Nine studies, all rated low or moderate quality, covering 219 patients between them. Real signal, and nowhere near enough of it to conclude.
Not a filler — a regenerative treatment that repairs the skin from within, stimulating your own fibroblasts to rebuild quality, tone and hydration.
The market's own words. No brand is named, because the claim is the thing under examination and it belongs to dozens of them.
In adults with age-related skin laxity or under-eye hollowing, does a course of injected polynucleotides, compared with saline or with no treatment, improve instrument-measured skin elasticity or hydration at three months — in trials large enough and well enough conducted to conclude?
The same claim written as a proposition somebody could go and check: who, compared with what, measured how, over how long.
What kind of missing this is
Something was tested, but what was tested is not specified well enough for anyone to reproduce it — source, dose, concentration, particle, batch. The result belongs to one jar, not to a category.
Lampridou and colleagues, in the Journal of Cosmetic Dermatology in February 2025, ran a registered systematic review of polynucleotides in aesthetic medicine and found nine studies. Nine. Between them they cover 219 patients — fewer people than a single mid-sized trial of almost anything in mainstream dermatology.
The reviewers appraised quality using the Critical Appraisal Skills Programme checklists and describe the nine as being of low and moderate quality. Their conclusion is measured and worth quoting in full rather than paraphrasing into something harsher: polynucleotides offer promising potential in aesthetic medicine, however there is limited consensus regarding their optimal use, and rigorous, high-quality studies are essential to validate the effectiveness and safety of PN.
"Limited consensus regarding optimal use" is doing a lot of quiet work in that sentence. It means the nine studies are not nine attempts at the same thing. Concentration, molecular weight, injection depth, number of sessions and interval between them all vary, so the field has not converged on what the treatment is, let alone on whether it works. Pooling them gives you an impression rather than an effect size.
Which is a fair description of where this sits: a plausible mechanism, an accumulating set of small studies, and a treatment that has become widely commercially available considerably faster than it has become well characterised.
A randomised, saline-controlled trial in at least 150 adults, using one specified preparation at a stated concentration and molecular weight, on a fixed protocol of three sessions at three-week intervals, with endpoints measured by instrument at three and six months: cutometer elasticity, corneometer hydration, and blinded assessment of a validated skin-quality scale.
Saline rather than no-treatment, because injecting anything into skin produces a wound-healing response and the whole claim is about a wound-healing response. Without a needle in the control arm, the trial measures needles.
One preparation rather than "polynucleotides", because the next clinic needs to know whether they are buying the thing that was tested.
Two trials of that shape, agreeing, and this moves to Partially established. The narrower claim they would support — improved measured hydration and elasticity at three months for one named preparation — is not the claim in the brochure, and the entry would say so.
It does not mean polynucleotides do nothing. Nine studies found things. The finding of this entry is about the weight of that evidence, not its direction.
It does not mean the treatment is unsafe. The safety picture in the published studies is unremarkable, and the review appraises safety alongside effectiveness.
It does not mean people happy with their results are wrong about their own faces. They are usually right. What a happy patient cannot tell you is how much of the result belongs to the polynucleotides and how much to the several sessions of needling that delivered them.
And it does not mean this is the same conversation as exosomes, dermal filler, or skin boosters made of hyaluronic acid. Those are different substances with different literatures, and the industry's habit of grouping them under "regenerative" is precisely the habit that lets evidence migrate between them.
You are paying for a course, not a session — typically three, sometimes more, at a few hundred each, with maintenance implied and rarely quantified at the point of sale. Ask what the maintenance interval is before you agree to the first one, because the total is the actual price and it is almost never the number you were quoted.
What you are not paying for is a filler. That part of the marketing is accurate and it is worth understanding: there is no volume here, no immediate change in the mirror, and if you are expecting one you will be disappointed at the two-week mark and told to be patient. Whether there is anything else is what these nine studies could not settle.
The honest framing is that this is an early treatment being sold at the price of a mature one. If you can afford to find out and you understand that is what you are doing, that is a legitimate choice and I am not going to pretend otherwise. If the budget is one course of one thing, the treatments with a decade of controlled data behind them are the ones that get to charge like this.
Type and funding are stated because they change what a study is allowed to prove, and because a trial paid for by the company selling the thing is not disqualified — it is just not the same evidence as one that was not.