Laser Resurfacing for Dark Circles Under Eyes?

I heard that laser resurfacing could help dark circles under eyes. Is this true? What can you do for dark circles under the delicate eye area, without going under the knife to tighten them? They seem to tell me that only a cream might help. I just think there surely is somethig out there that I could do at this spa im at. They offer quite a bit of stuff, but they don't tell me I can do anything for it. Thanks.

Doctor Answers 11

Treating Dark Circles Can Be Challenging

Treating dark circles under the eye is still one of the most challenging cosmetic concerns that we see on a regular basis in our office. First and foremost, make sure you are seeing a board-certified dermatologist or plastic surgeon who can thoroughly examine the skin and underlying anatomy to make a determination of why you are having these dark circles. If the problem is skin only, a really good skin care routine with an appropriate eye cream, may be helpful. And in 2014, many of the cosmeceutical companies are makinggreat eye creams, like the ones from Neocutis and Skinceuticals, amongst others.

If there are tear troughs present that are causing some of this darkening through shadowing, a filler may be very useful. Products such as Restylane, Juvederm, and Belotero all work here. Sometimes a laser procedure, a fractional non-ablative or fractional ablative procedure will make the skinlook much better, and with skin care, keep it lasting that way for a long time. And if there are bulging fat pads, we would recommend a surgical procedure,especially if all the other procedures and topicals do nothing at all. Again, this can be determined with your board-certified dermatologist.

Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Dark Circles - Underlying Causes & Potential Treatments

Laser skin resurfacing can remove dark pigmentation under the eyes, but there can be many other underlying causes and potential treatments:

1) Hyperpigmentation: Excessive or irregular pigmentation of the skin beneath the eyes. This can be treated with creams that "bleach" the skin or laser skin resurfacing, which removes the dark patches.

2) Hypervascularity: Blood vessels beneath the skin surface. Certain lasers (V-Beam, Pulse Dye Laser, etc) as well as IPL may alleviate some of these vessels.

3) Dermatochalasis: Shadows caused by lower eyelid "bags". Subtle cases can be improved by placing fillers in the shadowed area to the level of the puffiness to mask the problem. For more serious cases, surgery to remove the baggy skin is the definitive option.

Dark circles under the eyes have many causes

There are a number of causes for dark circles under the eyes, therefore treatments should be directed accordingly. From outside in, the skin can have fine wrinkles. These may respond to creams and superficial peels, including lasers that smooth the skin. If the underlying muscle is over-active it can be relaxed with minute amounts of Botox. Eyelid skin is very thin, dark circles can be due, in part, to bluish blood vessels seen through this thin skin. Going deeper, eye-bags or herniated fat will cast a shadow that no concealer or eye cream can fix without surgery to reduce the bags. Lastly, there is pigment that is more common in certain ethnic groups. Response to laser for pigment is variable.

The first thing I do is lie patients back to remove the shadows to check for pigment. So, to answer your question, lasers will help fine lines and even visible blood vessels. See a facial surgery specialist to discuss your best options.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 109 reviews

Dark circles under the eyes and laser resurfacing.

First of all one has to determine the CAUSE of dark circle. In most cases this is racial (I have them as well), in some cases, it is due to deep tear troughs, in others a combination of PIH or skin hyper pigmentation due to eczema, and in many cases a combination of factors. I do believe that laser resurfacing, though reported, is too aggressive for the treatment of dark circle in most patients - especially darker skin types. 

In the US, we use Restylane in this area to correct volume loss due to deep troughs, however in Australia, Restylane and JUVEDERM VOLBELLA can be used. I do place the filler deep- namely on bone, this reduces the chances of a Tyndall effect (blue tinge).

Other ways to treat dark circles under the eyes include -

1. Treat any skin irritation - namely simplify your skin care regime- use a good eye cream- this can reduce inflammatory changes on the skin
2. Low dose Q switch lasers
3, Microneedling and PRP
4. Low strength HQ creams – this is used to decrease melanin activity
5. Multiple sessions of either Clear + Brilliant or Low Level Fraxel 1550 ( I do however believe that Picosure Focus is better than Fraxel in my hands for dark circles- 3-4 sessions needed)
6. Very low strength peels including 6-8% TCA – five to six peels in combination with fading agents.

Even with multiple treatment methods, dark circles can only be reduced, and not totally eliminated. Realistic expectations are crucial in treatment of this problem, and combination tailored to EACH patient.

All the best
Dr Davin Lim
Laser and aesthetic dermatologist
Brisbane, Australia.

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 62 reviews

Drak circles under the eyes.

There are many possible causes for the dark circles that range from anatomy, fat bulges, pigment, thin skin, hollows, etc. Depending on these the treatment can vary from injections/fillers, peels chemical or laser, bleaching creams, etc. Meet with a professional to discuss the best options for you. It is very difficult to tell from the picture what is best suited for your correction.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 72 reviews

Laser Resurfacing for Dark Circles Under Eyes

Depending on the underlying cause of the dark pigmentation, there are different options. Laser can be very effective for the appropriate candidate. Consult in person with an experienced and expert treating physician to understand your options.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 36 reviews

Yes, Depending on the Cause

Dark circles under the eyes have a lot of possible causes. Puffiness, inherited pigmentation, blood vessels, and hollows can all create the appearance of dark circles. Laser resurfacing with the Halo hybrid fractional laser can be an appropriate path to reduce pigmentation, but you may also find that bleaching the area with specialized creams is effective. But for puffiness (or bags under the eyes), you will probably need lower eyelid surgery. Schedule a consultation with a qualified plastic surgeon or skincare specialist to determine the cause and develop a treatment plan. Good luck to you.

Otto Weiglein, FRCSC
Burlington Plastic Surgeon
5.0 out of 5 stars 4 reviews

Treatments for dark circles

Dark circles under the eyes are usually caused by a combination of several factors: volume loss, increased pigmentation, increased vascularity, and fine lines and wrinkling. If fine lines and wrinkling is the main contributing factor, then laser resurfacing can be an excellent treatment option. However, volume loss is better addressed with fillers and pigment and vasculature is best addressed with pigment and vessel-specific lasers. Usually, combination treatment will result in the best outcome. As this can be a tricky area to treat, it’s best to see an expert laser surgeon who has a solid understanding of the various causes of dark undereye circles to tailor your best treatment.

Douglas Wu, MD
San Diego Dermatologist
5.0 out of 5 stars 37 reviews

Treating dark circles under the eyes

The main causes of dark circles are due to

1. Bulge below the eye- treated by fat removal or repositioning, usually from inside the eyelid

2. Hollow area below the eye bulge. Treated temporarily by fillers, typically Prevelle or Restylane. Treated more permanently by various grafting techniques including fat injection and LiveFill TM, an ultrashort incision cheeklift (i.e. USIC or LUSIC)

3. Loose skin below the eyelid. Minor relief with skin care products, Retin A, More permanent results with laser resurfacing or an ultrashort incision cheeklift. NOT recommended is a conventional blepharoplasty with canthopexy, in my opinion, as this may predispose to an alteration in eye shape.

4. Pigmentation. Temporary relief with make-up or possibly minimal relief with bleaching agents. Also possible to perform laser with pigment-specific lasers (variable success).

5. Prominent globe (forward set eye). Temporary relief with fillers. More permanent relief with autologous fillers (fat injection, LiveFill TM). Augmentation must be conservative in my opinion.

The lower eyelid is a very delicate area and choosing a surgeon with great experience with the midface and an excellent reputation are your best bet for achieving your best result.

Your pictures are a bit difficult to interpret with the shadowing effect and make-up and angle of the photograph.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 136 reviews

Dark circles under the eyes

 Dark circles under the eyes may respond to creams and sometimes lasers.  Most of the time the dark circles are due to the muscle showing through the thin lower eyelid skin. This is very difficult to treat.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 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.