Problematic dark circles under the eyes

Dark circles under the eyes can cause a person to look tired and older. As we age, the skin under our eyes loses volume and thins out. This can cause the appearance of dark circles.

Make up works well to conceal this, but I have found that using hyaluronic acid, such as Restylane or Juvederm, injected under the eyes works amazingly well to eliminate or significantly reduce the dark circles. This may sound painful, but I assure you, most patients tell me that they can't even feel it! Of course we use a topical anesthesia first, but there are not a lot of nerve endings in this area and with anesthetic ointment the pain is non-existent to very minimal.

We have found that Restylane is superior to Juvederm in this specific area, as Juvederm has more of a tendency to cause a bluish tint to the skin, known as the tyndal effect, while Restylane does not. However, both work very well for this correction.

There are few factors that create dark circle under the eye. One must address all or some of these problems to fix the dark circles.

• Darker skin color: There many genetic and environmental factors creating darker skin color (hyper pigmentation) under the eye. Most of this hyper pigmentation can be treated with skin bleach (hydroquinone). It would take few months for the cream to work. For quicker fix one can do laser or chemical skin resurfacing (peels).

• Hollowness under the eyes: With age or genetic predisposition, some people get hollowness under the eye that creates a dark shadow. Fillers such as fat, radiesse , or restylane can fix the crease.

• Fat under the eye: Sometimes fatty bulges under the eye create shadow under the bulge creating dark circle. Fillers or traditional eyelid surgery could help with this problem.

• Allergy: Patients who suffer from allergy could get venous congestion under the eye creating dark circle. Seeing an allergist is the first step.