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This article is intended for qualified aesthetic practitioners and prescribers. It is not consumer advice.
Sunekos is an injectable medical device from Professional Dietetics S.p.A. in Milan that combines non-crosslinked sodium hyaluronate with a fixed blend of amino acids. It sits in the skin booster and biorevitalisation category rather than the volumising filler category, and the range now covers several formulations with different hyaluronic acid (HA) profiles and indications. If you are deciding whether to add Sunekos to your menu, or which product in the range suits a given patient, the short answer is this: Sunekos 200 is the long-established face and periocular product, Sunekos 1200 uses high molecular weight HA and is often used to open a course, and Sunekos Performa is the newer pre-mixed formula aimed at wrinkles and laxity on the face, periocular area and neck.
Below we cover what is actually in the vials, how the products differ, the published evidence, typical protocols and the practical points that matter in clinic.
The manufacturer describes Sunekos as a patented combination of hyaluronic acid and amino acids, and states on the official Sunekos site that its products are for use by qualified healthcare professionals only. The amino acid component is marketed as HY6AA, a blend of six amino acids. The rationale is that amino acids such as glycine and proline are building blocks of collagen, so supplying them alongside HA is intended to support the extracellular matrix rather than simply hydrate or fill.
Because the HA is not crosslinked, Sunekos does not behave like a volumising filler. Practitioners use it for skin quality: hydration, fine lines, crepiness and laxity. That positioning is important when you set patient expectations and when you choose between Sunekos and products such as Profhilo, polynucleotides or a light crosslinked filler.
The most detailed public composition data comes from a 2017 open-label study of Sunekos 200 published in the Journal of Clinical Trials (Sparavigna and Orlandini). It lists the lyophilised amino acid vial as glycine, L-proline, L-leucine, L-lysine HCl, L-valine and L-alanine, combined with 30 mg of low molecular weight sodium hyaluronate in 3 ml. The two components are mixed immediately before injection.
The manufacturer's injectable line currently lists Sunekos 200, Sunekos Performa, Sunekos 1200, Sunekos Body and Sunekos Cell 15. The three facial products are the ones most UK clinics stock.
Sunekos 200 pairs low molecular weight HA with the amino acid blend, supplied as separate powder and gel vials for reconstitution. The manufacturer lists it as suitable for the face and periocular area and describes it as developed for delicate areas and skin-quality protocols. It is the product behind most of the published data and the one many practitioners use around the eyes.
Sunekos 1200 uses high molecular weight (1200 kDa) sodium hyaluronate with a separate amino acid component that is reconstituted before use. According to the manufacturer's Performa protocol folder, one pack provides a single 3 ml treatment. The manufacturer lists it for the face. The higher molecular weight HA gives a little more substance in the tissue, which is why many practitioners use it as the first session of a course before switching to a lower molecular weight product. Stock is listed on our Sunekos 1200 page.
Performa is described by the manufacturer as an evolution of the Sunekos approach. The protocol folder states that it contains low molecular weight HA with the HY6AA amino acid formula in a new amino acid to HA ratio, and that it comes pre-mixed, with one pack containing two 3.5 ml treatments. That removes the reconstitution step, which saves chair time and reduces handling. Indications listed are wrinkles and skin laxity, and the manufacturer lists the face, periocular area and neck as suitable areas. See Sunekos Performa for the current pack.
Sunekos Body is positioned for stretch marks and skin laxity, and Cell 15 for cellulite. They are outside the scope of this facial guide, but they share the same HA and amino acid concept.
The evidence base is modest, and it is worth being honest with yourself and your patients about that. The 2017 Sparavigna and Orlandini study enrolled 25 women aged 48 to 65 at a single Italian centre. Each received four sessions of Sunekos 200 at day 0, 10, 20 and 30, using 3 ml per session through a 30G 13 mm needle, with follow-up to six months. The authors reported improvements on cheek volume, nasolabial wrinkle and crow's feet scales, plus instrumental measures of hydration and skin elasticity. Side effects were limited to bruising at injection points, which resolved within 5 to 10 days, and one episode of mild periocular oedema.
The limitations are clear. It was open label, with no control group, a small sample and authors who list an affiliation with the manufacturer. The manufacturer's clinical studies page also cites a 2018 in vitro study (De Servi et al.) on amino acid and HA mixtures in cultured fibroblasts. That is useful mechanistic background, but in vitro data does not predict clinical outcomes. Use this evidence to frame Sunekos as a skin-quality treatment with a reasonable safety record in small studies, not as a product with guaranteed results.
Always follow the current instructions for use (IFU) supplied with the product. The points below summarise what the manufacturer and published literature describe.
For Sunekos 200, the published study used four sessions at roughly 10-day intervals. For Performa, the manufacturer's protocol folder recommends one facial session every two weeks for three sessions, with an optional fourth depending on the patient. It also lists an optional first session with Sunekos 1200 before moving on to Performa. Maintenance intervals vary with the patient's age, skin and lifestyle, so set them at review rather than promising a fixed schedule.
The Performa protocol folder specifies injection into the medium to deep dermis, perpendicular to the lines of folding. It lists:
In practice, many injectors use micro-boluses on a grid across the treatment zone with a fine needle, and a cannula where they want to reduce entry points and bruising in vascular areas. Around the eyes, keep to the superficial planes the IFU describes, use small volumes per point and pay close attention to the patient's lymphatic drainage, since periocular oedema was the one notable event in the published study.
Sunekos 200 and 1200 must be reconstituted under aseptic conditions immediately before use. Draw the HA solution, transfer it to the amino acid vial, mix gently until fully dissolved and inject promptly. Treat each pack as single-patient use and discard any remainder. Performa arrives pre-mixed, which simplifies handling and is one reason clinics with a high skin-booster workload are switching to it. Store all products according to the IFU, record batch numbers in the patient's notes and keep the pack labels for traceability.
Sunekos suits patients who want better skin quality without volume: early laxity, crepey under-eye skin, dehydrated or dull skin and fine lines. It is less suitable where the main problem is structural volume loss, which needs a crosslinked filler or a collagen stimulator, or significant skin excess, which needs a surgical referral.
Take a full medical history and screen for the usual contraindications in the IFU, including active skin infection or inflammation at the treatment site, pregnancy and breastfeeding, and known hypersensitivity to any component. Explain that results build gradually over a course, that individual responses vary and that bruising and swelling are common. Document consent fully and give written aftercare.
Patients and practitioners often ask how Sunekos compares with Profhilo. Both are non-volumising HA treatments, but they differ in design. Profhilo uses stabilised hybrid complexes of high and low molecular weight HA with no added amino acids, delivered at fixed points (see our guide to Profhilo injection points). Sunekos adds the amino acid blend and is usually injected across a wider grid or with a cannula. There is no head-to-head trial, so choosing between them comes down to the indication, the area treated and your own experience.
Sunekos is also close in concept to Jalupro, which pairs amino acids with HA. Polynucleotides are a different class altogether. Many clinics stock more than one, and you can compare options across our skin booster collection or see the full Sunekos range.
Neither is better in every case. They have different compositions and protocols, and no comparative trial exists. Sunekos is often chosen for periocular skin and for skin-quality courses where the amino acid blend fits the treatment aim. Profhilo is often chosen for broad hydration and laxity using a five-point technique per side.
Sunekos 200 uses low molecular weight HA and is listed for the face and periocular area. Sunekos 1200 uses high molecular weight (1200 kDa) HA, is listed for the face and is often used as the opening session of a course. Both need reconstitution before use.
The published Sunekos 200 study used four sessions about 10 days apart. The manufacturer's Performa protocol recommends three sessions two weeks apart, with an optional fourth. Tailor the course and maintenance to the individual patient and the IFU.
No. Sunekos is supplied as a medical device, not a medicine. The manufacturer restricts it to qualified healthcare professionals, and you should only use it within your scope of practice, training and insurance cover.
Sunekos gives practitioners a skin-quality option that combines non-crosslinked HA with a defined amino acid blend. Use Sunekos 200 for delicate and periocular work, Sunekos 1200 as a higher molecular weight opener, and Performa where you want a pre-mixed formula for wrinkles and laxity on the face and neck. The published evidence is encouraging but limited, so set realistic expectations, follow the IFU closely and record each course carefully. Filler World supplies the Sunekos range to qualified practitioners across the UK.
