Profhilo or Polynucleotides? How We Choose, and Where Sunekos Fits
Profhilo usually suits skin that has lost firmness and hydration across the face, neck or hands. Polynucleotides are where we lean when the skin is thin and crepey under the eyes, sun-damaged or acne-scarred. Sunekos sits between the two, for lost elasticity and fine lines, on the face and around the eyes.
None of the three adds volume or replaces filler or anti-wrinkle treatment, so if the real problem is a hollow, the honest answer is not a skin booster at all. Here is how we decide between them at our clinic in Reigate.
What each one actually is
All three prompt your own skin to repair rather than filling it. They differ in what is injected, and so in what each one is good at.
Profhilo is a high concentration of pure hyaluronic acid that is not cross-linked, so it spreads through the tissue rather than staying where it is placed, hydrating the skin and prompting it to make its own collagen and elastin. More on Profhilo in Reigate.
Polynucleotides are purified fragments of salmon-derived DNA in a gel, not hyaluronic acid. They act on the fibroblasts, the cells that make collagen and elastin, and calm inflammation in the tissue. We use Plinest and Vitaran. More on polynucleotides in Reigate.
Sunekos combines hyaluronic acid with six amino acids, the building blocks the skin uses to make collagen and elastin. It comes in a lighter strength for the eyes and fine lines and a stronger one for skin that has lost more elasticity. More on Sunekos in Reigate.
The short answer: which suits whom
The first question is whether the problem is the skin or the structure beneath it. If it is the skin, this is the broad rule we work to.
Profhilo
What it is: Non-cross-linked hyaluronic acid at a high concentration
Usually suits: Lost firmness and hydration on the face, neck, hands or décolletage
Typical course: 2 to 3 sessions, four weeks apart
Typically lasts: 9 to 12 months, longer with maintenance
From: £300 per session
Polynucleotides
What it is: Purified, salmon-derived DNA fragments in a gel (Plinest, Vitaran)
Usually suits: Thin, crepey under-eye skin, sun damage and acne scarring
Typical course: 3 sessions, a few weeks apart
Typically lasts: 9 to 12 months, longer with maintenance
From: £250 per session (eyes)
Sunekos
What it is: Hyaluronic acid with six amino acids
Usually suits: Lost elasticity and fine lines on the face; fine lines and crepiness around the eyes
Typical course: Usually 3 sessions, three to four weeks apart
Typically lasts: 9 to 12 months, longer with maintenance
From: £250 per session (eyes)
Some people suit one, some plans use two in sequence, and some people are better served by filler, or by nothing at all, in which case we will say so.
Who none of them suit. We do not treat anyone who is pregnant or breastfeeding, and we do not treat anyone under 18. Polynucleotides are derived from salmon, so we will not treat anyone with a known fish allergy; for Profhilo and Sunekos, a known reaction to hyaluronic acid products rules them out. An active skin infection, cold sore or inflamed acne in the area means waiting.
Under the eyes
This is where the choice matters most, because thin skin and a hollow can look alike and need opposite treatments.
A hollow between the lower eyelid and the cheek is a loss of support. It needs volume, which means tear trough filler or, in a good proportion of people, cheek filler first. No skin booster will fill it. Thin, crepey skin with fine lines is a skin problem, and filler placed into thin, poor-quality skin tends to show.
For the skin itself we use polynucleotides or Sunekos, each of which has its own eye treatment: polynucleotides when the skin is thin and crepey, sun-damaged or scarred, and Sunekos for fine lines and early crepiness. Where someone has both a hollow and thin skin, we usually address the hollow first and the quality of the skin after that.
Sun damage, texture and acne scarring
When the problem is the texture of the skin itself, polynucleotides are usually where we start: they work on the cells that make collagen, calm inflammation, and prompt the skin itself to repair. Profhilo suits skin that has lost firmness. Where the skin is sun-damaged or acne-scarred rather than lax, polynucleotides may be the better skin treatment, and where a face has both problems, the plan sometimes uses both.
For texture, pores and early scarring, microneedling, which works from the surface rather than by injection, is often the right starting point and pairs well with the injectable treatments. Our skin boosters page sets out every option, with a video of Dr Ashraf comparing all three.
Where Sunekos fits
Sunekos shares hyaluronic acid with Profhilo and a superficial, across-the-area technique with polynucleotides, and it sits between them. Where Profhilo hydrates and remodels, Sunekos is designed to give the fibroblasts the raw material to rebuild the skin's own support.
We use it in two ways: across the full face, for skin that has lost elasticity and picked up fine lines, and around the eyes, where a lighter product is needed and where fine lines, crepiness and dark circles are so often a skin problem rather than a volume one.
Compared with Profhilo, it suits elasticity and fine lines rather than firmness across a wider area such as the neck and hands. Compared with polynucleotides, it is the one we lean towards for fine lines and early crepiness rather than sun damage or scarring. Like both, it will not fill a hollow.
Courses, results and cost
How many sessions
All three are courses rather than one-off treatments.
Profhilo: two to three sessions, four weeks apart; most people have two.
Polynucleotides: usually three, a few weeks apart; some people need two, some four.
Sunekos: usually three, three to four weeks apart; some have two, some four.
When you will see a change, and how long it lasts
Results build rather than appear, because you are waiting for your own collagen rather than for a product. The first change, mostly hydration and texture, usually shows at around four weeks with Profhilo and polynucleotides, and a few weeks in with Sunekos. The full effect is around three months after the course.
Results typically last nine to twelve months, and longer with maintenance: a single session when the effect begins to fade, which for polynucleotides is usually once or twice a year. Results are individual.
What it costs
Profhilo is £300 for one session, £550 for two and £800 for three, and one session covers the face, neck, hands and décolletage. Polynucleotides are £250 a session for the eyes (£700 for three) and £500 for the full face (£1,300 for three). Sunekos is £250 a session for the eyes (£700 for three) and £500 for the full face (£950 for two, £1,350 for three). Every price is on our pricing page.
Can you combine them?
Yes. Some plans use two skin boosters in sequence, and pairing a booster with filler or anti-wrinkle treatment is often the right plan, because skin boosters treat the skin, filler treats structure and anti-wrinkle treatment treats expression lines. The order and spacing are decided at your consultation. The booster-or-filler question has its own article: Skin boosters or dermal fillers? How we decide which you need.
How we decide at your consultation
Every appointment starts with a consultation with Dr Haroon Ashraf, a GMC-registered doctor who injects full time and carries out every treatment himself. He is a senior clinical trainer at Derma Medical and has trained over 1,000 doctors, dentists and nurses in injectable technique and complication management.
We assess skin quality separately from structure: texture, hydration and firmness, how the skin recoils, any sun damage or scarring and, under the eyes, whether there is a true hollow. Then we tell you which treatment we would choose and why, even when it is not the one you came in asking about. There is no obligation to book a course on the day. Book a consultation and we will work through it with you.
Questions we're asked
Do I need to know which one I want before I book?
No. Profhilo is the skin booster we are asked for by name more than any other, but the name you arrive with is a starting point rather than a decision. You can book an in-person or video consultation online, and if you are considering more than one treatment, one appointment slot is enough.
I have a fish allergy. What can I have instead of polynucleotides?
We will not treat anyone with a known fish allergy with polynucleotides, because Plinest and Vitaran are derived from salmon DNA, and the medical questionnaire asks about it specifically. Sunekos also improves thin, crepey skin around the eyes without adding volume, and Profhilo treats lost firmness across the face, neck and hands, so either may be worth discussing. Both are hyaluronic acid products, so a known reaction to hyaluronic acid rules them out.
I have an event coming up. Which one should I choose?
Let your skin decide, but plan the timing. Each is a course, and the full effect is around three months after the last session, so start well ahead. Small bumps are significantly less visible after the first 24 hours, but a bruise, particularly around the eyes, can take up to a week to fade, so leave a week between a session and the event.
What are the risks, and do they differ between the three?
All three are medical procedures and carry medical risk: less than filler, but not none. Common and expected are small bumps at the injection points for a few hours to a day or two, redness, tenderness and bruising, which is more likely around the eyes. Less commonly, swelling or bumps take a few days to settle, or bruising is more pronounced. Rare but serious risks are infection and a reaction to the product. The main difference is the source: polynucleotides are derived from fish, so we screen for fish allergy.