Polynucleotides vs Profhilo

• Material: Profhilo is a high concentration of hyaluronic acid (both high and low molecular weight) stabilised without chemical cross-linking. Polynucleotides are chains of purified DNA, usually from salmon or trout.
• Main intent: Profhilo is generally used for hydration and a degree of skin firmness and laxity across a larger area. Polynucleotides are generally used for skin quality, texture and thin or fragile skin, including delicate areas.
• Technique: Profhilo is classically placed at five fixed points per side of the face and spreads. Polynucleotides are placed as multiple small deposits or fanned with a cannula across the treatment zone.
• Course: Profhilo is typically two sessions four weeks apart. Polynucleotides are typically two to three sessions two to four weeks apart.
• Cost: both usually sit in a similar bracket per session in the UK. See costs.

Profhilo is a branded hyaluronic acid product made by IBSA. Hyaluronic acid occurs naturally in skin and binds a large amount of water. Profhilo’s distinguishing feature is its thermal stabilisation process, which lets it hold a high concentration in a very fluid form that spreads through the tissue after injection.

Polynucleotide products contain purified nucleotide chains rather than hyaluronic acid, although some brands include hyaluronic acid as a carrier. Their proposed action is partly physical hydration and partly a signalling effect on fibroblasts — see how they work.

Both are regulated in the UK as medical devices rather than as licensed medicines, so neither requires a prescription in the way that botulinum toxin does.

With Profhilo, the standard protocol is two sessions a month apart, with changes in hydration often noticed within a couple of weeks and firmness developing over one to two months. Maintenance is commonly offered at around six months.

With polynucleotides, two or three sessions two to four weeks apart is more usual, with results assessed a month after the last session and maintenance suggested at six to twelve months. The immediate appearance differs too: Profhilo leaves a small number of visible blebs that settle within hours, whereas polynucleotides leave a larger number of much smaller ones.

Neither treatment produces a dramatic change. Both aim at an improvement in how skin looks and behaves, and both need repeating to maintain.

A practitioner will usually weigh up the area being treated, the type of concern and your history. Broadly:

• Widespread dehydration and early laxity over the cheeks, neck or arms often points towards Profhilo or a similar bio-remodelling product.
• Thin, crepey or fragile skin, particularly under the eyes, often points towards polynucleotides.
• A known allergy or previous adverse reaction to either material rules that one out. Polynucleotides are avoided in people with a fish or seafood allergy.

Some practitioners combine the two across a treatment plan, usually in separate sessions rather than on the same day. Evidence directly comparing the two is very limited, so any confident claim that one outperforms the other should be treated with scepticism.