Polynucleotides
Polynucleotides for acne scars: what can the evidence support?
Early research suggests a possible role for polynucleotides in selected atrophic acne scars, but one injectable cannot treat every scar type or replace control of active acne.
Start by identifying the scar—not just ‘acne marks’
Acne can leave different changes. Flat red, purple or brown marks are not the same as true scars. Atrophic scars sit below the surrounding skin and may be described as ice-pick, boxcar or rolling scars; hypertrophic and keloid scars are raised. Each pattern has different structural features and may need a different approach.
Polynucleotide research has mainly considered atrophic scars and skin quality. It should not be assumed to remove pigment, release tethered rolling scars, fill a deep ice-pick scar or flatten a keloid. Consultation should examine the skin in good lighting and agree which feature is being treated.
Control active acne first
Treating old scars while new inflamed spots continue to form does not address the cause of further scarring. The NHS advises seeking medical help when acne is deep, painful or causing scars. Active infection, inflamed cysts or broken skin may also make an elective injectable appointment unsuitable until the skin has settled.
A scar plan should therefore include acne treatment, skincare, sun protection and the risk of new scars. Polynucleotides are not an acne medicine and should not replace appropriate GP or dermatology care. Picking or squeezing spots can increase scarring and should be avoided.
What has been studied?
A small double-blind randomised study compared a highly purified polynucleotide formulation with saline for moderate-to-severe atrophic acne scars. It included only 20 women aged 30 to 50, with two sessions three weeks apart and follow-up to three months. The reported scar scores improved more in the treatment group.
That result is encouraging, but it is not proof that every product, dose, technique or scar type will respond. The participants had not had active acne for five years, so the findings should not be transferred directly to someone with ongoing breakouts. The small, narrow sample also limits predictions about individual benefit or durability.
The wider evidence remains developing
A 2025 systematic review of aesthetic polynucleotide treatment found nine studies and 219 participants across several indications. It judged the overall evidence low to moderate quality because studies were small and used varied products, areas, schedules and outcome measures. A 2026 review of randomised trials similarly called for larger, adequately powered studies.
Newer observational research may add useful information, but a study without a comparison group cannot show how much change came from the injection, natural variation, other treatment components or the way results were assessed. ‘Regenerative’ language describes a proposed approach; it does not guarantee complete scar removal.
Expect a plan, not one universal procedure
Scar treatment is often individualised. Depending on scar type, depth, skin tone, active acne and previous treatment, alternatives or staged options may be more appropriate. Combining procedures is not automatically better: it can add downtime, cost and risk, and makes it harder to identify which part produced a change or adverse effect.
Progress should be judged after early swelling has resolved, using consistent photographs and an agreed scar measure where possible. Temporary plumping immediately after injection is not evidence that a depression has been permanently corrected. A subtle improvement may still leave a visible scar, and some people may see little change.
Downtime, risks and suitability
Expected short-term effects include raised injection points, redness, tenderness, swelling and bruising. Less common problems may include infection, inflammation, persistent lumps, pigment change or an allergic reaction. Seek prompt clinical advice for increasing pain, heat, spreading redness, discharge, fever, marked swelling or unusual skin colour; urgent symptoms need urgent medical help.
Pregnancy or breastfeeding, relevant allergies, medicines affecting bleeding, active skin disease, autoimmune or wound-healing conditions, previous keloid formation and earlier injectable reactions require individual discussion. The exact product and its instructions also matter. A face-to-face consultation should explain realistic limits, alternatives, aftercare and access to review before treatment is agreed.