24, male, dark patches under eyes. Do you have any suggestions? (Photo)

From around the age of 16 I've had dark skin under my eyes. I wouldn't call them eye bags because they don't really bulge and they never go away. I think its just genetics & pale, thin skin at work here. But I'm scared of taking off my glasses because people say I look wierd. Do you have any suggestions?

Doctor Answers 8

Treatment for dark lower eyelids

 Thank you for sharing your question and posting photographs. You would most likely benefit from laser skin resurfacing and injection of fillers underneath the eyes. See an experienced eyelid specialist for comprehensive evaluation in person to determine the best option for you. Good luck, 

New York Oculoplastic Surgeon
5.0 out of 5 stars 144 reviews

Treating Dark Patches Under the Eye

Although it is hard to tell from just the picture, you appear to have a combination of increased pigment in the area and a depression which has shadows increasing the darkness. The first is best treated with hydroquinone creams or an IPL (Intense Pulsed Light). After eliminate or reducing the pigment, you will need to protect the area from further sun damage (the cause of the pigment) by daily use of a zinc oxide sun block. Once you have taken care of the pigment, you can decide how much filler is needed to flatten the area and reduce the shadowing. For this you need a filler like Juvederm Voluma or fat. Make sure you see someone very experienced in these techniques. 

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

24, male, dark patches under eyes. Do you have any suggestions?

The dark patches are likely due to two different reasons including 1) hollowness under eyes and 2) pigmentation changes.  The first problem can be addressed with filler injection under eyes. See following link and video.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 74 reviews

Lower lid circles - zero downtime peels

Limited evaluation of lower lid discolorations attainable from a couple of front view photos alone

        Need full work up with physical examination and complete medical history to distinguish the nature or source of the discoloration and structural anatomic components.

        Commonly, blepharomelasma or brown hyperpigmentation of the lower lids may be treated with mild, minimal downtime weak or superficial peels in weekly succession. If resistant, would employ stronger medium depth peels or lasers after several weeks of skin priming with retina A only at night, hydroquinone twice daily, and hytone. Shadow from lower lid hollow would benefit from a filler, such as Belotero or your own fat. Bulges of lower lid bags would benefit from blepharoplasty with fat resection or modification (fat slid where needed over rim or into tear trough).

        Clearly, best to proceed conservatively with lower lid hyperpigmentation after proper diagnosis. With all these choices, the recommended way to obtain treatment is to visit a Board certified specialist with experience and training in skin care, injectables, and blepharoplasty. 

        Hope this helps. Remember, total sunblock  (Zinc Oxide,etc) during and after treatment needed for optimal results and also helps avert recurrences. 

Joseph M. Pober, MD, FACS
New York Plastic Surgeon
4.5 out of 5 stars 17 reviews

Dark patches under eyes

I think the most common cause of this is that the eyelid skin can be quite thin in this area in some people.  This makes the skin almost translucent and if there is not much fat the underlying muscle of the lower lid shows through as a slightly bluish dark colour.  In my experience there is not much surgery can do for this.  See if you can find a concealer that could be applied.  

Alastair J. Platt, FRCS (plast)
Hull Plastic Surgeon
5.0 out of 5 stars 24 reviews

Dark patches under eyes

It is a bit difficult to tell exactly what is causing the dark patches under your eyes without examining you.  It may be possible that it is discolored due to blood vessels under the skin and it may be able to be improved with a laser treatment.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Under Eye Rejuvenation with fillers, lasers, microneedling/prp

The dark bags you have are genetic and can be treated with lower eyelid surgery or fillers, lasers, and microneedling/PRP. Please see an expert for a formal consultation. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Eye bag treatments, younger people

There are many causes of eye bags. Some are shadow issues some are discoloration issues.  

1. Prolapsed orbital fat through the orbital septum (less likely in young people): treated with lower lid blepharoplasty and fat re-positioning. Can also be helped with fillers or auto fat transfer to the face 

2. Ezcema: much more common in young people with fair skin. I believe this is your issue. The treatment for this is to hold off on make-up and any manipulation of the lower lid (allergies?) for a few weeks and try some topical anti inflammatory medications. If you have allergies those should be treated. 

3. Fluid accumulation and/or redundant skin. Could be possible in young but would need a good facial analysis and exam to determine. Could treat with filler and/or lower lid blepharoplasty.

4. Decent of midface cheek pad. Unlikely in your case but can happen. Treated with mid face lift or fillers.

It is all about the balance of this transition from the orbit to the cheek. There are many ways to treat this and they vary by the underlying cause. I recommend seeing a surgeon who also does a lot of skin care. This can make a big difference as most people have a combination of the above that lead to the issue.

Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 10 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.