Injectables
Dermal Fillers
- Duration
- 45 mins
- Downtime
- Usually mild. Temporary swelling or tenderness is common, often settling over 24 to 48 hours.
From £240
Skin concern
Under-Eye Concerns
Dark circles, hollowing and fine lines under the eyes have different causes, each requiring a different approach. Volume loss and vascular shadowing look similar but are treated very differently.
Understanding the cause
What's happening in your skin
01
Not all dark circles are the same
Dark circles have three main causes: volume loss creating a shadow in the tear trough; vascular shadowing where vessels show through thin skin; and hyperpigmentation in the periorbital skin itself. A treatment targeting one cause will not address the others.
The under-eye area loses structural support earlier than most of the face. Subcutaneous fat diminishes, the skin thins, and the bony orbital rim becomes more visible, creating a hollow that casts a shadow regardless of how much sleep you have had. Separately, the periorbital skin is exceptionally thin, often allowing the underlying muscle and vasculature to show through as a bluish or purplish tone. These two presentations can coexist, and identifying which is dominant shapes the entire treatment decision.
02
Volume loss in the tear trough
The tear trough is a ligamentous attachment between the lower eyelid and the orbital rim. As volume depletes, this attachment becomes more visible as a groove, casting a shadow that topical products cannot fill.
Dermal filler placed precisely in the tear trough restores the volume that creates the shadow. This is one of the more technically demanding facial injection sites due to the proximity to the eye and the vascular anatomy of the region. At The London Road Clinic, tear trough treatment is carried out following an in-person consultation with our prescribing clinician. A cannula technique is used rather than a needle, which reduces bruising risk and the chance of vascular complications. Results are typically visible immediately and last twelve to eighteen months.
03
Skin quality and fine lines
The periorbital skin is the thinnest on the face and loses collagen faster than surrounding areas. Polynucleotides delivered around the eye stimulate local collagen production and improve skin elasticity without adding volume.
Where fine lines and skin quality are the concern rather than volume loss, polynucleotide injections and skin boosters address the periorbital skin directly. Polynucleotides stimulate fibroblast activity and increase local collagen production, improving crepiness and texture over a course of two to four sessions. LED light therapy supports the same collagen pathway non-invasively and can be used as a standalone or alongside injectable protocols.
Recommended treatments
What we use for under-eye concerns
Injectables
Polynucleotides
- Duration
- 30 mins
- Downtime
- Usually minimal. Temporary swelling, redness or small injection-site marks can occur and usually settle quickly.
From £200
Injectables
Profhilo Skin Booster
- Duration
- 30 mins
- Downtime
- Usually minimal. Small bumps, redness or mild tenderness can occur temporarily after treatment.
From £170
Skin
LED Light Therapy
- Duration
- 30 mins
- Downtime
- None
From £30
Clinical perspective
The under-eye area is one of the most common concerns I see and one of the most frequently overtreated. People come in asking for filler when the shadow they are seeing is not from volume loss at all, it is from thin skin and vasculature showing through. Putting filler into that situation does not help and can look odd. The assessment needs to establish what is actually driving the appearance before any treatment is chosen. When filler is the right choice, the change is very significant. When it is not, polynucleotides or LED can still make a real difference to the quality of the skin in that area.
Assess before treating Three distinct causes Volume, quality or pigment
In their own words
The difference the tear trough treatment made was more than I expected. People kept asking if I had been on holiday. I looked less tired within two weeks and the result has held well.
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Common questions
Frequently asked about under-eye concerns
How do I know if filler is right for my dark circles?
The best way to assess this is in person. A clinical assessment looks at whether the shadow is caused by volume loss in the tear trough, vascular visibility through thin skin, or periorbital pigmentation. Each responds to a different treatment. Filler addresses volume-related shadowing specifically. Applying filler to vascular or pigmentation-driven dark circles will not produce a meaningful result.
Is tear trough filler safe?
Tear trough is one of the higher-risk injection sites due to the proximity to the eye and the vascular anatomy of the periorbital region. At The London Road Clinic, this treatment is carried out following an in-person consultation with our prescribing clinician, in line with current GMC, NMC, GPhC and GDC guidance. A cannula technique is used rather than a needle, which reduces the risk of bruising and vascular injury.
What are polynucleotides and how do they help the under-eye area?
Polynucleotides are injections of highly purified DNA fragments that stimulate fibroblast activity and local collagen production. In the periorbital area they improve skin elasticity, reduce crepiness and support the structural quality of the thin skin around the eye. They are not a volumising treatment and do not fill the tear trough, but they are highly effective for fine lines and general skin quality in the area.
Can LED light therapy help with under-eye concerns?
LED light therapy supports collagen synthesis and reduces localised inflammation through specific wavelengths of light. The red and near-infrared wavelengths used in Dermalux LED treatment stimulate fibroblast activity in the periorbital skin, improving skin quality over a course of sessions. It is a comfortable, non-invasive option that can be used standalone or in combination with injectable protocols.
How many sessions will I need?
This depends on the treatment and the severity of the concern. A single tear trough filler session produces immediate results, with effects typically lasting twelve to eighteen months. Polynucleotide protocols usually involve two to four sessions spaced three to four weeks apart, with maintenance every six to twelve months. LED therapy courses are typically six to ten sessions, often recommended as a series before moving to maintenance.
Ready to take the next step?
Book a consultation
Your clinician will assess your skin, review your history and design a treatment plan matched to your specific presentation, not a generic protocol.
Medically reviewed by Dr Shahe Boghossian, Medical Consultant, GMC 5204600 . Last reviewed 21 May 2026.
