Polynucleotides — PDRN (polydeoxyribonucleotide) and PN — are injectable fragments of highly purified DNA, extracted from salmon and stripped of all protein, whose structure is about 95% similar to human DNA. Injected into the skin, they bind to A2A receptors — the repair switches on collagen-making cells, blood-vessel cells and immune cells and switch on the body’s own repair programme: fibroblasts multiply and produce collagen and elastin, chronic low-grade inflammation is dampened, new microcirculation forms and damaged cells repair their DNA. This is a genuinely different mechanism from hyaluronic-acid injectables — fillers add volume, Profhilo and Sunekos work in the space between cells, polynucleotides work on the cells. It is why they succeed for vascular under-eye dark circles, reactive or damaged skin and thinning hair where HA products fall short. A course of three to four sessions 2–4 weeks apart produces results from 2–4 weeks, peaking 4–8 weeks after the course and lasting up to 12 months. At Medisha Clinic every session is performed by Dr Nish Shah MD using The Medisha Method.

At Medisha Clinic in Mayfair a single polynucleotide session is £350, a course of three is £950 and a course of four is £1,295. PDRN scalp treatment for hair is priced on assessment. Consultation with Dr Nish is £50, redeemable in full against treatment, so if you go ahead it costs nothing. A course review is included. The clinic is at 58 South Molton Street, Mayfair, London W1K 5SL, three minutes from Bond Street station.

They are the most effective injectable for one specific type: vascular dark circles, where thin, translucent under-eye skin shows the blue-purple of the vessels beneath. The kind that look worse when you are tired and improve slightly when you gently stretch the skin. Polynucleotides thicken that skin through cellular regeneration and calm the vascular congestion, so the vessels show through less and the area lightens — without adding any volume, so there is no risk of puffiness. They help only partly with structural dark circles (a shadow cast by a hollow tear trough), where filler is the treatment, and not at all with pigmented dark circles (melanin), which need pigment treatments. Most patients have a mix, which is why Dr Nish diagnoses the cause at consultation before recommending anything — step one of The Medisha Method, and often sequences tear-trough filler first with polynucleotides four weeks later.

Three to four, spaced 2–4 weeks apart. Polynucleotides work by prompting cells to repair and multiply, and that response builds with repetition: one session produces a modest improvement, three produce the visible change under the eyes and on the face that patients are looking for, and four are recommended for more pronounced dark circles or damaged skin. For the scalp, four to six sessions are usual. After the course, a single maintenance session every six to twelve months sustains the result. At Medisha the response is photographed and reviewed at each visit, so you are never asked to have a session you do not nee

Results are gradual and cumulative, which is what you would expect from a treatment that works by cellular repair rather than by adding something. The first change — calmer, better-hydrated, slightly smoother skin — appears around 2–4 weeks after the first session. Under the eyes, lightening usually becomes visible after the second or third session. Peak improvement arrives 4–8 weeks after the final session of the course, when the new collagen and microcirculation have matured. That is when your review photographs are taken. Results last up to twelve months, and one maintenance session every 6–12 months holds them.

All three improve skin quality and all three are performed by Dr Nish, but they work by different mechanisms and suit different skin. Profhilo is ultra-pure hyaluronic acid that spreads through the dermis, hydrating intensely and triggering bio-remodelling — best for sagging and dehydration. Sunekos is HA with six amino acids that fibroblasts use directly to build collagen and elastin — best for crepey texture, fine lines and thin under-eye skin. Polynucleotides are DNA fragments that act on the cells themselves via the cells’ A2A repair switches — best for vascular dark circles, reactive or damaged skin and hair, and the only one with a genuine anti-inflammatory action. Under the eyes, polynucleotides with Sunekos Performa is Dr Nish’s standard programme. On the face, Profhilo then Sunekos because he performs all three, his recommendation is based on your skin rather than on what he sells.

Yes. The polynucleotides used in aesthetic medicine are extensively purified to remove every protein. It is proteins, not DNA fragments, that cause fish allergy — leaving only nucleotide chains that the body recognises and metabolises normally. PDRN has been used in wound-healing medicine for over thirty years with an excellent safety record, and the products Dr Nish uses are CE-marked and medical grade. The one sensible precaution is that patients with a known fish or seafood allergy should disclose it at consultation. In that situation Dr Nish will usually recommend an alternative regenerative treatment rather than take even a theoretical risk. Vegetarian and vegan patients should also be aware of the salmon origin.

Very little. Immediately afterwards you will have small bumps at each injection point, which flatten within 6–24 hours, and mild redness for a day or two. Under the eyes, slight puffiness for a day and occasional pinpoint bruising for up to a week can occur — sleeping with your head slightly raised the first night helps. Most patients go straight back to work. For 24–48 hours avoid make-up on the area (12 hours), rubbing the eyes or massaging the points, strenuous exercise, saunas, sunbeds, alcohol and active skincare. There is no restriction on flying or normal activitie

Yes — PDRN scalp injections are one of the best-evidenced non-surgical treatments for early to moderate hair thinning, including androgenetic (pattern) hair loss and diffuse shedding. The same A2A repair mechanism that repairs skin improves the environment around the hair follicle: inflammation is reduced, blood supply to the follicle increases and follicles shrinking. The process by which each successive hair grows finer and shorter — slows. Published studies show measurable increases in hair density and shaft thickness maintained at twelve months. A course of four to six sessions 2–4 weeks apart is usual, often combined with a medical hair-loss regimen. Dr Nish assesses the pattern and stage of hair loss at consultation; PDRN is not a treatment for advanced baldness.

Yes, and the best results at Medisha usually come from a planned combination based on the diagnosis. Polynucleotides with Sunekos Performa addresses vascular dark circles and thin skin together — Dr Nish’s standard under-eye programme. Tear-trough filler first, then polynucleotides four weeks later, treats a structural hollow and the vascular component in sequence. Polynucleotides with Profhilo pairs cellular repair with deep hydration on the face and neck. Polynucleotides before and after laser or resurfacing prime the skin and speed recovery. Different injectables are usually spaced 2–4 weeks apart so each can be assessed; Dr Nish will design the sequence at consultation.

Polynucleotides have an excellent safety record built over thirty years of medical use. Expected, temporary effects are small bumps for up to 24 hours, mild redness for 24–48 hours, slight under-eye puffiness for a day and occasional bruising for up to a week. Uncommon effects include small bumps persisting for several days (usually from placement that is too superficial — avoided by correct depth), transient swelling and, rarely, infection at an injection point. Allergic reaction is very rare because the product is protein-free, but a fish allergy history is taken at consultation as a precaution because polynucleotides are placed into the skin in tiny volumes and add no bulk, the vascular complications associated with dermal filler do not apply in the same way. All risks are discussed at consultation and every session is performed by a medically trained doctor.

Because polynucleotides only work when injected for the right reason, and Dr Nish diagnoses before he treats. He is a medically trained doctor, Senior International Clinical Trainer at Derma Medical, Official UK Trainer for Sunekos, and Brand Ambassador and Key Opinion Leader for dermal fillers with a global manufacturer. He performs every polynucleotide session himself using The Medisha Method: establishing whether your dark circles are vascular, structural or pigment. Choosing the product and depth for the area, and reviewing the response at every visit because he also performs tear-trough filler, Sunekos and Profhilo, he will recommend polynucleotides when they will work and something else when they will not. Course of three £950; £50 consultation redeemable. 58 South Molton Street, Mayfair, London W1K 5SL, three minutes from Bond Street. Also Marylebone.