Aesthetics

Do polynucleotides really work?

Medically reviewed by Dr Suha Kersh, Co-Founder & Lead Aesthetic Doctor · Published 9 November 2026 · Last reviewed 9 November 2026

Quick answer: Polynucleotides show early, promising results. Small randomised trials report better skin texture, elasticity and hydration than placebo, with mostly mild, short-lived side effects. But the evidence base is still small: a 2026 meta-analysis found only five randomised trials. They aim to improve skin quality gradually, not to add volume, and results vary.

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What are polynucleotides, and what is PDRN?

Polynucleotides are injectable gels made from purified fragments of DNA, usually taken from salmon or trout [1][3]. They are placed in small amounts within the skin to support its own repair, aiming for thicker, more elastic, better-hydrated skin, not a change in shape.

PDRN (polydeoxyribonucleotide) is a closely related ingredient made of shorter DNA chains. The terms are often used interchangeably, which a 2025 review in Biomolecules said has caused "considerable confusion"; the authors proposed separating them by fragment size [2].

How polynucleotides work is not fully settled. A 2024 review in the International Journal of Molecular Sciences notes that the proposed repair mechanism comes from PDRN research and has not yet been demonstrated for polynucleotides themselves [1].

What do the trials actually show?

Polynucleotides have encouraging but limited evidence. The strongest summary so far is a 2026 systematic review and meta-analysis of five randomised controlled trials, involving 315 patients in total [4]. Compared with placebo, polynucleotides improved skin texture, elasticity and hydration; compared with hyaluronic acid, overall aesthetic results were similar [4]. The authors called for larger, standardised and longer-term studies [4].

A 2026 scoping review found just six relevant clinical studies, reporting gains in hydration, elasticity, firmness and texture, but concluded that safety and effectiveness are not yet firmly established [5]. Most of the wider research is observational or small pilot work [1], and a 2024 overview in Archives of Plastic Surgery noted that one widely cited early trial has since been retracted [3]. In plain terms: promising rather than proven.

How many polynucleotide sessions do I need?

Polynucleotides are given as a course, not a single appointment. Published protocols commonly use three to four sessions spaced about three to four weeks apart, and a European consensus suggests three sessions roughly three weeks apart [3].

At 23MD, a course is usually two to three sessions, followed by maintenance every 6 to 12 months. Each appointment takes 30 to 45 minutes. Your doctor will set the schedule for your skin and the area being treated.

How long do polynucleotides take to work?

Polynucleotides work gradually, over weeks rather than days, because any change builds across the course. Studies usually measure results at around 12 weeks and follow people for up to 6 to 12 months [1].

In our clinics, some people notice a subtle change after the first session, with the fullest result typically 4 to 8 weeks after the course. Results vary, and some people notice little change.

Are polynucleotides safe?

Across the published studies, side effects have been mostly mild and short-lived. Reviews report redness, swelling and minor injection-site pain, with no serious adverse events [4][5]. Small, temporary bumps at the injection points are common [3], and injection marks or mild swelling can show for 24 to 48 hours.

Long-term safety data are still limited [5]. Because the material is fish-derived, anyone with a known sensitivity to fish products should not have it. As with any injectable, bruising and, rarely, infection or reactions are possible; your doctor will discuss risks with you.

Polynucleotides vs skin boosters: what's the difference?

Both aim to improve skin quality rather than add volume, but they work differently. Skin boosters place stabilised hyaluronic acid within the skin, mainly for hydration and glow. Polynucleotides are described as biostimulators that aim to encourage the skin's repair and collagen processes [3].

	Polynucleotides	Skin boosters (hyaluronic acid)
Main aim	Support skin repair, elasticity and thickness	Hydration, smoothness and glow
Made from	Purified fish-derived DNA fragments [1][3]	Stabilised hyaluronic acid
Typical course	2 to 4 sessions a few weeks apart [3]	Often 2 to 3 sessions
Evidence today	Early: a handful of small randomised trials [4]	More established for hydration, though many studies are small [3]

The two are sometimes combined [3]. For a side-by-side comparison that includes dermal filler, see our guide to skin booster vs filler.

Do polynucleotides work under the eyes?

There is some trial evidence for the under-eye area. In a randomised, double-blind, split-face trial of 27 people, polynucleotides on one side were compared with a hyaluronic acid gel on the other [6]. Overall scores were similar, but the polynucleotide side improved more in roughness and pore volume, with no serious adverse events [6].

A 2026 review concluded that hyaluronic acid fillers remain better for structural correction, such as a hollow tear trough, while polynucleotides improve skin quality, such as thin or crêpey skin; differences between studies prevent firm conclusions [7]. Under-eye polynucleotide treatment is offered at both our London and Dubai clinics; read more about tired eyes and dark circles.

Are polynucleotides worth it?

Polynucleotides may be worth considering if your concern is skin quality, you are happy to commit to a course, and you accept that the evidence is early. They are unlikely to meet expectations if you want a change in shape or volume, or a quick result.

The 23MD view

"I like polynucleotides for skin that has become thin, tired or crêpey, especially around the eyes and neck, but I am honest with patients that the research is still young. They are a quality treatment, not a shape treatment, so I rarely use them alone. With Treatment Stacking, I look at skin, lines, volume and bone together, and polynucleotides may be one layer alongside skin boosters or energy-based treatments. The aim is rebalancing the face rather than taking it over." — Dr Suha Kersh

Dr Kersh sets out where polynucleotides fit, and where they don't, in Polynucleotides, examined.

Who this is for, and who it isn't for

May be worth discussing: adults noticing thinner, drier or crêpey skin where face shape has changed little, who prefer gradual change over a course.
Not for: anyone looking for added volume, lifting or an instant result.
Not suitable: during pregnancy or breastfeeding, with active infection or inflammatory skin disease in the area, or with a known sensitivity to fish-derived products.
Needs a doctor's assessment first: people with autoimmune or other medical conditions.

Frequently asked questions

Are polynucleotides made from salmon sperm?

Most are made from purified DNA from salmon or trout reproductive cells [1][3].

Are polynucleotides the same as PDRN?

They are related DNA-derived ingredients. Polynucleotides have longer chains; researchers have proposed a size-based definition to separate the two [2].

How long do polynucleotide results last?

Studies and consensus suggest roughly 6 to 12 months, which is why maintenance sessions are usually planned [3].

Can polynucleotides replace filler?

No. Polynucleotides improve skin quality; they do not restore lost volume or structure [7].

Not sure whether your skin concern is about quality, volume or both? Explore your options with our Skin Analyser: upload a photo for a general skin assessment based on Dr Kersh's approach. It gives general information only, does not diagnose, and does not replace a consultation with a doctor.

Talk to a 23MD doctor

If you would like to know whether polynucleotides suit your skin, our doctors are happy to talk it through in a 45 to 60 minute first consultation. Suitability and results vary; your doctor will discuss benefits and risks, including whether treatment is right for you at all. Learn more about polynucleotides at 23MD.