Deciding not to
Every article in this document has been written on the assumption that not having the treatment is a real option. This one says so directly.
Choosing not to have polynucleotide treatment requires no justification, produces no medical consequence, and costs nothing. It is one of the outcomes a proper consultation is supposed to contemplate, and professional guidance on consent is explicit that the option of doing nothing must be presented as an option rather than as a formality.
This article exists because that option is systematically underrepresented. Every clinic page, every social post and every consultation has a commercial reason to present treatment as the default and no treatment as an absence. It is not an absence. It is a choice with its own reasons, and several of them are good ones.
6.6.1Reasons that are good reasons
The evidence is not there yet
The central claim of this category, that an effect persists after the material has cleared, is unresolved. Someone who declines to pay for an unproven claim and waits to see whether better evidence appears is behaving rationally. If the evidence arrives, the treatment will still exist.
The cost, properly calculated
Working out the total course cost plus annual maintenance over the period you imagine continuing produces a figure that changes many people's minds, and changing your mind at that point is the calculation working rather than failing.
You would rather not be in this loop
Regular cosmetic appointments create a rhythm of critical facial assessment. Some people find that fine. Others find that it directs attention onto features that were not previously a focus, and would rather not begin.
What you want is not what it does
If your concern is structural, pigmentary or volumetric, this treatment addresses none of it, and the right response is not a different injectable but a proper assessment of what would actually help, which may be nothing.
Someone else wants it more than you do
Consent given under another person's influence is not consent in any meaningful sense, and no practitioner should proceed on it.
You would rather spend the money elsewhere
A complete reason requiring no elaboration.
6.6.2What else there is, stated without enthusiasm
Nothing in this section is a recommendation and none of it is offered as an equivalent. It is here because people who decide against one treatment are often looking for what else exists, and it is better to give a plain account than to leave the question hanging.
- Sun protection. The single best evidenced thing anyone can do for the long term appearance of their skin. Unglamorous, cheap and effective, and the NHS publishes accessible guidance on it.
- Stopping smoking. Well evidenced in relation to skin as well as everything else.
- Sleep, and managing the things that disrupt it. Particularly relevant for anyone whose main concern is under eye appearance, which fluctuates with sleep, salt, alcohol and allergy.
- Getting a dermatological assessment. If there is a specific skin condition, treating that is a different and generally better evidenced proposition than a cosmetic injectable. Pigmentation in particular has causes that matter.
- Topical treatments with an evidence base. Some have one. Some do not. A dermatology assessment is a better guide than a website.
- Nothing. The most underrated option, and one that leaves every other option open indefinitely.
| Option | Evidence position | What it costs |
|---|---|---|
| Polynucleotide treatment | Plausible mechanism, central claim unproven | A course plus indefinite maintenance |
| Sun protection | Well evidenced for long term skin ageing | Very little |
| Stopping smoking | Well evidenced, for skin and for everything else | Difficult, and free |
| Dermatological assessment of a specific condition | Depends entirely on the condition, and often much better evidenced | An appointment |
| Doing nothing | Not applicable | Nothing, and it keeps every option open |
A framework written by this publication to organise a decision. It is not a measurement, it is not drawn from any study, and no figure in it should be quoted as a finding.
6.6.3The pressure, named
It is worth being direct about the environment in which this decision is made. Image based platforms are designed to hold attention and they hold it particularly well with content about faces. Filters have shifted the reference point against which people assess their own appearance. A great deal of cosmetic treatment content is incentivised and undisclosed. And the sector spends substantially on advertising that has no pre approval requirement.
None of that means anyone wanting a treatment has been manipulated into it. Plenty of people arrive at these decisions thoughtfully and are pleased with the outcome. It does mean that the impulse to have something done arrives through channels with an interest in producing it, and noticing that is not cynicism.
6.6.4This document is not against the treatment
It would be easy to read the whole of this reference as an argument against having polynucleotide treatment. It is not one, and it would be a poor reference if it were.
The position taken throughout is narrower. The mechanism is plausible. The short term effect is real. The central claim is unproven. The regulatory framework does not require it to be proven. And a person who understands all of that and decides to go ahead has made a decision this document has no quarrel with.
What this reference exists to prevent is a different thing: someone deciding on the basis that the question has been settled, when it has not, and finding out later what they were not told.
6.6.5Deciding later
Not now is not the same as never. Nothing about declining this treatment forecloses anything. The products will still be available, more evidence may exist by then, and the regulatory position in England may have changed.
If you want a practical way to hold the decision open: take standardised photographs now, in consistent light. Set a date some months ahead. If at that point you still want it, you will be making the decision with a real baseline and without the pressure of the room you were in when you first considered it. That is a better position than the one most people decide from.
Questions
Is it reasonable to decide against this?
Entirely, and it requires no justification. Professional guidance on consent is explicit that the option of doing nothing must be presented as a genuine option rather than as a formality, and nothing about declining forecloses anything later.
What should I do instead?
Possibly nothing, which is the most underrated option. Sun protection is the best evidenced thing anyone can do for the long term appearance of skin. If there is a specific skin condition, having it assessed properly is a different and generally better evidenced proposition than a cosmetic injectable.
Will I look worse if I do nothing?
You will age, as you would with or without treatment. The framing of doing nothing as a loss is a sales device rather than a description, and it is worth recognising when it is being used.
Is this website telling me not to have it?
No. The position throughout is that the mechanism is plausible, the short term effect is real, the central claim is unproven, and a person who understands all of that and proceeds has made a decision this document has no quarrel with. What it exists to prevent is someone deciding on the basis that the question has been settled.
How do I keep the decision open?
Take standardised photographs now in consistent light, set a date some months ahead, and revisit it then. You will be deciding with a real baseline and without the pressure of the room you were in when you first considered it, which is a considerably better position.
- NHS, Cosmetic procedures
- GMC, Decision making and consent
- British Association of Dermatologists
- NHS, Sunscreen and sun safety
- Advertising Standards Authority
Links to regulators, professional bodies, legislation and research indexes. They are cited because they are public and checkable, not as endorsement of this publication. No source listed here has any commercial relationship with us.
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