The Tale of the Salmon Sperm Facial: A Story of Promise, Risk, and the Gray Areas of Modern Aesthetics
To inject or not to inject salmon sperm beneath the surface of the skin—that is the question of the hour. And it is one I can assure you William Shakespeare never asked himself. But it is 2024, and everything goes, so let us unravel this tale together.
Why is it even called a "salmon sperm facial"? The name is deliberately provocative, designed to shock and to spread like wildfire across social media. Social media loves a thing that is considered gross. But the name is not accurate. The far less viral, but far more accurate, term is polynucleotide treatment. Those who refer to it as a "salmon DNA treatment" are closer to the truth, but that is just not as sexy as the sperm moniker.
The Heart of the Matter: Polynucleotides and Rejuran
Polynucleotides are used in injectable skin booster treatments that originated in South Korea. Rejuran is one of the most popular and well-known polynucleotide treatments, and it is derived from salmon DNA. Where does that salmon DNA come from? Yes, the salmon sperm. Through a series of biochemical processes, the cellular structure of the sperm is broken down, the DNA is separated from other components, and the resulting polynucleotides are what goes into Rejuran.
Not all skin boosters are created equal. If you are in Europe, you might think of Profhilo, which is a hyaluronic acid skin booster. Polynucleotide boosters are very different because they come from two very different things. That is how the term "salmon sperm facial" was born.
Why Salmon? The Question of Biocompatibility
Why salmon? Couldn't they have picked a more aspirational animal? Something fast and sexy, like a cheetah or a leopard? No. Salmon was chosen because the DNA of salmon is the most biocompatible with human skin. All living organisms have polynucleotides in their DNA, but not all are biocompatible with human DNA. Salmon was the lucky one.
In Korea, this ingredient is even found in over-the-counter skincare in the form of polydeoxyribonucleotides (PDRN). Topically, the claims are that it has soothing effects and low-level anti-inflammatory benefits, leaving the skin calmer and more at peace. But internally, when injected, it is said to have more profound benefits.
What the Science Says (So Far)
There is some preliminary research. One study reviewed papers on PubMed from the last 25 years on PDRN and wound healing. It found that PDRN does have beneficial effects for wound healing: it helps the skin heal by activating blood vessels and drawing in cells for regeneration.
A 2010 study in the International Journal of Cosmetic Science found that DNA from salmon sperm can help increase elasticity, collagen levels, and hyaluronic acid production compared to controls. The problem? It was a 12-week study with only 20 people, divided into two groups of 10. That number is simply not high enough to be robust. More solid scientific evidence supporting its use in facial treatments is still needed. The data remains limited.
The Real Benefits: Collagen, Hydration, and Calming
Rejuran has been classified in South Korea as a skin booster since around 2014, used for nearly a decade. It is a biostimulator, meaning it triggers your own skin's natural healing and rejuvenation process. Like Sculptra helps stimulate collagen production, this helps your body heal itself.
The three biggest benefits touted for this treatment are:
- Stimulates collagen production: By stimulating fibroblasts (the cells that produce collagen and elastin), it improves skin firmness.
- Enhances hydration: It has strong water-binding properties that help the skin retain moisture, which you lose as you age, leading to plumper, dewier skin.
- Anti-inflammatory effects: It soothes the skin, reducing redness and irritation.
People undergo this treatment to minimize swelling and redness, look plumper and dewier, and promote collagen production over time.
The Injection Experience: Not for the Faint of Heart
The method of injection varies: either a single series of injections or a multi-needle "gun" approach that injects at multiple points beneath the skin. I have had a few patients who traveled to South Korea for this treatment. They report it can be extremely painful in certain areas, leading to intense swelling and bruising. The extent of swelling depends on what is being injected, and apparently this one can leave big bumps and welts.
The Caveats: Risks, Unknowns, and the Shady Gray Area
Now that we have all this information, we must consider the risks beyond the pain and swelling.
Allergic reactions: Though it is derived from fish, the risk is not directly cross-reactive with fish allergies. But anything injected can cause an allergic reaction, so a patch test is always safer.
Infection: Anytime we inject anything under the skin, infection can occur. This is not a specific risk unique to Rejuran, but it is a risk.
Unknown long-term effects: Ten years sounds like a long time, but do we remember silicone? Silicone was all the rage in the 1990s, and 20 to 30 years later, people's faces started looking distorted. Long-term data for polynucleotide treatments is still lacking. Everything great was once new, but not everything newish is great.
Most critically: These treatments are not FDA approved. The FDA is not the holy grail, but in the United States, lack of approval means the full range of potential risks and side effects may not be fully understood or documented. There is no guaranteed safety. And because it is not FDA approved as a treatment, there is no legal way to purchase the material to inject into your face.
This raises a deeply ethical question: Where is your provider getting the salmon sperm? Are they fishing it themselves and extracting it in their kitchen? Are they buying it from the crystal meth dealer on the corner? From a friend in South Korea who ships it? Or from a shady distributor on Amazon? How can they guarantee what they are injecting into your face is legitimate? At the end of the day, a medical professional is putting their own license on the line. But if your provider is an aesthetician—who is not technically legally allowed to break the surface of your skin and inject anything—they have nothing to lose. That is a dangerous place to be, a major red flag.
A Parting Thought on Exosomes (and the Bigger Lesson)
I also want to touch on exosomes very lightly. Like salmon sperm facials, exosomes have been used in skincare as a relatively new hot topic. They have limited research and lack FDA approval. People are injecting exosomes for hair growth, rejuvenation, cellular renewal, fine lines, and wrinkles. But it is very novel and not FDA approved. If a physician is injecting exosomes, it raises the same ethical questions about how they are obtaining the product.
I will end with this truth: Everything great was once new. Not everything new is great. If you live in a country where a treatment is not viewed as legal, that does not necessarily mean it is bad. But if the service is being offered, the question becomes: how is your provider getting the stuff to do the service? That is a shadier question with many shades of gray. It makes you wonder about your own provider and forces you to ensure you are in the right and safe hands.
So, if you are going to South Korea and visiting the most reputable clinics, go ahead, try it, and let us know. But in the United States and elsewhere, be smart about the treatments you get. Understand what is legal and what is not. And when something is not quite clear-cut and legal, it puts the ethics of your provider into question—a much broader and more important discussion than we have covered today.