By area

Polynucleotides for Under-Eyes

The skin under your eye is around half a millimetre thick, thinner than anywhere else on the body, and that single fact explains both why this area ages first and why it responds to a treatment that repairs skin rather than one that fills it.

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The short answer

What this treatment is

Most people arrive at this treatment having decided the problem is a shadow. They have looked in a mirror in bad light, seen darkness, and gone looking for something to fill it. Sometimes that is right. Often it is not, and the difference decides whether a course of polynucleotides is money well spent or a disappointment you pay three times for.

Under-eye skin has almost no fat beneath it and very little collagen holding it. As that collagen thins, two things happen at once: the surface develops the fine crepey texture that catches the light, and the vascular tissue underneath starts showing through as a blue-grey cast. Polynucleotides work on both, because both are consequences of the skin itself having got thinner. What they will not do is refill a hollow that has lost its fat pad, and no honest assessment will tell you otherwise.

Under-eyes at a glance during and after your session

Session timeAbout 30 minutes with numbing
CourseUsually three, sometimes four
IntervalTwo to three weeks apart
First visible changeAround the second session
BruisingCommon here, up to a week
Result judgedAt about eight weeks

Areas treated

What's included

Softens fine crepey texture in the skin under the eye
Reduces the blue-grey darkness that comes from thin skin
Thickens the skin so it catches less light in the creases
Improves hydration in an area that holds very little
Suits people who have been told they are not ready for filler
Can be used alongside volume treatment when both are needed

Boundaries of practice

What's not treated

Good practice means saying no when indicated:

Known allergy to fish, since the source material is salmon or trout
Pregnancy or breastfeeding, where no safety data exists for this treatment
Active skin infection, inflammation or an open wound in the area
Active autoimmune disease affecting the skin, without clinical advice first
Anticoagulant or antiplatelet therapy, which needs assessment before treating
A course of isotretinoin taken within the last six months

Patient journey

What to expect

Consultation & preparation

Stop fish oil, high-dose vitamin E and anti-inflammatory painkillers for a few days beforehand if your own doctor is content for you to, because each of them makes bruising more likely. Come with a list of what you have already had done and when, and the medicines you take. Describe what you dislike in your own words rather than naming a treatment, so the assessment starts from the problem.

During treatment

Three different problems that all look like tired eyes

The first is lost volume. The fat pad that sits under the eye shrinks and descends with age, leaving a genuine trough. Light falls into it and casts a shadow. Nothing that improves skin quality will lift this, because the deficit is structural. It needs volume replaced, or in some cases surgery.

The second is pigment. Some people, particularly with deeper skin tones, carry genuine melanin deposition in the under-eye skin. It is often hereditary, it usually affects both eyes evenly, and it does not change much with sleep. Polynucleotides will not lighten it, and neither will filler. It is a pigmentation problem and needs treating as one.

The third is thin, poor-quality skin, and this is the one that responds. The skin has lost collagen, so it is finely lined, it creases when you smile and holds the crease, and the vessels beneath show through it as a dusky cast. This is what polynucleotides are for.

Plenty of people have two of the three, or all three. That is not a reason to avoid treatment, it is a reason to have the areas separated at assessment and treated in a sensible order rather than all at once.

Why thin skin is the version this treatment reaches

Polynucleotides are chains of nucleotides, purified from salmon or trout DNA. Placed into the dermis they do two things. They bind water, which hydrates a layer that is chronically short of it. More importantly they act on the fibroblasts already living in your skin, prompting them to behave like younger cells and lay down new collagen and elastin.

That second mechanism is why the result takes weeks rather than appearing on the way out of the clinic. You are not being given a substance that occupies space. You are being given a signal, and the tissue does the building. In an area where the whole problem is that the tissue stopped building, that is exactly the right intervention.

It also explains the sequencing. The skin needs the gap between sessions to respond, which is why three appointments two to three weeks apart is the usual shape, and why the honest answer to "when will I see it" is the second session at the earliest and eight weeks for the real answer.

How this differs from tear trough filler

They are frequently discussed as alternatives and they are not. Tear trough filler is hyaluronic acid placed deep, usually onto bone, to replace volume that has gone. It works immediately, it is reversible, and in the right hands on the right patient it is very effective. It does nothing for the quality of the skin lying over it.

Polynucleotides are placed superficially across the area to change the skin. They do nothing for volume.

If your under-eye is hollow and the skin is good, filler is your treatment. If the skin is crepey and the volume is fine, polynucleotides are. If both are true, most practitioners will treat the skin first, because putting filler under thin, poor-quality skin tends to show every irregularity and can look worse than doing nothing. That order matters and it is worth asking about directly.

What the session and the recovery are actually like

Numbing cream goes on for around 20 minutes. The injections themselves take 10 to 15 minutes: a series of small, shallow deposits placed across the area below the orbital rim, either with a fine needle or with a cannula depending on how the practitioner works.

You will leave with small raised blebs where the product sits. These flatten within a few hours, occasionally by the next morning. Most people go straight back to work.

Bruising is the honest caveat. The under-eye is richly vascular and the skin is thin, so bruising here is considerably more likely than on the face or neck, and it can last the better part of a week. Concealer covers it. If you have something you cannot be bruised for, count backwards and leave two clear weeks, and be aware that you are committing to this three times rather than once.

Aftercare

Leave holding a written plan that names the area, the number of sessions, the intervals between them and the total cost including any review. Read it somewhere other than the clinic. A fortnight between assessment and first treatment is the interval commonly recommended for elective cosmetic procedures, and nothing about this treatment is urgent enough to shorten it.

FAQ

Common
questions

Will polynucleotides get rid of my dark circles?

It depends what is causing them. Darkness from thin skin letting the vessels beneath show through usually improves, because thickening the skin is exactly what the treatment does. Darkness from hereditary pigmentation, or shadow cast by a genuine hollow, will not improve, and an assessment should tell you which you have.

How many sessions do under-eyes need?

Three is the usual course, spaced two to three weeks apart, though many practitioners work to four for this area because the skin is so thin and the collagen response is being asked to do more. The result is judged at around eight weeks from the first session.

Is bruising really that likely under the eyes?

More likely here than anywhere else this treatment is used. The area is richly vascular and the skin is around half a millimetre thick, so a small bleed shows readily. Expect the possibility each session, allow up to a week, and plan the dates around anything you cannot bruise for.

Can I have polynucleotides and tear trough filler together?

Frequently, yes, but usually in sequence rather than the same appointment. Most practitioners treat the skin first and assess the volume afterwards, because filler placed under thin, crepey skin tends to show irregularities. Ask directly which order is being proposed for you and why.

What if my eye bags are actually fat pads?

Then this is not your treatment. A herniated fat pad is a structural change that produces a genuine bulge rather than a shadow, and no injectable improves it. The options there are surgical, and a practitioner who offers you a course of injections for it is worth walking away from.

How long will the improvement last?

Typically six to twelve months once the full course has settled. The collagen laid down is your own, so it ages at the rate the rest of your skin does. Most people who like the result return for a single maintenance session somewhere in that window rather than repeating the full course.

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Describe what you want changed.
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Polynucleotides Marylebone • UNTIL Marylebone, 1 Orchard Street, London W1H 6HJ

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