PRP, iPRF, Polynucleotides and Exosomes: Which Regenerative Treatment?

PRP, iPRF, polynucleotides and exosome therapy are each described as regenerative treatments, and each does support tissue repair and skin quality improvement. They do not work in the same way, and the differences between them matter for matching the right treatment to the right concern. This article explains the mechanism behind each, what the evidence shows, what they are each best suited to, and how the decision is made when more than one option could apply.

At The London Road Clinic all four are available. The choice is made at consultation based on your specific concern, the evidence, and the clinical judgement of Dr Shahe Boghossian (Medical Consultant, GMC 5204600).

What “regenerative” means here

In aesthetics, regenerative treatments are those that work by supporting the skin’s own biological repair processes rather than adding external volume or blocking a physiological process. They stimulate fibroblast activity, collagen and elastin synthesis, tissue remodelling and cellular renewal. The visible result is improvement in skin quality: better texture, more hydration, improved tone and, over time, some structural firming. They do not add bulk the way filler does, nor do they reduce muscle activity.

The four treatments covered here each activate these processes, but through different biological pathways and using different source materials. That distinction drives the clinical choice.

The four treatments at a glance

PRP (Platelet Rich Plasma) is produced from a small sample of your own blood. The sample is processed in a centrifuge, which separates and concentrates the platelet-rich fraction. Platelets contain growth factors that are released at the treatment site and stimulate local fibroblast activity, new collagen synthesis and tissue repair. PRP has been used in medicine for decades across wound healing, orthopaedics and surgery before its application in aesthetic skin and hair treatment.

iPRF (Injectable Platelet Rich Fibrin) is an evolution of PRP. The blood sample is centrifuged at a lower speed, which preserves a natural fibrin matrix alongside the concentrated platelets. This fibrin scaffold encapsulates the platelets and growth factors and releases them gradually over days rather than hours, extending the biological signal at the treatment site. iPRF also retains a higher proportion of white blood cells, which may contribute additional regenerative signalling.

Polynucleotides (PN) are purified fragments of DNA derived from salmon or trout sources and extensively purified for clinical use. At The London Road Clinic we use Croma Polyphil by Croma Pharma. Unlike PRP and iPRF, polynucleotides are not produced from your own blood. They work by activating adenosine A2A receptors in the skin, which promotes fibroblast proliferation, type I collagen synthesis and tissue repair. They also carry anti-inflammatory properties and act as a substrate for cellular DNA synthesis. The mechanism is distinct from growth-factor signalling.

Exosome therapy uses extracellular vesicles derived from mesenchymal stem cells. At The London Road Clinic we use BLESKIN EXXO. Exosomes are nanoscale particles that carry proteins, lipids, RNA and signalling molecules. Applied to the skin after a treatment such as microneedling, they interact with local cells through paracrine signalling: modulating gene expression, reducing inflammation and supporting the repair cascade. Exosomes are not injected at this clinic; they are applied topically following microneedling to maximise delivery.

Side by side

When each tends to be the stronger choice

PRP is the most established option across the widest range of regenerative indications. For patients who want a well-evidenced autologous treatment for skin quality, early hair thinning or under-eye improvement, PRP has the longest track record and can be applied across multiple treatment areas in a single session.

iPRF is generally preferred where the goal is a more sustained biological signal. It is also useful when PRP has been tried and the result was good but shorter-lived than expected.

Polynucleotides are the preferred choice when the concern involves delicate areas where precise placement of a supportive, anti-inflammatory regenerative signal is needed: the under-eye, fine lines around the mouth, crepey texture in the mid-face. Their anti-inflammatory properties also make them useful alongside other treatments where skin calm is a secondary goal.

Exosomes are most useful as an amplifier of microneedling rather than a standalone treatment. Patients who are already planning a course of SkinPen microneedling for texture, scarring or hair restoration and want to maximise the regenerative response from each session are the strongest candidates.

Combination approaches

These four treatments are not mutually exclusive. At The London Road Clinic, combination protocols are common:

• PRP or iPRF combined with microneedling
• Exosomes added to the same microneedling session to compound the signalling effect
• Polynucleotides used in delicate injectable zones alongside a broader PRP course
• Hair restoration protocols combining scalp mesotherapy, polynucleotides and exosomes

The appropriate combination, if any, is discussed at consultation based on your primary concern, skin assessment and medical history.

Frequently asked questions