By concern

Polynucleotides for Acne Scarring

Whether anything helps your acne scarring depends almost entirely on what kind of scarring you have, and that is a question most consultations skip past on the way to proposing a package.

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The short answer

What this treatment is

This page is more cautious than the others on this site, deliberately. Acne scarring is where regenerative injectables are most oversold, usually to people who have been dealing with their skin for years and are willing to keep paying for something that is not working.

The honest position: polynucleotides have a genuine role in treating acne scarring, and it is a supporting one. The treatments with the strongest evidence for scarring are resurfacing, whether laser or deep microneedling, and subcision for tethered scars. Polynucleotides improve the quality and healing of the tissue those treatments work on, which makes them a sensible companion and a poor solo purchase.

Anyone proposing a course of polynucleotides alone as the answer to established atrophic scarring is selling you the wrong thing.

Acne scarring at a glance during and after your session

Session timeAbout 30 minutes
CourseThree to four sessions
IntervalTwo to three weeks apart
Best usedAlongside resurfacing, not instead
DowntimeNone from this part of the plan
Result judgedAt three months

Areas treated

What's included

Improves the overall quality of the skin the scars sit in
Supports healing between resurfacing or subcision sessions
Reduces the background redness left behind by active acne
Helps shallow, soft-edged scarring more than deep scarring
Suits skin too reactive to tolerate aggressive resurfacing
Adds no downtime to a treatment plan that already has some

Boundaries of practice

What's not treated

Good practice means saying no when indicated:

Known allergy to fish, since the source material is salmon or trout
Pregnancy or breastfeeding, where no safety data exists for this treatment
Active skin infection, inflammation or an open wound in the area
Active autoimmune disease affecting the skin, without clinical advice first
Anticoagulant or antiplatelet therapy, which needs assessment before treating
A course of isotretinoin taken within the last six months

Patient journey

What to expect

Consultation & preparation

Stop fish oil, high-dose vitamin E and anti-inflammatory painkillers for a few days beforehand if your own doctor is content for you to, because each of them makes bruising more likely. Come with a list of what you have already had done and when, and the medicines you take. Describe what you dislike in your own words rather than naming a treatment, so the assessment starts from the problem.

During treatment

Scar type decides almost everything

Rolling scars are shallow with soft, sloping edges, giving skin an undulating look. They are tethered from below by fibrous bands. These respond best of the atrophic types, and best of all to subcision that releases the tether, with regenerative treatment supporting the healing afterwards.

Boxcar scars have sharp, defined vertical edges, like small craters. Improving skin quality softens their appearance somewhat but does not fill them. Resurfacing that ablates the edge is what changes these.

Ice pick scars are narrow and deep, extending well into the dermis. They respond to almost nothing injected. The treatments that work are focal: punch excision, or targeted chemical reconstruction of the scar.

Post-inflammatory redness and pigmentation is not scarring at all. It is the discolouration left after inflammation and much of it fades over months without treatment. It is regularly presented to patients as scarring, and treated as such at considerable cost.

Where polynucleotides genuinely contribute

Two things. First, they improve the condition of the tissue surrounding the scars: better hydrated, better vascularised, denser skin makes the scarring less conspicuous even when the scars themselves are unchanged, because there is less contrast between scar and surround.

Second, and more usefully, they support the healing response to the treatments that do the structural work. Resurfacing and subcision both rely on the skin rebuilding well afterwards, and skin that has been damaged by years of inflammation frequently does not. Polynucleotides given between sessions improve that.

They also matter for people whose skin is too reactive or too pigment-prone to tolerate aggressive resurfacing, where a gentler plan is the only realistic one. In that situation the expectation has to be set carefully, because the ceiling on what is achievable is genuinely lower.

What an honest plan looks like

It starts with the acne being controlled. Treating scarring while active acne continues is building on a moving foundation, and any practitioner who proceeds without addressing that is not thinking about your outcome.

It names your scar types rather than describing your skin generally, and it explains which treatment is aimed at which type.

It puts the structural treatment at the centre and positions anything regenerative as support.

And it gives a realistic ceiling. Meaningful improvement in acne scarring is measured in the fifty to seventy per cent range over a long plan, not in erasure. A consultation that promises clear skin is one to leave.

Aftercare

Leave holding a written plan that names the area, the number of sessions, the intervals between them and the total cost including any review. Read it somewhere other than the clinic. A fortnight between assessment and first treatment is the interval commonly recommended for elective cosmetic procedures, and nothing about this treatment is urgent enough to shorten it.

FAQ

Common
questions

Can polynucleotides alone fix my acne scars?

No, and a plan built on that premise is the wrong plan. The treatments with the strongest evidence for atrophic scarring are resurfacing and subcision. Polynucleotides improve the quality of the surrounding skin and support healing between those sessions, which makes them a useful companion rather than the main treatment.

Which type of acne scar responds best?

Shallow rolling scars with soft edges, particularly after subcision has released the tethering beneath them. Boxcar scars improve modestly. Ice pick scars, which are narrow and deep, respond to almost nothing injected and need focal treatments such as punch excision or targeted chemical reconstruction.

Are the red marks left by my acne actually scars?

Often not. Post-inflammatory redness and pigmentation is discolouration rather than a change in the skin surface, and a good deal of it fades over six to twelve months without any treatment. Run a finger over it: if the surface is smooth, it is discolouration and not a scar.

Should I treat scarring while my acne is still active?

No. Controlling the acne comes first, because new inflammation produces new scarring and undoes the work. Anyone willing to start a scarring plan while your acne is still breaking out is not prioritising your outcome, and it is a reasonable point on which to seek a second opinion.

How much improvement is realistic?

For established atrophic scarring, meaningful plans aim at roughly fifty to seventy per cent improvement over an extended course of several treatment types, not erasure. Anyone describing clear skin as the outcome is overselling. Ask what percentage improvement they expect and over how many months.

Get Started

Describe what you want changed.
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Polynucleotides Marylebone • UNTIL Marylebone, 1 Orchard Street, London W1H 6HJ

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