Sunekos is not widely used by doctors in the USA primarily due to regulatory and market factors. One of the main reasons is that Sunekos may not yet have FDA approval, which is necessary for any injectable treatment to be legally marketed and used in the United States. The FDA approval process is rigorous and ensures that treatments are safe and effective for patients. Without this approval, many practitioners opt for treatments that are already cleared for use. Additionally, the availability and popularity of other well-established skin boosters like Profhilo, which may already have FDA approval, contribute to the limited use of Sunekos in the US. Physicians often choose treatments that have a proven track record and are readily available. It's also worth noting that treatment preferences can vary based on regional practices and the specific needs of patients. While Sunekos might offer benefits for certain patients, the choice of treatment depends on individual patient conditions and the professional judgment of the dermatologist.