Rejuran
| Best used: Biostimulator, collagen stimulator | Caution: Realistic expectations | Best for: Anti-aging anti-wrinkles, collagen production |
| Comments: Stimulates collagen without addition of volume | Mode of action: Polynucleotide stimulates cells to produce collagen | Science 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.
View our Treatment Gallery
How many treatments will I need?
Most patients will benefit from 3 Rejuran sessions one month apart. If you have significant skin concerns such as deep wrinkles, sun damage & skin laxity a fourth treatment may be beneficial.
1-2 sessions are required every year to top up your collagen levels, via continued stimulation of fibroblasts (collagen producing cells).
How long does treatment take & is it painful?
Each treatment session takes between 10 to 15 minutes to perform. We use numbing gel for 30 minutes prior to Rejuran injections as this markedly reduces discomfort.
Jessner TCA peel, one session
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👉This is a medium depth peel. Occasionally I prep with retinoic acid beforehand, but thin skin like this patient, RA is not needed. I scrub with acetone, then coat with 2-4 layers of Jesser. I then have a cup of coffee then come back to finish off with TCA at 35%
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😁Was having a friendly banter with my mentor & close friend @aprofphilipbekhor last night. Peels vs lasers. Why do I like peels? My chill out time. No loud noises apart from the patient's muffled screams 😱😱(joking). Despite the tech of lasers, I still like looking carefully at end points from peels. It is tactile, much like driving a manual car vs an automatic. Sure the latter is easier, but sometimes it’s the challenge to get the downshift perfectly matched, or the epidermis so evenly gray that the entire sheet slides from the dermis. It’s old school cool
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👊🏻Disclaimer: You do need to watch your peel patients more closely cf. NA laser patients, that is fact💯
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😎Davin Lim
Dermatologist
Brisbane🇦🇺
#tca #jessner #jessnertca #chemicalpeels #dermatologist #dermatology #drdavinlim #skinrejuvenation
TCA peels are a simple way to rejuvenate skin. This picture is over a decade old, but I still enjoy peels over lasers (more tactile). It’ much like driving a older vintage car, it’s slower to get to your destination but the drive is more enjoyable🚘
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🔬Skin science: TCA can be applied as a superficial, medium (most common) & deep peel. In this case I employed it as a medium depth peel, to the upper papillary dermis. In some cases I combine it with Jessner for deeper penetration
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👉Downtime: 5- 8 days depending on the strength and coats
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😢Pain: Tolerable with topical application of numbing and skin cooling. I do give oral conscious sedation if deeper peeling
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👍🏻Good for: Skin type 1-2+, pigment, freckles, sun damage, solar keratosis, mild to moderate wrinkles, lentigos/ age spots
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👎🏼Not good for: Darker skin, deep wrinkles, melasma
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😎Davin Lim
Dermatologist
Brisbane🇦🇺
#chemcialpeels #TCApeel #jessner #jessnerTCA #skinrejuvenation #skinlightening #skinbrightening #davinlim #dermatology #skinscience
What is the recovery following Rejuran injections?
1-2 days. Unlike Profhilo injections with only 10 injection points to the entire face, Rejuran injections are scattered between 1-1.5 cm apart. Expect 40-60 blebs that usually last between 12 to 36 hours.
Firm massage 24 hours after injections can reduce healing time. My advice? Have this procedure done on a Friday afternoon or Saturday morning & you will be fine for Monday.
Will biostimulatory injectables give firmer lifted skin?
That’s the aim of injectables, however results are highly variable. The primary aim of biostimulation is to keep your collagen producing cells awake & active. Some patients will have better results than others. Polynucleotides are employed to reduce-
How is Rejuran different from Profhilo?
Profhilo is the latest multi-purpose hyaluronic acid injectable treatment for skin rejuvenation with more effects on skin hydration, followed by collagen stimulation & lastly volume replacement (minimal compared to true hyaluronic acid dermal fillers).
Profhilo injection has a maximum of 10 points for the entire face to deliver its benefits. With lesser injection points, there is reduced discomfort & downtime compared to Rejuran.
Learn more about Profhilo.
Where can Rejuran be used?
This dermal injection is typically used on the face, with off label injections on the neck. Unlike Profhilo injections, we can go closer to the eyelids to treat crow’s feet, fine lines, dark circles & shadows.
What age should I consider collagen stimulating injectables?
Though biostimulators can be used at any age after 20, they are best served in the late 20s & beyond.
*Collagen levels begin to decrease by 1% annually after the age of 20. It would be sensible to consider low level biostimulation in the mid to late 20s.
What is the difference between Rejuran Healer & HA dermal fillers?
Traditional dermal fillers replace volume from both collagen & fat depletion. Volume replacement provides a reproducible change in projection; hence they are useful in key areas such as the cheeks, lips, temples & jawline.
Rejuran provides minimal volume but concentrates its effects in the dermal layers of skin. Its primary role is to stimulate collagen producing cells known as fibroblast. In summary, not everyone will require HA dermal fillers for their skin, but anyone can benefit from polynucleotide/Rejuran. Biostimulation is universally advocated.
How does Rejuran compare to other collagen stimulating fillers?
Traditional fillers include PLLA – Sculptra & Radiesse or calcium hydroxyapatite. These agents provide collagen stimulation with variable increases in volume. This can be beneficial in patients with low facial volume; however, it is not for everyone.
The best injectables for collagen stimulation with minimal volume enhancement include PCL or polycaprolactone, and polynucleotide or Rejuran.
Dermal hydration is addressed with Profhilo & Skin Boosters.
What treatments can be combined with Rejuran?
My favourite combinations include-
Rejuran + Profhilo: Profhilo hydrates, whilst Rejuran polynucleotide provides collagen stimulation.
Rejuran + dermal fillers: Rejuran stimulates collagen, whilst dermal fillers address skin volume.
Rejuran + RF NuEra: This powerful combination of polynucleotide & skin tightening will increase the firmness of your skin. Downtime of 1-2 days.
Rejuran + Lasers: This combination is synergistic as it addresses collagen production. Downtime of 3-4 days.
What types of Rejuran are there?
This family of polynucleotides include the following variants. Most of these are TGA approved in Australia as of 2023.
- Rejuran: 2ml formulation of polynucleotide only.
- Rejuran HB: combination of polynucleotide + hyaluronic acid.
- Rejuran I: polynucleotide only. For eye rejuvenation including crow’s feet.
- Rejuran S: Highly concentrated polynucleotide for acne scar treatment
What is science behind polynucleotides & Rejuran?
Polynucleotides are naturally occurring molecules that are found throughout the human body. In the context of skin, they do three main functions-
- Stimulate fibroblasts to produce collagen. This exerts a powerful anti-aging effect & reduces photoaging, including fine lines & wrinkles.
- Antioxidant effects to protect further degradation of collagen & elastin.
- Provide hydration to optimize collagen production by cells.
How are polynucleotides made?
Polynucleotides are naturally sourced from…wait for it. Salmon or trout sperm, yes, it is true. The DNA is extracted from the gonads of fish, purified then injected. Whilst this sounds gross, Rejuran has a very long safety record, especially in Asia. It has been approved for use for nearly a decade in countries such as Korea & Singapore.
What are the potential side effects of polynucleotides?
Rejuran is composed of highly bio-compatible polynucleotide DNA fragments. Injection-related effects include:
- Redness of the skin
- Bumps immediately after an injection
- Itchiness
- Bruising
- Prolonged swelling
The effects are minimal and temporary, fading 1-3 days after treatment. Blood vessel occlusion, as seen in hyaluronic acid dermal fillers, are not seen with polynucleotide injections.
How would I know if Rejuran is right for me?
Book an appointment with our nurses or dermatologists. They will examine your skin & understand your goals. The key points we assess include-
- Degree of skin laxity
- Degree of volume deficit
- Degree of dermal hydration
From there we will provide you with recommendations on the suitable combinations based upon these 3 key factors. Read my comment below to understand the logic when it comes to biostimulatory injectables.
How does polynucleotide injections compare with retinol & prescription retinoids?
Injectables are going to win over topical creams as they provide better neocollagenesis & dermal hydration. In the context of polynucleotides, they are more potent stimulators of collagen, however work in a different mechanism compared to retinoids. Retinoids exert their effects via RAR or retinoid receptors.
In summary, combine both as they have synergistic effects.
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.
