session transformation should be re-consulted rather than treated.

The consultation

A polynucleotide consultation should cover the same ground as any injectable consultation, with three additions worth making routine. First, set the timeline honestly: explain that results develop over weeks, that a course is required, and what the realistic endpoint looks like for their skin. Second, screen for fish allergy where the product is salmon-derived, and document the answer. Third, explain what the treatment will not do, particularly for patients who arrive asking about lines or volume, so the boundary between this and filler is clear before any product is opened.

Record the discussion, the areas agreed, the number of sessions planned and the consent. A signed polynucleotide consent form with itemised risks does most of this work for you.

Record-keeping and the regulatory position

Most polynucleotide presentations on the UK market are not prescription-only medicines, which means a prescriber is not usually required in the way it is for botulinum toxin. That is not a blanket rule: classifications and presentations vary, so check the regulatory status of the specific product you use with the manufacturer or distributor, and confirm your insurance covers it by name.

Whatever the classification, the documentation standard does not relax. Every session needs written consent, a treatment record with the product name, batch number and expiry, the areas treated, volumes used and the technique, and a record that written aftercare was provided. Batch recording is what lets you identify and contact every affected patient if a product is ever recalled, and it is the kind of detail England’s planned licensing scheme is expected to make baseline; our licensing-ready records checklist sets out the full standard.

Aftercare and follow-up

Patients should expect small blebs or bumps at the injection points for 24 to 48 hours, possible redness, swelling and bruising, and a short list of things to avoid while the skin settles. Send written aftercare after every session rather than relying on the chair-side conversation; our polynucleotides aftercare sheet is ready to copy. Book the next session in the course before the patient leaves, and diarise a review after the final session so the outcome is assessed and photographed at the right point.

For more treatment and compliance guides for UK clinics, see the full guides library.

Running courses without the admin

Course-based treatments multiply the admin: multiple bookings, consent per course, a record per session, aftercare after each visit and a review at the end. AesthetiClinic handles this as one workflow, with e-signed consent before the first appointment, batch numbers on every treatment record, and aftercare emailed automatically after each session. See how it fits your clinic on the features page.