Gouri / Polycaprolactone


Best used: Biostimulator, collagen stimulatorCaution: Realistic expectationsBest for: Anti-aging anti-wrinkles, collagen production
Comments: Stimulates collagen without addition of volumeMode of action: Polynucleotide stimulates cells to produce collagenScience Score:


What is Rejuran?

This new injectable is available in Australia in 2023. Rejuran is- 

• A polynucleotide DNA derived injectable that is non-hyaluronic acid based

•  A bio-remodelling injectable, i.e., stimulates your own body to produce collagen

What is the clinical indication of Rejuran?

Polynucleotides are long chains of amino acids that are naturally found in your body. They are expressed in the skin where they play important roles in skin health. Injections are designed to provide cellular remodelling addressing –

• Collagen stimulation
•  Slowing down the aging process
Treatment of lines, wrinkles, pores & textural changes
Hydration of skin (though Profhilo is better at this)
• Reduction of acne scars

How long before I see results?

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

Davin’s viewpoint on polynucleotide/Rejuran injectables

This novel salmon sperm derived polynucleotide is new for Australia as of 2023, however it has been used extensively in Asian countries since 2015. Whilst Australian dermatologists are still learning about this bio remodelling injectable & where it sits in the arena of biostimulators, my overseas colleagues have a dearth of experience in its use. 

Collagen stimulating injectables & low-level energy devices can be useful for low level biostimulation. The concept is as follows-

Fibroblasts can be modulated by low levels of stimulation. These include injectables such as PLLA (Sculptra), CAH (Radiesse), PLC (Gouri & Ellanse) as well as HAs (Profhilo). More on these later. They can also be activated by low level multipass low heating of skin, namely radiofrequency. AHA peels in higher concentration are also a low to moderate level biostimulator as opposed to AHA skin care which acts like an exfoliant. Microneedling is also classed as a low level biostimulator. Fluffy stuff like retinol, retinoids, & microcurrent are very low level biostimulators, however they can play a role in a home-based routine. 

So, once we establish the role of Rejuran as a low level injectable biostimulator, where does it fit into the treatment algorithm in Australia (given the limited amount of biostimulators we have)? Here is my take on things- 

  • Hydration biased bio remodelling. Profhilo.
  • Volume based bio remodelling. Sculptra or Radiesse.
  • Collagen stimulation-fibrosis biased bio remodelling. Gouri, Ellanse or Rejuran.

In the real world there is an overlap with hydration, volume & fibrosis. What is universal however is fibrosis or neocollagenesis (collagen formation), hence everyone in their late 20s onwards (as collagen depletion starts in the early 20s), will benefit from one, or a combination of the 3 injectables, namely PLLA, CAH or polynucleotides. The other injectables are selected based on the clinical features of the patient; namely the degree of volume replacement required & or tissue hydration. 

High level biostimulators are combined with low level biostimulation when there are concerns to correct. For example, for cases of laxity around the eyes, a combination may look like this-

  • Low level biostimulation. Rejuran + Profhilo (avoid malar oedema), 1-2 times a year.
  • High level biostimulation. RF microneedling or CO2 laser.
  • Maintain low level biostimulation. Rejuran.

Skin rejuvenation is not about one therapy (monotherapy). It is about a combination of treatments that are universally beneficial (biostimulation), coupled with specific modalities based upon clinical examination of the patient. 

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