Non Surgical Treatment for Deep Under Eye Circles?

I look horible with those circles and every body asks me when i slept last time:( i need help

Doctor Answers 13

Laser Surgery is most effective treatment for dark circles under the eyes


You are correct that there is a depression beneath your lower eyelid-I call this the arcus deformity.

While IPL treatments can lighten the skin color of the lower eyelid, they will not help the depression and shadow beneath your lower eyelid.

I do not inject fillers beneath the lower eyelid-they are dangerous and can injure the eye, and many patients who have had filler injections beneath the eyes have had nasty complications.

The definitive operation to remove deep dark circles under the eyes is the transconjunctival laser blepharoplasty with arcus release and fat grafting. (See photo)

I use a laser to make a tiny incision on the inside of your lower eyelid, release the arcus which is causing the depression and take a tiny piece of fat from around your belly button and place it into the hollow area under your eye.

This is very different from external fat grafting by needle injection-I do not use the needle technique because the results are often inaccurate, the fat can be lumpy, and the injection technique can injure the eye.

Non Surgical treatment for Dark Circles

The skin around the eyes is the thinnest and most delicate – that is why it’s one of the first areas to show the signs of aging such as wrinkles, crows feet and dark circles. What’s more, this skin continues to get thinner and more translucent as we get older (why the small reddish-blue blood vessels under the skin can peek through, creating dark undereye circles).
The eye area also has very little subcutaneous fat tissue, and what’s there, diminishes with time—one reason this area (particularly under the eyes) can develop a sunken, hollow look as we age. The eye area is also surrounded by several facial muscles that regularly contract as we express ourselves.
Add to this a slowdown in the production of the skin-firming proteins collagen and elastin as we get older (and, as a result of exposure to the sun), and you have the development of fine lines and wrinkles both under and around the eyes (called “crows feet”). This is why the eye area is a very common concern we treat.
Our goal is to restore the eyes to their most natural, youthful beauty. We regularly do this with our patients through a variety of customized treatment options including:
Fillers: Like Restylane, Juvederm, hyaluronic acid fillers, are used to add natural volume back to the sunken areas under the eyes.
Injectables: Like Botox and Dysport help immobilize the muscles that surround the eyes to prevent the skin from creasing—causing wrinkles.
Lasers: Can help stimulate the growth of skin-firming tissues like collagen and elastin.

Dark circles can be hereditary—and can be caused by allergies, exposure to the sun (the sun’s UV rays trigger the production of the skin pigment melanin—which can make this area look darker), and even excessive rubbing. We will assess your eye area and advise you on the most effective treatments to help even out this area’s skin tone.

Dennis Gross, MD
New York Dermatologist
4.4 out of 5 stars 5 reviews

Genetic considerations

In reviewing your photos, you appear to be young and have a tear trough deformity. Pigment may play a role but is not a key factor in your problem. The reason for the deformity is a space between the muscles of the eyelid and the side of the nose/cheek. The space gives a tight depression that would only be corrected with a filler or implant into the area. Fat is a good filler for this problem. You can also go to a doctor skilled in tear trough implants.

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 33 reviews

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Options for under eye hollowness, dark circles

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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.

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Most effective treatment for dark under eye circles

Thank you for your question. Deep under eye circles are most often caused by thinning and descent of the fat pads in that area. There are a variety of customized treatment options we can pursue depending on your exact situation. At our practice, we like to use certain fillers, like Belotero and Restylane, to add natural volume back to that area under the eyes. We chose these fillers to minimize swelling and maximize smoothness. To prevent creasing and wrinkles from forming, injectables like Dysport and Botox are your best option to help immobilize the muscles that surround your eyes. Sometimes dark circles are due to pigment or vascularity. In that case, we start a topical program to brighten the eyes and use specific lasers to address those problems. Be sure to consult with a board certified dermatologist to determine the best option tailored to you!

Kimberly Butterwick, MD
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Best to try to cover dark circles

Most dark circles are inherited problems. Many are due to the number of small blood vessels under the thin skin of the lids. At your age a concealer would be a good option. I have had many patients do well with a product called Teamine. It has a micronized metal that reflects light and makes the area seem less dark. Other options, of course, include the injectable agents but it is unlikely that any bleaching creams would be of benefit.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
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Yes and No.

Hello Denisse,

Well you can have "fillers" injected into these "dents" under your eyes, the tear troughs, but these fillers do not last long. To change the color can be difficult using surgery, peels or lasers, but make-up, bleaching creams and sun screens can decrease this color a bit.


John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 27 reviews

Restylane for deep tear troughs

Restylane injections done by an experienced provider would be the best solution for you. Fat injection in this area can be tricky, and can change with time as you age. Restylane is temporary, but usually lasts really long in this area. You will probably need an injection about once a year.

Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon
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Bleaching creams,peels,laser and fillers!

Hello Denisse

There are several factors contributing to the appearance of dark circles around the eye:

1-A true hyperpigmentation (skin discoloration): Several bleaching creams, peels or lasers could help with the discoloration. The word of wisdom is to be conservative especially with lasers and peels.

2-The second factor is the presence of deep lines under the eyes (tear trough) Using filler will help to decrease the optical elusion of discoloration and shadows.

3-The simple, easy answer is using camouflage makeup (mineral makeup etc...).

I hope this will help

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

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.