What laser offers best results in reducing dark under eye circles due to genetics, aging, thin skin, and visible blue/red veins?

Question

"Laser" has been recommended to me for dark under eyes due to genetics, aging, thin skin, and visible blue/red veins. There are so many lasers out there now that I want the most effective to target this issue.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells and microneedling RF like Fractora PiXel8 or Morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Harold J. Kaplan, MD · Answer

Hello Thoughtful.  There are no lasers that work to remove or improve dark circles under the eyes.  We've tried q-switched lasers and resurfacing lasers but nothing works.  If you are interested in improvement of the dark circles, find a practice around yo that does good undereye injections with Restylane (see photos at link below).

Jason Pozner, MD · Answer

In lighter skinned people dark circles are almost always caused by increased veins in the lower lids. The best treatment for these blue veins is a Nd:YAG laser - wavelength 1064nm. Look for an experienced practice with a Sciton clear-v or Cutera excel-v. There are other 1064 lasers but these are modern devices that are less risky due to their cooling systems. I cant stress enough to go to an experienced practitioner

What laser offers best results in reducing dark under eye circles due to genetics, aging, thin skin, and visible blue/red veins?

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