What is the typical protocol for Rejuran Healer (polynucleotide) treatment?

Rejuran Healer (Polynucleotide) Treatment Protocol

The standard protocol for Rejuran Healer involves 3-4 treatment sessions spaced 2-4 weeks apart, with intradermal injections of 2 mL per session distributed across multiple points in the treatment area, though evidence quality remains limited and no formal guidelines exist for this aesthetic indication. 1

Treatment Sessions and Timing

• Initial treatment cycle: 3 sessions at 2-3 week intervals is the most commonly reported protocol 1
• Some protocols extend to 4 sessions with 2-week intervals between each treatment 2
• A consensus of aesthetic medicine experts (>80% agreement) recommends 3 treatment sessions for facial rejuvenation 1

Injection Technique and Dosage

• Volume per session: 2 mL is the standard dose for facial treatment 1, 3
• Injection method: Multiple intradermal injection points using approximately 0.05 mL per point 2
• For full face treatment, approximately 40 injection points per side (one cheek) have been used 2
• The product should be injected into the dermis, not subcutaneously 1

Specific Treatment Areas

Face (General)

• 2 mL per session distributed across treatment area 3
• 3 sessions at 2-3 week intervals 1
• Consensus recommendation achieved for facial application 1

Periocular Area

• Requires supplemental formulation (7.5 mg/mL concentration) when treating eyelids and periocular regions 3
• 3 injections with 2-week intervals showed efficacy and safety 4
• Consensus recommendation (>80% agreement) achieved for this area 1

Neck and Décolleté

• Consensus recommendations exist but specific volumes not detailed in available evidence 1

Hands and Scalp

• Consensus recommendations achieved but protocols less well-defined 1

Product Concentrations

• Standard facial formulation: 10-20 mg/mL polynucleotide concentration 3
• Periocular formulation: 7.5 mg/mL (lower concentration for delicate areas) 3
• Products may contain additional components like hyaluronic acid (10 mg/mL) and mannitol (200 mM) 3

Expected Outcomes by Age and Concern

• Patients in their 30s: Expect improvements primarily in pore size and skin thickness 2
• Patients in their 40s: Expect improvements in skin tone, melanin distribution, wrinkles, and sagging 2
• Skin elasticity and hydration improvements decrease over time but remain higher than baseline 4
• Roughness and pore volume show sustained improvement 4

Maintenance Protocol

• No standardized maintenance protocol exists in the literature reviewed
• The consensus report suggests repeat treatment cycles may be needed but does not specify intervals 1
• Effects on elasticity and hydration diminish over time, suggesting periodic retreatment 4

Critical Clinical Caveats

Important limitation: While polynucleotide products are used for aesthetic skin rejuvenation, the evidence base consists primarily of small studies without robust controls 2, 4, 3. The IWGDF 2023 guidelines specifically recommend against PDRN (a related polynucleotide product) for diabetic foot ulcers due to poor quality evidence, highlighting concerns about polynucleotide research methodology in general 5.

• No serious adverse events reported in aesthetic applications 2, 4
• Minor side effects may include temporary injection-site reactions 4
• Cost-effectiveness data are lacking for aesthetic polynucleotide treatments 5
• Most supporting studies have small sample sizes and lack intention-to-treat analysis 5

Common Pitfalls to Avoid

• Do not use single-session protocols: Multiple sessions are required for optimal results; single treatments show insufficient efficacy 1
• Do not inject too superficially: The product must reach the dermal layer for biostimulatory effects 1
• Do not use standard facial concentration in periocular area: Use the lower concentration (7.5 mg/mL) formulation for delicate periocular and eyelid regions 3
• Do not expect immediate volumizing effects: Polynucleotides work through biostimulation and tissue regeneration, not volume replacement like traditional fillers 1
• Do not assume evidence quality is high: The aesthetic polynucleotide literature suffers from methodological limitations similar to other polynucleotide applications 5