What should I do to get periorbital hyperpigmentation surgically or permanently fixed? (Photo)

Addressing periorbital hyperpigmentation, especially when non-surgical options have not been effective, can be challenging. Since you've been advised that blepharoplasty is not suitable for your situation, here are some alternative approaches you might consider:

Consult a Dermatologist: A dermatologist specializing in pigmentation disorders can offer targeted treatments. They can assess underlying causes, such as genetics, allergies, or lifestyle factors, and tailor a treatment plan accordingly.

Chemical Peels: Certain chemical peels can help lighten pigmentation under the eyes. These peels need to be performed by a qualified professional to ensure safety and effectiveness.

Microneedling: This procedure can improve skin texture and pigmentation by stimulating collagen production. It might be combined with topical treatments to enhance results.

Platelet-Rich Plasma (PRP) Therapy: PRP involves using your blood's growth factors to rejuvenate the skin. It can improve skin tone and reduce the appearance of dark circles.

Dermal Fillers: While not a permanent solution, fillers can help reduce the shadowing effect that can make dark circles more pronounced. They can be used to even out the contours under the eyes.

Topical Treatments: Consider prescription-strength topical treatments that contain ingredients like hydroquinone, retinoids, or vitamin C, which might be more effective than over-the-counter options.

Camouflage Makeup: While not a permanent solution, high-quality concealers can effectively mask dark circles. A professional makeup artist can provide tips on application techniques for the best results.

Lifestyle Modifications: Ensure you're addressing any lifestyle factors that might contribute to dark circles, such as inadequate sleep, dehydration, or dietary deficiencies.

Investigate Underlying Conditions: Sometimes, dark circles can be a symptom of an underlying health issue, such as anemia or thyroid problems. A thorough medical evaluation might be warranted.

Since surgical options are not viable, focusing on a combination of dermatological treatments and lifestyle adjustments may provide the best results. Be sure to discuss these options with a qualified dermatologist to develop a plan that is safe and effective for your specific needs.