Options for Genetic or Venous Congestion Caused Dark Eye Circles

Question

If it is genetic or due to venous congestion, what is the best route to pursue? I'm only 23 but my dark circles have been there pretty much my whole life, and now they are so noticeable that even makeup I went to a professional makeup artist to buy doesn't seem to work enough to cover it convincingly. My undereye areas are a bluish purple and it's not from anything sleep related, old age, or smoking, etc. SO, what might my options be and how much might they run, price-wise? Thank you!

Jeffrey E. Schreiber, MD, FACS · Answer

The cause of the darkness may be due to congenital discoloration of the skin or, as you mentioned, venous congestion.  Treatment is difficult to determine without seeing you, but it may include laser therapy (around $1,200) or hydroquinone (inexpensive cream.)  Make sure you're comfortable with the plastic surgeon or dermatologist who treats you, and check out some before and after pictures.  Good luck!

Kenneth D. Steinsapir, MD · Answer

Dear Maple 
There are a lot of misconceptions about dark circles. Some of the source of this information can be pediatricians, aestheticians, surgeons, but by far the biggest source are ads for under eye products. Confusing stuff.
Dark circles are primarily caused by skin optics. There are a few excepts to this related to true extra pigment in the skin. The lower eyelid skin is very thin. There is essentially no fat under this skin. In contrast, the cheek skin is thick and there is a thick layer of fat under the cheek skin. A portion of the light hitting the lower eyelid skin is transmitted through the skin where it encounters the dark red orbicularis oculi muscle. This structure absorbs much of this transmitted light, leaving very little to be reflected back into the eyelid. These leaves the eyelid looking dark. In contrast, light penetrating the cheek skin encounter yellow fat that effectively acts like a reflector, so this skin looks much brighter.
Currently, the best solution for this situation is using Restylane to filling in the hollow area under the eyes. This helps alter the component of the lower eyelid dark circle due to shadowing.

Mehryar (Ray) Taban, MD, FACS · Answer

Hi,
Dark circles under eyes in a young person can be caused by 3 things: chronic allergies, shadowing from surrounding elevation, and pigmentation changes.
Allergies, if present, should be treated. If not due to allergies, one good non-surgical option to improved the appearance is by using injectable fillers to fill the "hollow" areas, thereby improving the shadowing effect. I recommend seeking a physician who uses injectables in/around the eyelids.

William Portuese, MD · Answer

Dark circles underneath the eyes are certainly caused by genetics such as people from Mediterranean ancestry.  Uncontrolled allergies will also cause fat bags in the lower lids to be more pronounced, so it is important to have any allergy issues addressed.  Makeup is another alternative to dark brown and purple pigmentation.  Unfortunately there is no surgery indicated just for dark circles.  The goal of lower blepharoplasty surgery is to remove the fat bags from the lower lids, and in patients over 50 there is a small pinch of skin that can be removed to decrease excess skin.

Options for Genetic or Venous Congestion Caused Dark Eye Circles

Answers (4)

Answer: Dark circles underneath eyes are tough to treat

Answer: Dark circles underneath eyes are tough to treat

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Options for Genetic or Venous Congestion Caused Dark Eye Circles

Answers (4)

Answer: Dark circles underneath eyes are tough to treat

Answer: Dark circles underneath eyes are tough to treat

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.