Polynucleotides for under-eyes: who they suit, and who I'd send away

The under-eye is the area patients most often misread on their own skin. Someone arrives certain they need filler in the tear trough, when what they are actually looking at is thin, crepey skin and the shadow that thinning casts — not a hollow that needs filling. It is an easy mistake to make in the bathroom mirror, and a consequential one, because the right answer for one is close to the wrong answer for the other.

Polynucleotides have changed that conversation considerably. For a particular kind of under-eye, they are now my first choice — and for another kind, they are not the answer at all. Here is how I decide.

What polynucleotides actually do

Polynucleotides are fragments of purified DNA, typically derived from a salmon source, injected into the skin in small amounts. They do not add volume. They signal the skin's fibroblasts — the cells responsible for collagen, elastin and repair — to behave more like younger, more active cells. The result, over a course, is skin that is thicker, better hydrated, and better quality.

That is precisely why the under-eye is one of their strongest indications. The skin here is some of the thinnest on the body, the anatomy is unforgiving, and it responds well to a treatment that improves the skin itself rather than pushing volume into a delicate space.

The under-eye patients polynucleotides genuinely suit

Thin, crepey under-eye skin. Fine, papery crepiness that creases when you smile and looks tired even when you are not — this is the textbook indication. Polynucleotides thicken and firm the skin over a course, softening that crepey quality in a way creams cannot reach.

Dark circles caused by skin thinning. Not all dark circles are pigment. In many people, the under-eye looks dark because thin, translucent skin lets the underlying tissue show through. Improve the quality and thickness of that skin and the shadow genuinely softens. This is the group who do best.

The patient who has had filler and now needs skin quality. A common story: structural work was done years ago, the shape is fine, but the skin itself has aged and looks tired. Polynucleotides address the quality gap that filler was never designed to fix.

Skin too delicate for filler. Under-eye filler, placed badly, is one of the harder mistakes to correct, and not every under-eye is a sensible candidate for it. For thin-skinned patients who want improvement without volume, polynucleotides are often the more measured route.

Who I'd send away — or at least redirect

This is the more important half of the article, because it is where self-diagnosis goes wrong.

True tear-trough volume loss. If there is a genuine hollow — a defined gutter where the lower lid meets the cheek, casting a structural shadow — that is a volume problem. Polynucleotides will improve the skin over it, but they will not fill it. That is a filler or wider structural conversation, made carefully, by someone who treats the under-eye regularly.

Pigment-driven dark circles. Where the darkness is true pigmentation — often constitutional, more common in deeper or Mediterranean and South Asian skin tones — polynucleotides are not a pigment treatment and should not be sold as one. That is a conversation about sun protection, the right topical regime and, sometimes, in-clinic pigment work. Promising polynucleotides will lift genetic pigment is one of the quiet over-claims in this corner of aesthetics, and I would rather be straight about it.

Active skin disease in the area. Significant eczema, dermatitis or an active flare around the eye needs to be settled before any injecting begins.

A known fish or salmon allergy. Because polynucleotides are salmon-derived, a genuine fish allergy is a real consideration and must be raised at assessment.

First-timers with no homecare. Polynucleotides work hardest on skin that has been prepared. I would usually want a patient on a sensible medical-grade routine — the Elevate part of how we work — for a few weeks before we inject, so the treatment is building on a stable foundation rather than doing all the work alone.

The course, honestly

The under-eye is usually treated as a short course rather than a single visit — commonly around three sessions a couple of weeks apart, then maintenance roughly twice a year, though the exact protocol depends on the formulation and on your skin. A single session produces a response; the course is what produces a lasting change. Improvement is gradual and builds over the weeks that follow, and results vary from person to person. Expect small needle marks on the day, the occasional tiny bump that settles within a day or so, and the possibility of minor bruising in an area that bruises easily. None of this is dramatic, but it is honest.

Where this sits in the REGEN Method

Polynucleotides are a Generate treatment — regenerative work, alongside Profhilo, PRP and microneedling. But the decision that matters is made before any of that: whether your under-eye concern is skin quality, volume, pigment, or some combination, and therefore which treatment, if any, is right. At REGEN that assessment is the Reveal Consultation, and it is the same standard whether you see us in Norwich or in London. Sometimes it concludes that polynucleotides are exactly right. Sometimes it concludes that they are not, and saying so is the entire point of having a doctor decide.

If you want the full clinical detail on the treatment itself, it is on the polynucleotides treatment page.

Frequently asked questions

Do polynucleotides get rid of dark circles?

Sometimes — it depends on the cause. Where dark circles come from thin, translucent under-eye skin, thickening and improving that skin can soften them noticeably. Where they are true pigmentation or a structural shadow from a hollow, polynucleotides are not the right treatment, and an assessment is the only reliable way to tell which you have.

Are polynucleotides better than filler for under-eyes?

Neither is "better" — they do different jobs. Polynucleotides improve the quality and thickness of thin under-eye skin without adding volume. Filler restores volume where there is a genuine hollow. The skill is in choosing correctly, because the wrong one produces a poor result in skin that could have done well.

How many sessions do under-eyes need?

Usually a short course — often around three sessions a couple of weeks apart — followed by maintenance roughly twice a year. The exact plan depends on your skin and the product used, and is confirmed at consultation. Results build gradually and vary between individuals.

Is there downtime?

Minimal. Expect small injection marks, occasionally a tiny bump that settles within a day or so, and the chance of light bruising in an area prone to it. Most people return to normal activities the same day.

Who should not have polynucleotides?

Anyone with an active skin infection or flare in the area, a known fish or salmon allergy, and — as a sensible default — those who are pregnant or breastfeeding. Suitability always depends on your medical history and an in-person assessment.

If your under-eyes look tired and you are not sure whether the answer is skin quality, volume or something else, that is exactly what an assessment is for. A Reveal Consultation is the place to start.

— Dr Chris, Founder and Medical Director, REGEN Clinic

This article is general information, not individual medical advice. Suitability for any treatment depends on your medical history and an in-person assessment, and individual results vary.