Do polynucleotides help acne scars?
Polynucleotides are injectable fragments of DNA, usually derived from salmon, which are believed to stimulate fibroblasts and improve the quality of the skin. They do not correct the contour of a depressed scar, and anyone offering them as a replacement for subcision or resurfacing is overstating what they can achieve.
Injected into the skin, polynucleotides are believed to stimulate the cells responsible for producing collagen and improve hydration and the general condition of the dermis. The visible effect is upon skin quality: smoother, better hydrated, less red, with a modest improvement in fine surface texture. Treatment is usually a course of three or four sessions two to four weeks apart, with maintenance thereafter, and downtime is minimal, which forms part of their appeal.
The evidence is weaker than the marketing suggests. The published studies are small, follow-up is short, objective measurement is limited, and there is very little comparing polynucleotides directly against the treatments known to work for scarring. This does not mean they achieve nothing, but the honest position is that they are promising rather than proven.
They are sensibly used as an adjunct rather than a foundation: alongside or following correction of the contour, in order to improve the quality of the surrounding skin; for a patient unable to accept the downtime of resurfacing who wishes to improve skin quality. They are not a substitute for subcision in tethered scars or for TCA CROSS in ice pick scars.
Where the aim is for the skin to look better, polynucleotides are a reasonable treatment to consider. Where the aim is for the scars to be less deep, the money is better directed first towards the procedures that change contour, with polynucleotides considered afterwards.
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