Rejuran®

The area around the eyes also known as the periorbital area is central to our face and the focus of others given its prominence and importance to facial expression. The periorbital area is also more challenging to treat including multiple safety concerns and risks with many other injectable products from anti wrinkle injections, other biostimulators to traditional dermal fillers.

Rejuran injection can also be administered in a more targeted way than many of our other traditional skin boosters. Traditional boosters such as those containing the glycosaminoglycan hyaluronic acid have been designed to spread more widely under the skin following injection (which is both desirable but can also be undesirable or a risk when it is called dermal filler migration). Such migration of other boosters and dermal fillers can be responsible for periorbital puffiness as can wrinkle relaxing injections when not appropriately targeted. The more limited migration of this product is taken advantage of to target skin areas including problem skin areas (such as the periorbital area or when injected directly into lines or wrinkles) areas of concern, injured skin areas or scars.

Rejuran Indications

• Prejuvenation or slowing and delaying skin changes associated with ageing
• Targeting problem skin areas such as periorbital skin affected by fine lines, wrinkles, dark circles (due to a thin collagen layer) and hallowness (minor hollowing)
• Targeting skin scars, particularly ‘atrophic’ or where there is collagen +/- fat loss

The biostimulation may be aimed to address:

• Reduce wrinkles & fine lines
• Dry & dull skin
• Enlarged pores
• Uneven skin tone
• Irregular skin texture
• Dark eye circles
• Sagging skin
• Acne scars (less severe atrophic or where loss of collagen +/- minor fat loss)

A key clinical use is also aimed at speeding and improving healing after energy based laser and light skin treatments including radiofrequency needling, microfocused ultrasound and a CO2 laser or hybrid peel. 

What is Rejuran?

Rejuran is an injectable product made of polynucleotides (PN). These are formulated into a gel which is the basis of Rejuran. When injected this gel provides a stimulus for healing and repair along with a scaffold aimed at assisting skin maintenance. 

The polynucleotides in Rejuran are made up of DNA fragments of a specific size derived from wild salmon. Interestingly and important in an injectable product; salmon and man are not that different regarding our key building blocks, with salmon polynucleotides highly bio-compatible with humans.

How does Rejuran work?

Rejuran is injected with precise placement important to targeting its effects.

This is injected unusually in the collagen layer just under the skin’s surface (but can also be placed more deeply in the collagen layer and collagen – fat layer interface area.

Over time this polynucleotide gel breaks down into its building blocks (nucleotides, nucleosides and nitrogen bases). This gel and its breakdown products provide a scaffold that hydrates, holds nutrients, and actively supports regeneration. The gel slowly breaks down into these key components that have been shown to have cell metabolism stimulating and anti-inflammatory actions.

Rejuran’s action includes the stimulation of fibroblasts which are key to a healthy collagen skin layer including stimulating new collagen production. 

Benefits may stem from several key skin actions:

• The stimulation of fibroblasts – collagen production
• Stimulation of healing and repair
• Anti-oxidant actions aimed at protecting against collagen and elastin breakdown
• Improvements in skin elasticity and the skin’s collagen layer
• A healthy collagen layer is also key to the health and maintenance of the skin top layer or epidermis

Rejuran has been shown to improve the collagen layers density, improve fine lines, reduce pores and increase skin thickness (epidermal and dermal skin layers).

From as early as the age of 20 years there is a progressive decline in skin collagen every year (around 1%), in females this accelerates with menopause, and occurs at a higher rate in later years. We can’t avoid aging but products such as Rejuran are designed to target this loss of collagen. 

Should Rejuran be administered before or after my skin treatment?

Unlike many injectables Rejuran is more stable with prolonged heating such as that seen with radiofrequency or microfocused ultrasound (MFU / HiFU / Ultraformer MPT) treatments.

Rejuran’s heat stable characteristics, unlike dermal fillers and boosters based on glycosaminoglycans, make it a suitable product to consider in combination with energy based skin treatments to assist with skin healing and repair.

Rejuran may be injected both before and/or after many skin treatments.

What Rejuran products are available In Australia?

Rejuran Classic (colloquially known as Rejuran Healing) – for the face etc

Rejuran i – for use around the eyes

Rejuran s – scar (contains a higher concentration to target problem skin areas)

What is involved in a Rejuran injection treatment?

This may be performed on its own or as part of a combination treatment

Use of a topical numbing cream or gel prior to treatment may be recommended.

The product is injected in small amounts every 1-1 ½ cm and will be injected to also target problem lines, skin areas or scars.

The small blebs are injected superficially and immediately after you will see slightly raised lumps where injections have occurred. The raised blebs generally settle over hours or overnight. Do not massage. 

Injections are / may be administered right up to eyelid or lash line.

Injections may be administered more deeply when targeting scars particularly those involving both collagen and fat loss.

When do I notice skin changes and How often are Rejuran treatments repeated?

2-4 sessions might be recommended depending on your skin changes

These are generally scheduled approximately 3-6 weeks apart

Benefits may become visibly noticeable from 2 weeks

Greater improvement will generally be observed following your second ‘induction’ treatment

A maintenance treatment may be recommended (6 – 12 monthly), or when you feel more is needed.

Does everyone see benefits?

Rejuran is not designed on its own to address deep lines or wrinkles or severe photoaging or more severe skin laxity. 

Rejuran however is useful to assist with healing in combination with other laser, light and energy based skin treatments.

People vary in their response as people differ in their healing / skin response to treatment. Rejuran assists the skin to heal and sets up an environment to foster and encourage new collagen and elastin production and reduce inflammation’s effects on skin aging. 

More sessions or combination treatments will need to be considered in those with more significant skin concerns e.g. deeper wrinkles or more severe degrees of photoaging

How long does treatment take & is it painful?

A numbing gel / cream applied to the area being treated 30 min earlier should be considered as the treatment involves multiple injections.

A burning or stinging sensation at time of injection may be experienced. This normally settles over minutes.

Treatments vary in duration and this partly depends on the area being treated however treatments typically take between 15-30 minutes to perform.

Can Rejuran be utilized near the eyes and eyelids?

Rejuran can be used right up to eyelids. This is not the case for dermal injection bio remodellers and skin boosters where their use close to the eyes may cause or worsen puffiness or may have particular safety concerns (such as vascular occlusion risk).

When should Rejuran not be injected?

As a precaution at least 3 months should have passed since use of a dermal filler that includes cross-linked hyaluronic acid should have passed before you have a Rejuran treatment. This includes injection both near and/or in the skin areas planned for treatment. When in doubt speak with your medical healthcare professional about any skin treatments. 

Hypersensitivity has been rare, this may present with a rash, itch, burning and stinging in treated areas. Reactions to topical anaesthetic creams often utilized in conjunction with Rejuran treatments are much more common, reactions to topical anaesthetic include both skin irritation and occasionally allergy.

Blood thinners increase risk of bruising however they are not a contraindication. Superficial injections (usually utilized with Rejuran treatments) carry lower bleeding and bruising risk than deeper injections. 

What are the potential side effects of polynucleotides?

Injection related effects include:

• Redness of the skin
• Raised bumps in the hours after injection
• Itchiness
• Bruising
• Prolonged swelling

Most injection related side effects settle over a few days following treatment

How do I know if Rejuran is right for me?

During your appointment you will be assessed regarding your skin changes and skin treatment goals and any other medical considerations including previous cosmetic treatments and adverse reactions.

Factors that may influence recommendations include:

• Skin quality
• Problem skin areas that you want addressed
• Degree of skin wrinkling and laxity
• Degree of volume deficit
• Degree of dermal hydration

You can then make an informed decision balancing any potential benefits balanced by treatment associated risks. A combination treatment may be recommended in combination with Rejuran ‘healer’. 

Suitable treatments and combinations will be recommended based on your clinical findings and treatment goals

Your skin care is important for all skin treatments including actives and sun protection.

Rejuran’s collagen stimulation and healing effects make it a good combination treatment with radiofrequency needling and other skin energy and laser treatments.

Commonly utilized combination treatments include:

• Radiofrequency 
• Microfocused ultrasound 
• CO2 or Hybrid lasers
• Dermapen skin needling

These can be performed during the same treatment session and/or sequentially. 

Rejuran should be considered in combination with a number of laser and energy based treatments to assist in your skin healing and recovery. Ultrasound delivery may also be recommended following the application or use of topical Rejuran products following a range of skin penetrating treatments (including microneedling, non-ablative and ablative fractional laser, and sublative radiofrequency). 

If you would like to find out about your tailored treatment options to slow the loss of collagen and elastin that occurs over time, the restoration of lost collagen or elastin and/or find out more regarding skin treatment options:

Schedule an appointment with our experienced team of cosmetic dermatology nurses, dermal assistants and dermatologists. Your consultation will include discussion as to whether Rejuran is suitable for your skin changes, skin concerns, treatment goals and assessment of your treatment associated risks.

Alternatively book a cosmetic consultation with one of our cosmetic nurses or dermal assistants for a clinical assessment.