Will laser or chemical peel be better for my dark circles pigmentation issue? (Photo)

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Dark circles under the eyes may be caused by a variety of underlying issues, which include thin skin or loss of underlying fat, which allows for the skin to reflect the color of the dark blood vessels and muscles below. Or the color problem can lie within the skin itself  from genetics coupled and made worsened by sun chronic sun damage. If the loss of underlying volume and thin skin are believed to be the root of the problem, the injection of a filler, such as Belotero Balance or Teosyal Redensity II to which a tiny amount of a whitish colored filler, Radiesse, has been added can help to lighten the infraorbital region while simultaneously restoring a thicker intermediate layer between the underlying muscles and vessels and the overlying skin. If the skin itself is hyperpigmented then the regular and long-term at-home use of prescription-strength bleaching agents, such as hydroquinone, arbutin, kojic acid and licorice extracts combined with a series of superifical peels using varying strengths of low strength TCA or high concentration glycolic or salicylic acid may prove helpful, of course always coupled with strict sun protection measures and the use of high SPF sunscreens. Light-based therapies, in particular, run a particular risk of giving rise to prolonged or even permanent postinflammatory hyperpigmentation. So, do your due diligence before entertaining undergoing treatments with these relatively expensive bells and whistles devices. Make sure that you consult with an experienced board certified aesthetic dermatologist. Best of luck to you. 

Skin care over an extended period of time generally yields the best results.  Make sure to avoid sun exposure on the darkened skin as this will worsen the darker pigment.  Referenced is an excellent product for the lower eyelid areas.

Having "darkness" or discoloration in and around the under-eye area can be a very common, and very frustrating issue & can be caused from a long list of things: genetics, allergies, diet, lack of sleep, natural skin pigmentation etc. First off- figuring out what the cause can be, can sometimes make the treatment plan very easy. The skin of the eye area is the THINNEST on the entire face,which in turn means we need to be gentle in our approach. Light peels paired with a low setting IPL is a great place to start & will have no contra-indication to the filler you had injected. I also recommend finding an eye cream that has been ophthalmologist tested to treat closely to the eye with ingredients such as: retinol, ferulic acid & vitamin C.