Rejuran

Rejuran, an injectable skin treatment, significantly enhances skin texture, diminishes pigmentation, and targets concerns such as enlarged pores, scars, and fine lines/wrinkles. Unlike volumizing treatments, Rejuran doesn’t add volume. Optimal results are achieved through a series of three sessions, spaced four weeks apart. It’s the preferred injectable for achieving glass skin, reducing pigmentation as well as pigmented acne scars.

Benefits

Anti-pigment, anti-wrinkle, scar treatment

When to use

Once a month injections

Works with

Exosomes, pico laser

Caution with

Well tolerated

Treatment science scoremelasma clinic

What is Rejuran?

Rejuran is a DNA derived injectable. It is-

  • A polynucleotide that is non-hyaluronic acid based
  • A bio-remodelling injectable, ie. stimulates your own body to produce collagen
  • A pigment inhibitor 
  • A scar remodeler

 

What is the science behind Rejuran?

Rejuran works by –

  1. Increasing collagen production in the upper layers of skin, thus reducing pore size & fine wrinkles. 
  2. Improving the optical quality of skin, thus reflecting light to provide glowing skin. 

Reduces melanin production; thereby improving melasma & pigmentation.

What can Rejuran do for my skin?

Rejuran polynucleotide can-

  • Improve pigmentation including age & hormonal related melasma pigmentation.
  • Reduce fine lines & wrinkles.
  • Treat enlarged pores.
  • Improve skin quality & provide glowing skin.
  • Treat acne scars, especially pigmented scar types.

*Rejuran is best employed in combination with lasers, microneedling, topical creams & exosomes as it potentiates the collagen building properties of these treatments.

How good is it (really)?

It’s the best injectable to get you to glowing glass skin, seriously. Rejuran outperforms all the other injectables on the market. This Korean product can get you as close to glass skin as possible, namely flawless, poreless skin, void of pigmentation, blotches & imprections. 

*Best combined with pico lasers, skin care products & exosomes.

How does Rejuran compare with other melasma/pigment treatments?

Rejuran is not the first line treatment for melasma or other forms of pigmentation, however it is useful as an adjunctive treatment, namely combined with medical grade skin care, lasers & chemical peels. Here are the Rejuran combinations that our clinic employs-

  • Rejuran with pigment correctors; best for melasma pigmentation
  • Rejuran & novel chemical peels
  • Rejuran & pico laser as part of the Glow Series

What is the Glow Series & what is the science behind it?

The Glow Series pairs pico laser resurfacing with Rejuran polynucleotide injectables in the one session. Fractional laser treatment removes pigmentation, improves skin quality & stimulates collagen. Rejuran amplifies the results of laser & accelerates the healing from laser. The Glow Series is ideal for patients with-

  • Pigmentation
  • Fine lines & wrinkles
  • Sun damage
  • Aging skin 
  • Preventative against aging  

How many treatments are required?

For improvement in melasma pigment & skin rejuvenation 3 Rejuran sessions are performed, spaced 4 to 8 weeks apart. 

For upkeep & skin maintenance, 1-2 sessions are required annually. 

When will I see the results?

Results can be seen as early as the first three weeks, however it takes 3-6 months for maximal collagen remodelling to occur.

How long does Rejuran injections take & is it painful?

Each treatment session takes 15 minutes to perform. We use numbing gel for 45 minutes prior to Rejuran injections in addition to chilling the skin. This combination reduces discomfort.

What is the recovery following Rejuran injections?

Recovery is proportional to the depth of injection. With very superficial injections, it can take up to 48 hours for blebs to settle. Massage 24 hours after injections can reduce healing time. 

Deeper injections have less healing time- less than 12 hours. For melasma & pigment treatment, the placement is superficial, hence we often time these injections on a Friday or Saturday.

How good is it for melasma pigmentation?

Our clinicians do not employ Rejuran as a standalone treatment for melasma. As a stand alone injectable the positive outcomes are approximately 25%. 

Used in conjunction with skincare actives & pigment lasers, Rejuran success rates of up to 85% can be achieved. In our practice we employ this injectable as the second step in melasma treatment, namely to remodel the dermis, address aging cells, & build up the integrity of the basement membrane. A series of 3 injectable sessions are required, typically spaced one month apart.

Can Rejuran be used to treat other forms of pigmentation?

Rejuran PN & PDRN can also be employed to treat post-inflammatory hyperpigmentation due to acne & other causes. Much like melasma treatment, Rejuran is best combined with lasers, prescriptive skin care & or chemical peels for the best long term results. 

Rejuran is a powerful molecule used to treat certain forms of scarring, including superficial acne scars (boxcar scars, shallow rolling & atrophic scars). It is the injectable of choice for post-inflammatory hyperpigmentation due to acne; or Grade 1 acne scarring. 

Typically 3 injections are required, spaced 4 to 6 weeks apart. 

How does Rejuran compare with volumizing treatments?

Conventional volumizing treatments address volume loss stemming from bone loss, collagen and fat depletion, offering predictable enhancements in areas like the cheeks, lips, temples, and jawline. These are placed in the deeper layers of skin. They are designed to project & enhance. HA’s have minimal effect on pigmentation & skin quality when placed in the deeper layers of skin. Superficially placed hyaluronic acid, known as skin boosters, are different (see below). 

Rejuran focuses on stimulating collagen-producing fibroblast cells within the dermal layers, rather than providing significant volume. They also modulate pigmentation production & provide a scaffold for skin rejuvenation. 

In essence, while not everyone may need volumizing treatments, polynucleotide treatments like Rejuran offer benefits to all, emphasizing the universal recommendation for biostimulation & improvements in skin quality. 

A simple analogy is this- think of a car door with ‘dings’ from an accident. Rejuran is akin to a cut & polish, removing surface rust, mud, grime & surface scratches. In an aging car that has seen its fair share of shopping trolley accidents, the best restorations come with sorting out the digs & treating the paintwork. Aging patients will benefit from both volumizing treatments (volume loss) & skin quality improvements with Rejuran.

How does Rejuran compare with skin boosters?

Skin boosters are composed of non-cross linked lightweight hyaluronic acid molecules. Their placement is similar in depth to Rejuran, however their role is very different. HA molecules are known for their hydrophilic properties, namely they attract water (up to 1000 times their weight). Skin boosters are great for tissue hydration. 

Rejuran on the other hand improves the optical properties of skin, without adding volume. Their structure enhances the natural repair processes of skin, optimizing skin quality & light reflection. 

How does Rejuran differ from Profhilo HA injectables?

Profhilo is a HA based injectable that is best for dermal hydration. It has more biostimulatory potential than skin boosters due to its unique properties of high and low non-cross linked, heat stabilized hyaluronic acid molecules. 

Recovery from Profhilo is faster (about 6 to 12 hours), compared to Rejuran (48 hours). 

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How does Rejuran compare with retinol & tretinoin?

Injectables are poised to surpass topical tretinoin creams due to their superior ability to promote neocollagenesis, reduce unwanted pigmentation and enhance dermal hydration. Rejuran polynucleotides, in particular, exhibit stronger collagen-stimulating properties compared to retinoids, albeit through a different mechanism. Retinoids exert their influence via RAR or retinoid receptors. 

Rejuran on the other hand acts as a scaffold due to its unique 3D honeycomb lattice like structure. This enables collagen to ‘bind’ to this scaffold, in turn optiming volume & fibrosis. In essence, combining both treatments is recommended as they complement each other’s effects synergistically.

To date, there are no head to head comparisons of retinoids vs Rejuran PN when it comes to pigment reduction. 

What other treatments can be combined with Rejuran?

Our favorite combinations include-

Rejuran + HA injectables: Profhilo hydrates, whilst Rejuran polynucleotide provides collagen stimulation.

Rejuran + Exosomes: This powerful combination of polynucleotide & exosomes can reduce pigmentation & improve skin quality. 

Rejuran + Pico lasers: This combination is synergistic as it addresses collagen production whilst reducing skin pigmentation. 

What types of Rejuran are there in Australia?

This family of polynucleotides include the following variants. 

  • Rejuvan Healer: 2ml formulation of polynucleotide only. Most popular.  
  • Rejuvan HB: combination of polynucleotide + hyaluronic acid, coming to Australia in 2024. Provides hydration & collagen stimulation. 
  • Rejuvan I: For the eye area. 
  • Rejuvan S: Highly concentrated polynucleotide comes as a one ml syringe with higher viscosity. Used for scars.

What are the side effects of Rejuran?

This injectable consists of highly biocompatible polynucleotide DNA fragments. The safety record spans over a decade (though Australia has TGA approval for only one year). Potential side effects are extremely rare & include; redness of the injected skin (2-10 hours), persistent lumps & bumps lasting 3-5 days (less than 0.1%), bruising, swelling & tenderness. 

Blood vessel occlusion leading to blindness (as seen in certain volumizing treatments), are not reported with Rejuran injections. To date there are no delayed nodule reactions (as of 2024) reported in Australia. 

What is the science behind polynucleotides & melanin production?

PDRN significantly inhibits melanin synthesis by reducing the activity of tyrosinase (an enzyme responsible for pigment). It does so in a dose-dependent manner. 

Tyrosinase converts tyrosine to dopaquinone, is the main enzyme involved in the rate-limiting step of tyrosine metabolism. 

In another study, the inhibitory effect of PDRN on melanin production was determined in Mel-Ab cells. The suppression of melanogenesis occurs through the inhibition of melanogenic gene expression & enzyme activity.

Davin’s viewpoint on Rejuran for skin rejuvenation & pigmentation

Dr Davin Lim | Dermatologist
The Melasma Clinic, Brisbane | Sydney

This innovative polynucleotide derived from salmon sperm has recently made its debut in Australia in 2024, although it has been extensively utilized in Asian countries since 2014. 

Injectable collagen stimulators and low-level energy devices serve as valuable tools for low-grade biostimulation. The principle behind this concept is as follows: Fibroblasts can be influenced by mild forms of stimulation. These include injectables like PLLA (Sculptra), CAH (Radiesse), PLC (Gouri & Ellanse), and HAs (Profhilo). Additionally, low-level multipass heating of the skin, such as with radiofrequency, can activate fibroblasts. AHA peels at higher concentrations also act as moderate-level biostimulators, distinct from AHA skincare, which primarily exfoliates. 

Microneedling is categorized as a low-level biostimulator. Their role in melasma & pigmentation is to increase the absorption of topicals such as vitamin C, arbutin & botanicals. In the context of biostimulation in patients with background pigmentation, microneedling & RF microneedling should be cautiously applied as it often makes pigmentation worse. 

In practice, there is often an interplay between hydration, volume, and fibrosis. Nonetheless, what remains consistent is fibrosis or neocollagenesis (collagen formation). Thus, individuals in their late 20s and beyond (as collagen depletion commences in the early 20s) can benefit from one or a combination of the three injectables: PLLA, CAH, or Rejuran.The selection of other injectables depends on the patient’s clinical presentation, particularly the extent of volume replenishment needed and tissue hydration & pigmentation. Traditional collagen stimulating injectables do not play a significant role in improving skin quality, despite what company marketing suggests (PLLA esp.). 

Skin rejuvenation isn’t about a singular therapy (monotherapy) but rather a blend of universally beneficial treatments (biostimulation) coupled with tailored modalities based on the patient’s clinical evaluation, taking into account the requirement for improvement of skin quality- reduction in background pigmentation. 

Comparison of the effects of polynucleotide and hyaluronic acid fillers on periocular rejuvenation: a randomized, double-blind, split-face trial

Ye Jin Lee 1, Hak Tae Kim 2, You Jin Lee 2, Seung Hwan Paik 2, Young Seon Moon 2, Woo Jin Lee 2, Sung Eun Chang 2, Mi Woo Lee, Jee Ho Choi 2, Joon Min Jung 2, Chong Hyun Won 2

Journal of Dermatolog Treat    2022; Feb 33(1) 254-260

Background: Filler injection has become an extremely popular method for facial skin rejuvenation, including the periorbital area. In recent years, new polynucleotide (PN)-containing filler products have been used for esthetic purposes.

Aim: We aimed to investigate the efficacy and safety of PN filler injection in the periorbital area.

Patients/methods: A total of 27 subjects were enrolled in this randomized, pair-matched, and active-controlled study. Each subject received filler injections thrice with two-week intervals, with a PN filler injection on one side and a non-crosslinked hyaluronic acid (HA) filler injection on the contralateral side of the periorbital area.

Results: Improvements in the visual analog scale and global esthetic improvement scale scores were not significantly different between the PN and HA groups. The improvement rates of skin elasticity and hydration decreased over time in both groups, with the PN group showing a higher improvement rate. The improvement rates of roughness and pore volume were higher in the PN group than in the HA group. The improvement rate of dermal density was not significantly different between the groups. No serious adverse events were reported.

Conclusion: The PN filler injection is effective and safe for periorbital rejuvenation.

Keywords: Polynucleotide; face; hyaluronic acid; rejuvenation.