Prospective Observational Study of Polynucleotide Injections for Periorbital Rhytides

INTRODUCTION: Polynucleotides (PN), derived from salmon sperm DNA, are highly purified DNA fragments with reported tissue-repair and anti-inflammatory properties mediated through adenosine A2A receptor activation. These agents have been increasingly used in aesthetic dermatology for skin rejuvenation and scar treatment. This study aimed to evaluate longitudinal changes in periorbital appearance and patient-reported outcomes following intradermal polynucleotide injections. METHODS: This prospective observational case series included patients presenting for undereye rejuvenation who received intradermal injections of absorbable polynucleotides (7.5 mg/mL; Pluryal Silk, MD Skin Solutions, Luxembourg), with a total volume of 2 mL per session. Outcomes were assessed using validated FACE-Q patient-reported questionnaires at baseline and at 1, 3, and 6 months following treatment. Adverse events were assessed 2 days after each treatment session. Statistical analysis was performed using paired t-tests. RESULTS: Forty-two patients were included. Significant improvements in lower eyelid and crow's feet appraisal scores were observed at all follow-up time points compared with baseline (p < 0.001). The greatest improvements and highest patient satisfaction were observed at 3 months following two treatment sessions. Reported adverse events were minimal. CONCLUSION: In this prospective observational cohort, intradermal polynucleotide injections were associated with improvements in periorbital appearance and patient-reported satisfaction over baseline, with minimal adverse events. These findings support further controlled studies to confirm efficacy and refine treatment protocols.