Dark circles - what are my options? (photos)

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells and microneedling RF like Fractora PiXel8 or Morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Thank you for submitting your question and photo. You may benefit from a non-surgical eyelift that uses facial fillers to add subtle volume beneath the eye and reduce hollows, resulting in a brighter and more vibrant appearance. This injectable treatment may address the discoloration and dark circles you describe. Facial fillers can also define the cheekbones to brighten under-eye shadows and allow light to reflect in this area naturally. I recommend that you schedule an in-person consultation with an experienced, qualified injector who can assess your needs and make the best recommendation to help you achieve your desired aesthetic.

Thanks for your question! Since you’ve already tried quite a few treatments, you may want to consider a consultation with your provider to discuss filler injections. Though your provider will best be able to address your specific concerns, I’d recommend cheek filler as a starting point, as it can be extremely helpful in improving the appearance of undereye hollows. However, you may also be a candidate for undereye filler; your provider can assess your anatomy and determine whether or not it's right for you.

Thanks for your question. “Dark circles” don’t necessarily mean pigment. I suggest you find a dermatologist who will do a thorough exam under dermoscopy. Based on your photos I would not be surprised to see dilated blood vessels in that area. Because prp promotes neovascularization, it’s not surprising that the problem got worse, not better. IPL on a vascular setting or even pulsed due laser might be helpful. Also don’t rule out filler in the tear troughs. In good hands this may make a big difference. Good Luck!

Fillers would improve this but you would have to start with idea that some improvement would make you happy and not expect perfection. You still will have hyper pigmentation but less shadow. You photos are too close up to know whether you need fillers in cheek but I often tell patients similar to yourself that I prefer to inject cheek first as that sometimes will make a huge difference and you might need less filler in eye area. Go to dermatologist or plastic surgeons that you trust and that has experience with this. this is not something I would do at a spa or in a place with inexperienced injectors.

The "dark circles" you have are due to a natural depression from the way your muscles attach to the malar bone below the orbital rim. This causes shadows and highlights. The things you have tried will not improve the "problem." The one thing that will is a filler on the bone above the attachment of the muscle to flatten the area and eliminate the shadow. This needs to be done by a true expert as most injectors will inject a light filler superficially.