Quick answer
The four are different substances. RE20 (Elravie Re2O) is particulated human acellular dermal matrix, which is donated skin with the donor's cells removed. Rejuran is polynucleotide, purified DNA fragments usually from salmon or trout. Profhilo is hyaluronic acid. Sculptra is poly-L-lactic acid (PLLA), a man-made polymer. Juvelook, a fifth name people ask about, is poly-D,L-lactic acid (PDLLA) mixed with hyaluronic acid. The order of the table is not a ranking.
| Product | What it is made of | How it is thought to work | Size of the evidence | On Malaysia's MDA register, 26 Oct 2026 |
|---|---|---|---|---|
| RE20 (Elravie Re2O) | Particulated human acellular dermal matrix: skin donated by deceased donors, cells removed, collagen-rich scaffold left (the maker's description) | The sources read set out no mechanism. The trial injected it into the mid-dermis and measured skin density, volume and hydration on instruments | One published trial: 20 adults, split-face, 20 weeks, product supplied by the maker. A second trial is registered | Not found |
| Rejuran (polynucleotide) | Purified DNA fragments, usually from salmon or trout | Proposed: binds a cell receptor and supplies DNA building blocks to stressed cells; mostly laboratory support | Class: seven randomised trials, 183 people. Two Rejuran trials retracted. One 25-woman study after radiofrequency | Yes. Rejuran HB Plus: GD11766525-217431. Rejuran, Rejuran i and Rejuran s also listed |
| Profhilo (hyaluronic acid) | Hyaluronic acid of two molecular weights, 32 mg + 32 mg in 2 mL | Hyaluronic acid holds water in the skin; used to improve skin quality | A 12-woman trial against saline, a 24-woman comparison with another hyaluronic acid booster, a 13-study review of the class | Yes. Profhilo: GD7879920-39222. Profhilo Structura: GD4776424-177823 |
| Sculptra (poly-L-lactic acid) | PLLA, a man-made polymer, supplied as a dry powder mixed with sterile water | A biostimulator: particles that prompt the skin to build its own collagen as they are slowly absorbed. It contains no collagen | A 14-study review of PLLA and CaHA; one 40-woman randomised trial of PLLA for skin quality | Yes. Sculptra: GD25241521018 |
| Juvelook (poly-D,L-lactic acid) | PDLLA mixed with hyaluronic acid as a carrier | A biostimulator, as above | Trials of PDLLA in aesthetic use remain limited (2024 consensus on one PDLLA product) | Yes. Juvelook-branded implant: GD5846923-150010 |
What is RE20 made of, and what is known about it?
RE20 is the only one of the five made from human tissue. Its maker, L&C Bio of Korea, says the skin comes from donors in the United States through accredited tissue banks, that donors consented in advance to cosmetic use, and that the cells and DNA are removed. Those are the company's statements. The article on how RE20 is made goes through each step.
The evidence is one published trial, in 20 adults, comparing a mixture of the donated skin particles and hyaluronic acid with hyaluronic acid alone. The test side did better on several instrument readings over 20 weeks, with no serious adverse events. The product was supplied by the maker, and the authors list their own limits. The article on what RE20 is covers it in full.
On 26 Oct 2026 we could not find RE20 on Malaysia's medical device register or NPRA's product list. Some clinics in Malaysia advertise RE20 boosters online. An advertisement is not a register entry, and the register is the place to check.
Rejuran: DNA fragments usually taken from salmon
Rejuran is a polynucleotide product: purified DNA fragments, usually taken from salmon or trout. The Malaysian register lists Rejuran, Rejuran i and Rejuran s as sodium polynucleotides at 20 mg/mL for the mid to deep dermis, and Rejuran HB Plus, which combines polynucleotide with hyaluronic acid. The two proposed mechanisms are binding a cell receptor called the adenosine A2A receptor and supplying DNA building blocks to stressed cells. Both rest mainly on laboratory studies, which is a step short of a proven clinical effect.
The evidence is for the class more than for the brand. A 2026 systematic review found seven randomised polynucleotide trials with 183 participants, with benefit strongest in wound healing and more modest in skin rejuvenation. None of its four rejuvenation trials compared an injected polynucleotide with an injected placebo. Two published Rejuran trials in crow's feet are retracted, and one small 25-woman study tested it after radiofrequency. Anyone with a fish allergy should say so, and the register entry excludes children, adolescents, and pregnant or breastfeeding women. More is in the Rejuran, Plinest and Newest comparison and the article on PDRN and salmon DNA.
Profhilo: hyaluronic acid
Profhilo is hyaluronic acid, the substance that holds water in the skin. The register describes it as highly purified sodium hyaluronate of two molecular weights, 32 mg of each in a 2 mL syringe, with Profhilo Structura at 45 mg of each. Its maker describes it as stabilised by heat rather than by a chemical cross-linker.
The trials are small. In 12 women, split-face against saline around the mouth, wrinkles and pores improved on imaging, but dermal thickness rose on both sides and the authors concluded the effect on thickness did not exceed the placebo effect. In a 24-woman comparison with another hyaluronic acid booster, both improved hydration and elasticity over 14 weeks and did not differ significantly. A 2023 review of 13 studies of injectable hyaluronic acid for skin quality found improvement in hydration, firmness and texture and called for large randomised trials. More is in the NCTF 135HA, Profhilo and Skinvive comparison.
Disclosure: in September 2026 I received the 2025 IBSA Key Opinion Leader Award; IBSA makes Profhilo.
Sculptra and Juvelook: particles that prompt collagen
Sculptra is poly-L-lactic acid (PLLA), a man-made polymer also used in absorbable stitches, supplied as a dry powder and mixed with sterile water. It is a biostimulator: the particles prompt the skin to build its own collagen as they are slowly absorbed, and it contains no collagen. The effect builds over weeks. The FDA gives up to two years for PLLA, and a 2026 review of 14 studies reported effects maintained for up to 25 months. A 40-woman randomised trial of PLLA against saline for skin quality reported higher elasticity and hydration at 12 months in the PLLA group.
Juvelook is poly-D,L-lactic acid (PDLLA), a close relative, which the register describes as mixed with sodium hyaluronate as a carrier. It belongs to the same class, and a 2024 consensus on one PDLLA product says clinical trials of PDLLA in aesthetic use remain limited.
One fact matters before a first session. Hyaluronidase dissolves hyaluronic acid, and PLLA and PDLLA particles are not hyaluronic acid, so they cannot be dissolved that way. The full account is in the biostimulator types article.
Is RE20 better than Rejuran, Profhilo or Sculptra?
No one can say. No head-to-head trial of RE20 against polynucleotides, PLLA or Profhilo was found. The trials that do exist differ in product, area, comparator and measure, so their figures cannot be laid side by side. A higher number in one study is not a better result in another.
What can be compared is the label. What is the material, and where does it come from: human donor tissue, fish, hyaluronic acid or a man-made polymer? Is it on the register? How big is the evidence for that product, and who paid for it? Those answers differ between these five, and they are checkable.
What to ask before any of them
- What exactly is it made of, and where does the material come from?
- What is the registration number on the box, and does it match the Medical Device Authority register? The article on checking a product shows how.
- What trial exists for this product in this area, who ran it and who paid for it?
- Can it be reversed, and what is the plan if a lump appears? Hyaluronic acid can be dissolved with hyaluronidase. PLLA and PDLLA particles cannot. For RE20 the sources read do not say.
- Allergies and timing: a fish allergy matters for polynucleotides, allergy to lidocaine or bacterial proteins matters for some hyaluronic acid gels, and the safety of fillers in pregnancy and breastfeeding is unknown.
- How many sessions, how will the result be judged, and who injects?
A skin booster answers a question about skin quality. Whether that is the question the skin is asking is settled by examining it, and no product name can do that.
What does Dr Ong think about RE20?
Dr Ong Jin Khang said on 26 October 2026: "I'm really not sure of the results and I for one feel it's very icky to inject cadaver tissue."
RE20's published evidence is one small trial of 20 adults over 20 weeks. The table above shows how that compares with the other four.
