What Is Sunekos and Is It Right for Your Skin?

If you have been researching injectable skin treatments and you keep seeing the name Sunekos appear alongside words like "extracellular matrix," "elastin," and "biostimulator," you are not alone. Sunekos has grown steadily in the UK market over the past few years, and it is increasingly being recommended in consultations where a few years ago only Profhilo might have been mentioned.

But what actually is it? How does it work? And who is it genuinely suited to?

What Is Sunekos?

Sunekos is an injectable treatment containing a patented combination of low-molecular-weight hyaluronic acid and six specific amino acids: glycine, L-proline, L-lysine, L-leucine, L-valine and L-alanine.¹ It is manufactured by IBSA Farmaceutici Italia and is CE-marked for use in the United Kingdom.

It is not a dermal filler. It does not add volume in the way that hyaluronic acid fillers do. It is also not a toxin and has no paralysing effect on muscles. It belongs to the category of skin biostimulators: treatments designed to stimulate the skin's own regenerative processes rather than to replace what has been lost.

The hyaluronic acid in Sunekos is low molecular weight, which means it integrates into the skin rather than sitting within it as a structural support the way higher-molecular-weight HA fillers behave. It attracts and retains water in the tissue, supporting hydration at a cellular level.¹

The six amino acids are the building blocks from which fibroblasts produce collagen and elastin. The clinical argument for Sunekos is that by delivering these amino acids directly into the dermis alongside HA, the treatment provides fibroblasts with the raw material they need to upregulate both collagen and elastin production simultaneously.^1,2 This dual stimulus is what distinguishes Sunekos from many other skin boosters, which primarily target collagen alone

The Extracellular Matrix: Why It Matters

The extracellular matrix, or ECM, is the structural framework that surrounds skin cells. It is made up of collagen fibres, elastin fibres, proteoglycans and glycoproteins, and it is what gives skin its firmness, elasticity, bounce and structure. When the ECM is healthy, skin snaps back. When it degrades, skin becomes lax, crepey, and thin.

Collagen loss begins in the mid-twenties, at approximately 1% per year. Elastin loss is less well quantified but is significant from the thirties onwards, and accelerates sharply after the menopause due to oestrogen withdrawal.³ Because elastin fibres are extremely difficult for the body to regenerate once lost, treatments that specifically target elastin production have a meaningful clinical advantage over those that target collagen alone.

Sunekos works at the level of the ECM. Its proposed mechanism is to provide fibroblasts with the amino acid substrates they need to produce both collagen type I and collagen type IV, alongside elastin.¹ The result, when this works as intended, is a broader, more structurally complete regeneration of the ECM than collagen-only approaches can achieve.

The Clinical Evidence for Sunekos

A 2024 pilot study published in Cureus assessed Sunekos in ten post-menopausal women (mean age 53.6 years) treated with three intradermal sessions one week apart. The study used validated biophysical measurement tools including the Cutometer, which measures skin elasticity mechanically.¹

At twelve weeks, the study found statistically significant improvements in both skin firmness (R0, p=0.005) and net elasticity (R5, p=0.022). All ten participants showed at least 25% physician-rated improvement by week twelve. Patient satisfaction was high, with a median score of 8 out of 10 at both week two and week twelve.¹

Adverse effects were mild and transient: injection site erythema, swelling and a brief burning sensation, all of which resolved within 48 hours.¹ No serious adverse events were reported.

The study's authors acknowledged its limitations: the sample was small, there was no control group, and it was conducted in a specific patient population. Larger, controlled trials are needed. The findings are consistent with the proposed mechanism, but the evidence base for Sunekos is still developing compared to more established treatments.¹

What Does Sunekos Treat?

Sunekos is indicated for skin quality concerns rather than structural volume loss. The primary indications are:

What Sunekos Does Not Treat

Sunekos will not replace lost volume. If you have significant volume loss in the cheeks, temples or mid-face, or deep nasolabial folds driven by structural fat pad depletion, Sunekos addresses the wrong layer of the problem. Volume loss requires volumising treatment, whether that is hyaluronic acid filler or Sculptra.

Sunekos will not relax dynamic expression lines. Forehead lines, crow's feet and frown lines that are driven by muscle movement respond to anti-wrinkle injections, not skin biostimulators.

And Sunekos will not deliver significant improvement in patients with marked skin laxity. Where there is genuine structural sagging, treatment needs to address the deeper tissues, either with Sculptra, PDO threads, or both.

Patient Questions About Sunekos

This is one of the most common questions in aesthetic consultations right now. The short answer is that Profhilo and Sunekos work differently and address slightly different problems, and they are not always alternatives to each other.

Profhilo is a hybrid HA product containing a very high concentration of both high and low molecular weight hyaluronic acid. Its primary action is profound tissue hydration and the stimulation of collagen types I, III and IV through HA-mediated pathways. It does not contain amino acids, so its elastin stimulus is indirect.⁴

Sunekos contains lower concentrations of HA but adds the six amino acid complex that directly supplies fibroblasts with the substrates for both collagen and elastin production. This makes it particularly useful for patients whose primary concern is elasticity and the extracellular matrix rather than hydration.^1,2

For crepey texture around the eyes and on the neck with early elasticity loss, Sunekos would generally be the more targeted choice. If you also have marked dehydration or want the deeper tissue remodelling that Profhilo offers, they can be combined.

Sunekos is not a treatment for under-eye hollows in the volumising sense. If you have a structural hollow, it will not fill it. What it can treat is the skin quality component of the periorbital area: the crepe-like texture, the thinness that makes the skin translucent, and the early fine lines that form at the outer corner of the eye.²

The reason it is often discussed as an alternative to tear trough filler is that for some patients, what reads as a hollow is partly a skin quality issue rather than a volume issue. Thinner, less elastic skin casts more shadow. Improving the skin quality and elasticity can sometimes reduce the visual appearance of hollowness without any volume addition.

If there is a genuine anatomical hollow, Sunekos alone will not address it. The right approach depends on what is actually driving the appearance, which is an assessment that needs to be made in person.

How Many Sessions and How Long Do Results Last?

Sunekos and Polynucleotides: Can You Combine Them?

Yes, and in many clinical presentations this is the recommended approach. Polynucleotides and Sunekos act on the skin through different pathways and are genuinely complementary.

Polynucleotides, derived from purified salmon or trout DNA, work primarily through cellular regeneration: they stimulate fibroblast proliferation, support the repair of oxidatively damaged DNA, and have a strong anti-inflammatory action in the skin.⁵ Their mechanism is fundamentally cellular.

Sunekos works at the ECM level, providing the structural building blocks for collagen and elastin. Its mechanism is substrate-based.

A combined protocol typically sequences polynucleotides first to optimise cellular health and fibroblast activity, followed by Sunekos to then provide those active fibroblasts with the amino acid substrates they need to produce collagen and elastin at full capacity. The two treatments reinforce each other in a clinically logical way.^2,5

Is Sunekos Safe?

Sunekos has a well-established safety profile across published literature and clinical practice. The most commonly reported adverse effects are injection site reactions: erythema, mild swelling and a transient burning sensation. In the published pilot study, all 27 reported adverse events were mild and resolved within 48 hours, with no serious adverse events.¹

Because Sunekos is injected intradermally using fine needles, bruising is possible, particularly in thinner skin areas such as the under-eyes and neck. This typically resolves within a few days.

Sunekos is not suitable for patients who are pregnant or breastfeeding, patients with active skin infection in the treatment area, or patients with known hypersensitivity to any component of the formula.

References

1. Ayatollahi A, Hosseini H, Moradi Tuchayi S, et al. Intradermal Sunekos injection for labia majora rejuvenation: a pilot study. Cureus. 2024;16(5):e60301. Available at: pmc.ncbi.nlm.nih.gov/articles/PMC11127129/

   
   

2. Cosmetic Skin Clinic. Sunekos treatment. Available at: cosmeticskinclinic.com/treatments/sunekos/ [Accessed October 2026]

   
   

3. Rittie L, Fisher GJ. Natural and sun-induced aging of human skin. Cold Spring Harb Perspect Med. 2015;5(1):a015370.

   
   

4. Dr Sophie Shotter. Which skin booster is best for you? The difference between Profhilo, Sunekos and polynucleotides. Available at: drsophieshotter.com [Accessed October 2026]

   
   

5. Rios-Arrabal S, Morales JC, Valverde-Pozo J, et al. Polynucleotides in dermatology and aesthetic medicine: from skin healing to ageing treatment. Int J Mol Sci. 2023;24(16):12698.