PRP, Polynucleotides or Exosomes for Your Face. Which Regenerative Treatment Does What

Key points

• A 2022 meta-analysis in Frontiers in Medicine of 14 controlled studies and 472 patients found adding PRP to microneedling nearly tripled the odds of more than 50 percent improvement in acne scars, with an odds ratio of 2.97 and no increase in severe side effects.

• Two systematic reviews published in early 2026, one in Dermatology Practical and Conceptual and one in Cureus, found polynucleotides associated with improved skin elasticity, hydration and wrinkle depth, and both concluded larger standardised trials are still needed.

• The MHRA treats injected exosomes as a medicinal product with no UK marketing authorisation, so exosome injection is prohibited here. Lawful use is a CE marked, plant or animal-derived topical applied after microneedling. Human-derived exosomes are not approved for cosmetic use in the UK or EU.

• A 2025 case series reported adverse reactions after intradermal injection of exosome formulations, which are approved and sold as topical cosmetics without regulatory approval for injection in most countries.

If you are weighing these treatments for your skin, message us on WhatsApp or email team@thewellnesslondon.com and a doctor will match the treatment to your concern rather than to a trend.

What the 3 treatments actually are

PRP is made from your own blood, spun to concentrate the platelets, and injected into the skin or applied after microneedling. The growth factors it carries stimulate collagen production and repair, and because it is autologous there is nothing to react to. It is the oldest of the 3 in aesthetic use and has the most trials.

Polynucleotides are chains of purified DNA fragments, usually from salmon, injected into the skin in a course of sessions. They bind water and stimulate fibroblasts, the cells that make collagen and elastin, which is why the reported effects are on hydration, elasticity and skin quality rather than volume. They are regulated as medical devices in the UK when injected and have been used in wound healing for years.

Exosomes are nanoscale vesicles released by cells to carry signals. In aesthetics they are manufactured from cultured cells, plants or animal sources and applied to the skin, most often after microneedling or laser, to accelerate healing and improve texture. They are the newest, the most expensive and the least regulated of the 3, and the only one that cannot lawfully be injected in the UK.

What the evidence shows for each

PRP has the deepest record. A 2019 systematic review in the Journal of the American Academy of Dermatology of 13 studies found activated, leukocyte and platelet-rich plasma combined with fractional laser over 2 or 3 sessions improved acne scarring. The 2022 meta-analysis in Frontiers in Medicine pooled 14 controlled studies and 472 patients and found adding PRP to microneedling nearly tripled the odds of more than 50 percent improvement in acne scars, improved the Goodman scar score, and raised patient satisfaction without increasing severe redness or swelling. A January 2026 split-face study in the Indian Dermatology Online Journal tested the same combination in darker skin types.

Polynucleotides have a younger but growing record. Two systematic reviews in early 2026, Alzahrani and colleagues in Dermatology Practical and Conceptual and Flores Rodríguez and colleagues in Cureus, both found positive associations with skin elasticity, hydration and wrinkle depth, and both concluded larger, standardised trials are needed. That is a reasonable evidence base for a treatment that became the most requested of 2026, and an honest one. Exosomes trail both. A 2023 study reporting greater wrinkle improvement with microneedling plus exosome serum than with hyaluronic acid was a single small study, and the 2026 reviews describe the exosome evidence as promising early associations needing larger trials.

Send us a photograph of the area you want to improve on WhatsApp and a doctor will tell you which of the 3 the evidence supports for it.

Where UK law separates them

The 3 sit in different regulatory positions, and the difference decides what a clinic may lawfully do. PRP for a medical purpose is treated by the MHRA as an unlicensed medicine that doctors may prepare for their own named patients, which is why a doctor-led clinic can inject it. Polynucleotides for injection must comply with medicines or device regulation, and the established products do. Exosomes, when injected, are considered by the MHRA to be a medicinal product, no exosome injectable has a UK marketing authorisation, and injecting them intradermally, subcutaneously or intravenously is prohibited.

Save Face, the government-recognised register, has issued a patient safety warning that human-derived exosomes are not approved for cosmetic use in the UK or EU, that topical plant or animal-derived exosomes are lawful only when applied and not injected, and that unusually cheap exosome treatments should raise suspicion. A 2025 case series of adverse reactions after intradermal exosome injection shows why. For a patient this means a lawful exosome treatment in London is a CE marked topical applied after microneedling by a practitioner who can name the product, and anything described as an exosome injection is outside the law.

How to match the treatment to the concern

The useful question is not which treatment is best but which concern you have, because the 3 do different things. Acne scarring and uneven texture have the strongest evidence for PRP, particularly with microneedling, and that is where a doctor here would start. Crepey, dehydrated skin that has lost elasticity, particularly under the eyes, is the concern polynucleotides were reviewed for and where their hydration and fibroblast effects fit. Recovery after an energy-based treatment such as laser or radiofrequency microneedling is where topical exosomes are most often used, on the strength of small studies rather than trials.

Volume loss is none of them. A hollow tear trough or a flattened cheek is a filler or fat transfer conversation, and a regenerative treatment sold for it will disappoint. Deep static wrinkles are a laser or resurfacing conversation. And a patient in their 30s with good skin who wants to look rested rather than treated is usually best served by a single approach chosen properly rather than 3 stacked together. Combining all 3 is common in London and evidence for the combination beating the best single option does not exist. Stacking is a business model before it is a protocol.

Six questions before any regenerative facial treatment

Take these to whichever clinic you see, including ours.

• What is my actual concern, texture, scarring, hydration, elasticity or volume, and which of these treatments has evidence for that specifically.

• Is this being injected or applied, and if it is exosomes, is it topical and CE marked as UK law requires.

• Which published study supports this product for my concern, and how many patients were in it.

• If treatments are being combined, which study shows the combination beats the best one alone.

• What does the clinic charge for the single treatment with the best evidence for my concern, before any add-ons.

• Who is performing the treatment, and are they a GMC-registered doctor.

Our doctors put it this way. Your face does not need the treatment of the year. It needs the treatment for the problem it actually has, and in 2026 that is usually one of these three, not all of them at once.

Message us on WhatsApp with your concern, your age, and a photograph, and a doctor will tell you which single treatment, if any, fits.

What none of them does

None of the 3 adds volume, lifts sagging tissue or removes deep static wrinkles. None has a large randomised trial against the others, so any claim that one is best is a preference. PRP's evidence is strongest for scarring and texture and weaker for general rejuvenation. Polynucleotide evidence is positive but the 2026 reviews call for larger trials. Exosome evidence is early and the products cannot be injected in the UK. All 3 need courses rather than single sessions, all produce gradual rather than dramatic change, and none is available on the NHS for cosmetic use.

What each costs in London

Doctor-led under-eye and facial PRP at leading London clinics runs £400 to £850 per session or course, with PRP skin treatments advertised from around £320 at the lower end of the market. Tear trough filler, the volume alternative, costs £450 to £800 per session at leading London clinics and up to £950. Exosome sessions are advertised in London from around £350, and combination protocols of PRP with polynucleotides or exosomes are advertised at £450 to £700 and above.

The reframing is what the add-ons buy. A stacked protocol at the top of that range combines the treatment with the best evidence for your concern with 1 or 2 that have less, and charges for all of them. The single right treatment, chosen by a doctor who has examined the skin, costs less and rests on more.

Care at The London PRP Clinic by The Wellness is doctor-led and priced below flagship rates, with your exact figure confirmed at the free suitability review once a doctor has decided which treatment, if any, your concern needs.

Ask about the cost for your skin on WhatsApp and we will explain what the review covers.

The free suitability review

Every enquiry here starts with a free, doctor-led suitability review rather than a booking. A GMC-registered doctor examines your skin, identifies the concern, and gives one of two answers. Either you are approved for treatment, with a single named treatment, the reason it was chosen over the others, and realistic expectations for gradual change, or you are not approved, with an honest explanation of what would serve you better, whether that is a filler conversation, resurfacing, or nothing at all.

We decline a meaningful share of the people who enquire. That is deliberate. A clinic that approves everyone is optimising for bookings, not outcomes.

Why people choose The London PRP Clinic by The Wellness

• An 87 percent patient success rate across treatments.

• More than 187 five star reviews.

• Every treatment performed by a GMC-registered doctor.

• 100 supervised treatments completed by every clinician before they treat a patient here unsupervised.

• A 32 percent average density increase reported in our hair restoration programme.

Frequently asked questions

What is the difference between PRP, polynucleotides and exosomes

PRP is your own concentrated platelets, injected. Polynucleotides are purified salmon DNA fragments, injected, that hydrate and stimulate collagen. Exosomes are laboratory-derived signalling vesicles applied topically after microneedling. All 3 stimulate repair rather than adding volume, and each has a different depth of evidence.

Are polynucleotides better than PRP

For different things. Two 2026 systematic reviews found polynucleotides improve elasticity, hydration and wrinkle depth, with larger trials needed. PRP has the stronger evidence for acne scarring and texture, including a meta-analysis of 472 patients. Neither has beaten the other in a head to head trial.

Are exosome facials legal in the UK

Only as a topical. The MHRA treats injected exosomes as a medicinal product with no UK authorisation, so injection is prohibited. A CE marked plant or animal-derived exosome applied after microneedling is lawful. Human-derived exosomes are not approved for cosmetic use in the UK or EU.

Which regenerative treatment is best for acne scars

PRP with microneedling. A 2022 meta-analysis of 14 controlled studies and 472 patients found adding PRP nearly tripled the odds of more than 50 percent improvement, and a 2019 systematic review in JAAD supported PRP with fractional laser over 2 or 3 sessions.

Can you combine PRP with polynucleotides or exosomes

Clinics do, and lawfully for topical exosomes. No study shows any combination beats the best single treatment for a given concern, so the addition is unproven and paid for. Ask which study supports the combination and what the single treatment costs.

How many sessions of regenerative skin treatment do you need

All 3 are courses rather than single sessions, typically 3 sessions spaced weeks apart with maintenance afterwards, and results are gradual over 2 to 3 months. A clinic selling a single session of any of them is selling a demonstration rather than a treatment.

References

• Frontiers in Medicine, 2022. Kang and Lu. Combined effect of microneedling and platelet-rich plasma for the treatment of acne scars, a meta-analysis of 14 controlled studies and 472 patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882957/

• Journal of the American Academy of Dermatology, 2019. Hesseler and Shyam. Platelet-rich plasma and its utility in the treatment of acne scars, a systematic review of 13 studies. https://www.em-consulte.com/en/article/1293137

• Indian Dermatology Online Journal, 2026. A split face study to compare the efficacy of platelet-rich plasma combined with microneedling versus microneedling alone for treatment of acne scars. https://doaj.org/article/9535a9fe4c07460799f233003aec083c

• IAPAM, 2026. Regenerative aesthetics 2026, what the evidence supports, summarising the two early 2026 systematic reviews of polynucleotides by Alzahrani et al in Dermatology Practical and Conceptual and Flores Rodríguez et al in Cureus. https://iapam.com/regenerative-aesthetics-2026-evidence-guide

• Save Face, 2025. Exosome therapy in the UK, patient safety warning on new injectables. https://www.saveface.co.uk/en/blog/post/exosome-therapy-uk-patient-safety-warning

• Enhance Insurance, 2026. Exosomes in aesthetic practice, what UK practitioners need to know, including the MHRA position on injected exosomes. https://www.enhanceinsurance.co.uk/about-us/knowledge-hub/how-to-guides/exosomes-in-aesthetic-practice-worth-the-hype-or-the-risk-what-uk-practitioners-need-to-know/

• 2025. Adverse reactions following intradermal injection of exosome-based formulations, a case series. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12528963/

• Marie Claire UK, 2025, and Woman and Home, 2026, on regenerative treatment trends and polynucleotides as the most requested treatment of 2026. https://www.marieclaire.co.uk/beauty/top-tweakments-of-2026

• London clinic price lists for PRP, polynucleotide and exosome skin treatments and tear trough filler, accessed September 2026.