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Are you an adult seeking non-surgical solutions for under-eye concerns such as dark circles, crepey skin, puffiness, or a tired appearance? Polynucleotides under eyes are long chains of nucleotides used in aesthetic treatments to improve under-eye skin quality by stimulating collagen, elastin, and hydration, helping to reduce dark circles and puffiness without adding volume in this delicate area. With increasing demand for safer, non-volumizing under-eye treatments, they have rapidly become one of the most discussed options in UK aesthetic medicine.
This clinical guide is designed for adults—especially those aged 25 to 60—who want subtle, medically safe, non-surgical improvement of the under-eye area, particularly if you are more interested in better skin quality than added volume. Here, you’ll find:
Because under-eye skin is thin and prone to creasing, shadowing, and treatment-related complications, understanding the difference between volumizing and regenerative approaches is key to choosing the right option. As demand grows for treatments that improve skin quality without adding volume, this guide will help you make an informed decision.
What are polynucleotides?
Polynucleotides (PNs) are long chains of nucleotides used in aesthetic treatments, with a structure that is highly compatible with human skin.
What do they do under the eyes?
How long do results last?
Results from polynucleotide treatments typically last 6-9 months.
How many sessions are needed?
What are the side effects?
Who is not suitable?
What does it cost?
How often is maintenance needed?
Polynucleotides are purified chains of DNA fragments, most commonly extracted from salmon or trout. Their structural similarity to human DNA means the body tolerates them well, with strong compatibility with human skin rather than mounting an immune response. Polynucleotides improve skin quality, not volume. Polynucleotides stimulate collagen and elastin production. Polynucleotides enhance skin hydration by stimulating hyaluronic acid synthesis. Polynucleotides’ anti-inflammatory properties help reduce puffiness.
Once placed intradermally, they are understood to act as a biological signal to the surrounding tissue, increasing the activity of fibroblasts—the cells responsible for producing collagen and elastin, while supporting cellular regeneration, collagen synthesis, and the skin’s ability to repair and regenerate in the surrounding tissue. Their origins lie in wound healing, where they were used clinically long before their adoption in aesthetics. A systematic review in the Journal of Cosmetic Dermatology traces this lineage directly, describing their regenerative properties as carried over from that earlier therapeutic context.
The critical point, and the one most often obscured in consumer-facing material: polynucleotides are not a filler. They contain no hyaluronic acid, add no volume, and will not correct a hollow. Their intended effect is on skin texture, skin elasticity, and overall skin quality.
That distinction determines whether the treatment is appropriate for you, and it is the most common source of disappointment among patients who arrive expecting an outcome the product was never designed to produce.
The skin beneath the eye is the thinnest on the body, measuring approximately half a millimetre in places, and the under eye skin is delicate skin that is particularly vulnerable to sun exposure over time. Beneath it lies a dense arrangement of orbicularis muscle, fat compartments, retaining ligaments and lymphatic drainage channels within a very confined space.
A review published in the Journal of Clinical Medicine identifies the periorbital region as one of the most challenging anatomical sites in aesthetic medicine, citing its thin dermis, complex vascularity and susceptibility to oedema and contour irregularity.
Compounding this, under-eye shadowing has several distinct causes, and each responds to a different intervention:
Most patients present with two or three of these in combination. This is why accurate assessment matters more than product selection. Where shadowing is predominantly volumetric, polynucleotides will underdeliver. Where it is predominantly a matter of skin quality, filler can make the appearance materially worse.
Most patients researching under eye filler or tear trough filler encounter abundant before-and-after imagery and very little discussion of outcomes beyond the first six months. The comparison below addresses both.
Hyaluronic acid placed in the tear trough is an effective treatment for the indication it was designed for: correction of a volume deficit. Where a true hollow exists, no other modality replaces volume as directly or as immediately. A meta-analysis of 31 studies covering 2,556 patients reported a pooled satisfaction rate of 91% for tear trough hyaluronic acid treatment, with results apparent on the day of treatment.
For appropriately selected patients treated by an experienced injector, it remains an excellent option, and any account that dismisses it is not a reliable one.
The same evidence base is candid about the complication profile. Within that meta-analysis, pooled rates included swelling or oedema in 19.2% of cases, bruising in 18.4%, erythema in 7.1%, contour irregularity or lumping in 5.3%, and blue-grey Tyndall discolouration in 0.9%.
A study of 583 patients across 1,452 filler applications, published in Plastic and Reconstructive Surgery – Global Open, found that 82% of patients reported no complication after a first treatment. Of those who did, 10% experienced oedema with a median duration of four weeks and a reported range extending to a full year. The volume of filler injected was significantly associated with the risk of both oedema and contour irregularity—a finding with obvious implications for how conservatively the area should be treated.
The delayed picture is less frequently discussed at consultation. A systematic review cited in the Journal of Clinical and Aesthetic Dermatology found that delayed complications presented on average around 16.8 months after treatment, most commonly swelling, but also nodules, migration and discolouration, with discolouration in some cases appearing years later. The authors note that the high satisfaction rates and low complication rates associated with this treatment are most reliable within the first six months, and that the persistence of hyaluronic acid in the periorbital area can produce dissatisfaction over longer follow-up.
This mechanism explains the majority of cases patients describe as botched tear trough filler. Unlike other injectable treatments, polynucleotides do not rely on volume replacement. The typical presentation is not an acute injection injury. It is a satisfactory early result that deteriorated—product that attracted water and produced chronic puffiness, migrated beyond its intended plane, or became visible as the surrounding facial architecture changed around it.
Polynucleotides occupy a different clinical category as an innovative treatment within regenerative aesthetics. Because they add no volume and are not hydrophilic, they do not carry the risks of malar oedema, Tyndall effect or migration associated with placing a water-binding gel into a shallow, lymphatically congested area. In practical terms, polynucleotide treatment works by stimulating collagen and elastin production to support skin regeneration and tissue repair.
Key differences between polynucleotides and fillers:
For a substantial proportion of patients, the appropriate answer is not one modality or the other. It is polynucleotides first to improve the quality of the skin envelope by boosting collagen production, which improves skin elasticity and overall skin texture, followed by reassessment—at which point a smaller and more conservative volume of tear trough filler treatment is often sufficient, and sometimes no longer indicated.
| Tear trough filler | Polynucleotides | |
|---|---|---|
| Mechanism | Replaces lost volume | Stimulates dermal remodelling |
| Onset of results | Immediate | Gradual, typically 4–12 weeks |
| Course required | Often a single session | Typically 2–3 sessions, 2–4 weeks apart |
| Reversible | Yes, with hyaluronidase | Not applicable — fully metabolised |
| Principal risks | Oedema, Tyndall, migration, malar oedema | Bruising, transient swelling at injection points |
| Best indication | True hollowing from volume loss | Thin, crepey, dehydrated or finely lined skin |
| For a substantial proportion of patients, the appropriate answer is not one modality or the other. It is polynucleotides first to improve the quality of the skin envelope by boosting collagen production, which improves skin elasticity, followed by reassessment — at which point a smaller and more conservative volume of tear trough filler treatment is often sufficient, and sometimes no longer indicated. |
A measured account is warranted here, because commercial enthusiasm for this treatment has outpaced the research.
A prospective study published in early 2026 followed 42 patients receiving intradermal polynucleotide injections for under-eye rejuvenation, assessed using validated FACE-Q patient-reported outcome measures. It found statistically significant improvement in lower eyelid and crow’s feet appraisal scores at one, three and six months relative to baseline.
A randomised, double-blind, split-face trial compared polynucleotide injection against hyaluronic acid filler for periocular rejuvenation. As reported by Dermatology Times, the polynucleotide-treated side achieved higher Global Aesthetic Improvement Scale scores at 16 weeks and a greater reduction in skin roughness by week 28. Published data have also reported over 32 percent improvement in under-eye brightness and around 22 percent average improvement in skin elasticity.
The most rigorous synthesis to date, a systematic review from Imperial College London published in the Journal of Cosmetic Dermatology, included nine studies covering 219 patients receiving polynucleotide treatment. Its findings on skin rejuvenation, overall skin texture, and side-effect profile were favourable, but the authors graded the quality of the underlying evidence as low to moderate.
That is the accurate position. The direction of the evidence is consistent and the safety record is good. Proposed mechanisms also include anti-inflammatory properties, which may help reduce puffiness and support skin repair. The studies are small and the evidence base remains young. Any clinic presenting this treatment as clinically settled is overstating what has been demonstrated.
Patients reviewing polynucleotide under eyes before and after imagery should calibrate expectations against several factors.
Timeline. Visible change is not immediate. The first fortnight typically produces little beyond mild swelling at the injection points. Change generally becomes apparent from around week four and continues developing for two to three months following the final session. The published studies assess outcomes at three and six months for this reason.
What improves. The realistic outcome is skin that appears less crepey, can improve skin texture, support deep hydration, help with reducing dark circles where shadowing relates to skin quality, and reflect light more evenly in the under-eye area, with softened fine lines and reduced visibility of the underlying vasculature. The area reflects light more evenly, which is the characteristic that reads to others as a less tired appearance, usually as healthier-looking, youthful skin rather than a dramatic volumising change.
What does not improve. A structural hollow remains a hollow. Constitutional pigmentation remains pigmented. Herniation of the infraorbital fat pads—true under-eye bags—is a surgical consideration, and no injectable resolves it.
Photographic standards. Treat dramatic comparisons with caution where lighting, camera, angle and makeup have all changed between images. Standardised clinical photography produces more modest before-and-after results, and those are the results that remain credible at two-year follow-up.
A first appointment should be a consultation rather than a treatment. Same-day injection of the periorbital area without prior assessment is a meaningful indicator of clinical standards.
The practitioner should examine the area under appropriate lighting, determine which of the causes above are contributing to your shadowing, review your medical history and any previous injectable treatment, identify your main skin concerns, and advise you directly if you are not a suitable candidate. They should also agree a personalised treatment plan based on the desired outcome.
Topical numbing cream is generally applied for 20 to 30 minutes as part of an under eye treatment or eye treatment tailored to the patient. Injections are placed superficially across the infraorbital area, delivered either as a series of small intradermal deposits or via cannula, depending on the practitioner’s technique and your anatomy. Treatment time is approximately 20 minutes.
Patients typically describe the injections as sharp but brief. The periorbital area is sensitive and the procedure is not comfortable, though it is short.
Two to three sessions at two to four week intervals is standard, with polynucleotides used here as skin boosters to improve skin quality rather than add volume, though the treatment plan may vary depending on skin concerns and response between sessions, with maintenance generally required every six to twelve months, similar to other biorevitalisation treatments for the periorbital area.
Small raised papules at each injection point are expected and usually settle within a few hours, occasionally persisting overnight. Mild redness can also occur, and most short-term side effects typically resolve within 24-48 hours. Bruising is common in this area given the thin skin and superficial vasculature, and should be anticipated when scheduling around commitments.
Standard aftercare guidance includes avoiding makeup for 12 to 24 hours, refraining from exercise, saunas and steam rooms for 48 hours, avoiding alcohol on the day of treatment, sleeping with the head slightly elevated on the first night, and maintaining skin hydration during recovery. Your practitioner will provide specific instructions relevant to your treatment. A further advantage is minimal downtime for most patients.
You should also be given a route to contact the clinic if anything concerns you post-treatment. The absence of accessible clinical support outside appointment hours reflects on the clinic rather than on the treatment.
Polynucleotides are likely to be appropriate where: the infraorbital skin is thin, crepey or dehydrated; fine lines are present and accentuated on animation; the area appears dull or shadowed rather than genuinely hollow; previous filler has been placed and a non-accumulating option is preferred; or polynucleotides treatment is being considered for sensitive skin to support the skin’s ability to repair and maintain quality, alongside long term skin health rather than immediate volume.
Polynucleotides are unlikely to be appropriate where: the predominant feature is a deep structural hollow; significant fat pad herniation is present; shadowing is primarily constitutional pigmentation, which responds better to other approaches; you are pregnant or breastfeeding; there are active skin infections or inflammatory skin disease in the area, which will be screened for at consultation; or you have a fish or seafood allergy, which must be declared at consultation.
This is among the most common reasons patients seek an alternative treatment, and it warrants a direct answer.
Where existing tear trough filler is producing puffiness, blue-grey discolouration or contour irregularity, polynucleotides are not the corrective intervention. The appropriate first step is assessment of what is present, and in many cases dissolution of the existing product with hyaluronidase before any further treatment is considered. The literature indicates that filler-associated malar oedema frequently resolves once the product is removed.
Polynucleotides may then be a reasonable subsequent step, supporting the quality of skin that has been stretched or otherwise compromised. They cannot correct a placement problem, and any clinic proposing to layer them over problematic filler is not addressing the underlying issue.
The UK non-surgical aesthetics sector remains substantially unregulated, and the implications are greater for periorbital work than for almost any other area of the face.
Save Face, a government-approved register of accredited practitioners, reported 2,824 complaints in a single recent year concerning unregistered practitioners. Figures presented in a House of Commons debate attributed close to 70% of a comparable complaints total to dermal fillers, with women aged 18 to 25 accounting for approximately half of those affected.
The government has announced measures to address this and is progressing a licensing scheme for England, but it is not yet in force. Until it is, responsibility for verification rests with the patient.
Five questions worth asking before booking:
Pricing varies by clinic and by the number of sessions in a course. A full polynucleotide under eye treatment course often costs £850 to £1200, with many clinics charging around £250 to £350 per session. Central London and Harley Street clinics generally sit at the higher end of the range, reflecting practitioner seniority and clinical infrastructure. Substantially lower pricing usually reflects either product sourcing or the qualifications of the person injecting. [INTERNAL LINK: “our pricing” → Pricing page]
Results generally hold for six to twelve months following completion of an initial course, varying with age, skin condition and lifestyle factors. Because polynucleotides are fully metabolised rather than persisting in the tissue, maintenance sessions are required to sustain the effect.
Reducing dark circles depends on the underlying cause. Where darkness results from thin skin allowing underlying vessels to show through, improving dermal quality can produce visible benefit. Where it results from constitutional pigmentation or from a structural hollow casting a shadow, polynucleotides alone are unlikely to be the appropriate treatment.
They carry a different risk profile rather than a uniformly lower one. Because they add no volume and do not bind water, they avoid the complications specifically associated with hyaluronic acid in this area—malar oedema, Tyndall effect and migration. Bruising and transient swelling remain common, and as with any injectable there is a small risk of infection.
Typically two to three, at two to four week intervals. Patients with thinner or more photodamaged skin sometimes benefit from a fourth. This should be established at consultation rather than after treatment has commenced.
Frequently, though sequenced rather than delivered simultaneously. A common approach is to use polynucleotides as skin boosters to improve tissue quality first, then reassess whether volume correction remains indicated and at what quantity. Many patients require considerably less filler than anticipated once dermal quality has improved.
Most polynucleotide products are derived from salmon or trout DNA. Any fish or seafood allergy must be declared at consultation, and your practitioner will advise whether treatment is appropriate.
Minimal but not none, with minimal downtime for most patients. Small papules at the injection points are expected for several hours, and bruising may persist for a few days. Most patients return to work the same or following day, though scheduling around significant commitments is advisable.
The most useful outcome we can offer at a first appointment is not a treatment but an accurate assessment of what is producing your under-eye shadowing, and whether polynucleotides will address it.
At our Harley Street clinic, that consultation comprises examination of the periorbital area, a discussion of the options available to you including those we do not provide, and a direct recommendation if we consider another approach more appropriate. It is also used to build a personalised treatment plan around the under eye area and your desired outcome.
Book a consultation — or get in touch if you would prefer to ask a question first.
This article is provided for general information and does not constitute medical advice. Individual results vary and no outcome can be guaranteed. Polynucleotide treatment should be carried out only by a qualified, registered practitioner following a face-to-face consultation. Please seek personalised advice from a suitably qualified clinician.
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