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How Can I Treat the Dark Circles Under my Eyes?

I have dark circles under my eyes that make me look tired. What eye treatments are available to get rid of these dark circles?

Doctor Answers 11

Restylane for dark circles

Hi: This answer will only address the issue of dark circles. Puffiness, hollowness, etc. can be discussed in another reply.

Dark circles under the eyes (raccoon eyes) are mostly due to melanin pigmentation. Your degree of pigment is obviously genetic. Hence, many people who have this problem are of Afro-American, Caribbean, Mediterranean or Hispanic descent.

A second cause is vascular congestion. This is an area containing many, small blood vessels. In some people, these are congested, causing a somewhat purple discoloration. Rubbing the area under the eyes certainly worsens the situation. Thus, people with atopic dermatitis (eczema) often are burdened with this discoloration.

Any dermatologist can tell you that a hallmark of eczema are these "allergic shiners." Rubbing can also be precipitated by an allergic contact dermatitis. Patch testing by your dermatologist might be able to elicit an allergy. Avoidance of that allergan would certainly help.

As we age, we lose collagen in general. This area, whose skin is thin to start off with, suffers the most noticeably. I am not talking about laxity here, although that is true too. The thinness of the skin makes the blue-brown pigmentation under the skin look even more apparent.

What to do about this problem? Fillers are probably the best solution as far as cost and convenience. Restylane is the better choice here since it is a little less mobile and remains where it is placed better. Also, it gives less of a blue tinge than its competitor Juvederm.

IPL may help. The vascular-pigment application at wavelengths between 530-600 would give you a good benefit as would a laser. As far as eye creams for this problem, there are as many of these as excuses for the Cubbies not going to the World Series.

Most of these products contain the following ingredients: Vitamin K, green tea, Vitamin C (make sure it has ferulic acid - Journal of the American Academy of Dermatology Sept 2008 - as this creates a much more stable product), licorice (yeah, that's licorice... the good tasting stuff), hydroquinone, and kojic acid. There are, of course, other helpful ingredients.

Brands I like, in no particular order:

  • RevaleSkin Eye Replenishing cream
  • SkinCeuticals Eye Gel
  • Neutrogena Radiance Boost Eye Cream
  • Olay's Definity
  • Hylexin (nervous about recommending the latter because they hype their product SO much.)

We did discuss this topic on our radio show. So feel free to call us on the show or email me.

Virginia Beach Dermatologist
4.5 out of 5 stars 10 reviews

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Permanent effective removal of dark circles under eyes requires laser surgery

Blue and purple dark circles are usually caused by blood vessels and can be improved with IPL or Photofacial treatments.

Brown colored dark circles under eyes are usually pigment and can be treated with fractional ablative laser resurfacing.

The true deep depressed dark circle under the eye, which I call the arcus deformity is treated with a procedure called the laser arcus marginalis release with fat grafting.

Dark circles appear for more than one reason. The skin...

Dark circles appear for more than one reason.

  1. The skin of the eyelids is ofter darker than that of the rest of the face. As we age and our skin has less elasticity and sags, the difference between the eyelid skin and the upper cheek is more obvious.
  2. As we age and the skin gets thin, the network of blood vessels within the skin becomes more visible, making the area look dark or purplish.
  3. As the skin gets more thin, the "hollow" under the eyes appears or looks larger.

Therefore, I use a combination approach to treat the undereye area. Fillers, such as Restylane, plump up the skin and decrease the hollow appearance under the eye. Creams are used to firm the skin, increase collagen production, and lighten dark pigmentation.

Jordana S. Gilman, MD
Atlanta Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

There are few factors that create dark circle under the...

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.

Payman Simoni, MD
Beverly Hills Facial Plastic Surgeon
3.5 out of 5 stars 8 reviews

Treating Dark Circles Under Eyes

Dark circles beneath the eye are caused by many factors including hereditary pigmentation, edema, allergies, etc.
The depressions that cast shadows of your lower lids can be improved with fillers. In this area it is very important to have an experienced injector so as not to place the filler too close to the skin. I would recommend trying Jeuvederm or Restylane first as they are not permanent and can be reversed if you do not like the result. If you do like the result, then fat is a good option for a more permanent correction

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 59 reviews

Management of lower eyelid circles

Cricles may be due to a variety of causes:

  1. Descent of cheek fat causing the groove under the eye to be more prominent
  2. Laxity of the lower eyelid structures allowing fat to bulge forward and cause lower eyelid fullness
  3. Hyperpigmentation (chloasma or mask or preganancy) associated with oral contraceptive use
  4. Thin skin allowing the underlying muscle to be more visiblle and create a bluish-purplish appearance
  5. Repeated irritation or inflammation with hyperpigmentation or depositiion of pigment in the skin

Depending on the cause the treatments may vary according the the above:

  1. Filling of the cheek groove or a midface/cheek lift
  2. Lower eyelid blepharoplasty
  3. Skin bleaching
  4. Retinoids or cosmetic camouflage
  5. Chemical peels or laser treatments

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 54 reviews

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.

Arnold W. Klein, MD
Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

Dark circles under the eyes can be caused by two things:...

Dark circles under the eyes can be caused by two things: pigment deposits in the skin or shadows created from fat bulging from the lower eyelid. The treatment for each of these is different.

If pigment deposits are the problem, bleaching agents or skin resurfacing may be the answer. Skin resurfacing can take the form of deep chemical peels or ablative laser (such as CO2 or erbium) treatments.

If fat shadows are the problem, the solution is a lower blepharoplasty in which the fat of the lower eye is addressed. There are multiple approaches to the lower eyelid, including through skin incisions or possibly through incisions on the inside of the lower eyelid. The fat can then be repositioned over the bone of the eye socket (the orbital rim) or removed.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
4.0 out of 5 stars 13 reviews

Dark Circle Treatment

Sometimes, the dark circles or what appear as "bags" can actually be caused by a loss of volume in the tear troughs. This can be corrected by proper placement of a soft filler. The tear troughs can be challenging to treat since the skin is quite thin, so proper technique and choice of the correct filler is paramount. If the dark circles are caused by discoloration of the skin, lightening creams such as hydroquinone can help improve this discoloration.

Ava Shamban, MD
Santa Monica Dermatologic Surgeon
4.0 out of 5 stars 6 reviews

Treatment options for dark circles

Dark circles around the eyes are caused by multiple factors, commonly including a combination of loss of volume (fat loss resulting in a depression and shadow under the eyes), very thin skin (thinnest in the body, with fine blood vessels under the skin) ethnic pigmentation under the skin and skin laxity and wrinkles under the skin.
As a consequence of the dark circles being caused by multiple factors, each of these factors needs to be addressed with treatment. The combination of treatments may include non-surgical treatments including volume augmentation of the tear trough depression (hyaluronic acid and platelet rich plasma (PRP). These are non-surgical and does not require general anaesthesia or surgical intervention, with a rapid recovery of less than one week. During the recovery, there maybe mild bruising and some swelling in the lower eyelid.

For some patients there may have additional changes in the lower eyelid including fat bags and/ or malar oedema, skin laxity. These additional changes may require eyelid surgery (blepharoplasty) to correct.
Unfortunately there is no cream that used in isolation is effectively going to improve dark circles on their own, however in some patients a combination of specific eye depigmentation creams may be used with non-surgical or surgical treatments to enhance the results.

As a general principle dark circles can be substantially improved with a customised approach to treatment of the dark circles. There is not a single treatment that offers a silver bullet, and most treatments will be effective in offering an improvement, as opposed to a cure.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.