How Can I Fix Dark Circles? I've Had Them My Whole Life

Question

I'm 19 I have undereye darkness and bags that will not go away no matter what I try. They been there since a child, always had a poor diet, insomia. BUT I've made changes, eat much better, vitamins, proper rest, workouts, drink TONS of water. I am underweight, can't seem to gain it. But nothing changes for my eyes. I have Hyperthyroidism that comes and goes but my eyes never change! It effects me, I dress like a muslim to hide my face. Surgery would be okay if there's promising results!

Hannah Vargas, MD · Answer

Options for this problem typically include some type of filler and/or fat removal via eyelid surgery. Why would I need fat taken out and fat put back? in you may ask. The key is where the fat goes. Just under your eye, fat from around your globe has fallen forward while just below that there is an indentation. Obviously you need to be evaluated in person. Review your options in detail to find the right ones that fit with your lifestyle. Good luck!

Mark Hamilton, MD · Answer

Dark circles can be due to a variety of issues and the treatment really depends on what the underlying cause is. Many times this area can have increased pigmentation (hyperpigmentation). These areas of brown discoloration can typically be addressed with bleaching agents which can be done topically at home by the patient or more aggressively but with chemical peels done by a physician’s office. Another cause of dark circles in the eye area can be due to shadowing from fat pseudoherniations. These pseudoherniations are typically best addressed through blepharoplasty, a surgical procedure to rejuvenate the eye. For those not ready for surgery, sometimes injectable fillers such as Juvederm or Restylane can be injected in this area to help camouflage the puffiness. Lastly, allergies or just skin that is thin and hypervascular (increased number of superficial blood vessels) can be the cause of darkening in the eyelid area. This is typically best treated with topicals. Teamine is an excellent product which treats a variety of causes of dark circles in this area. Lastly, in this situation too, sometimes chemical peels can be helpful. Determining which option is best for you can start by meeting with a facial plastic surgeon to evaluate what is causing your dark circles and determine the best option.

Steve Laverson, MD, FACS · Answer

Although it is difficult to be sure from the photo, because of your young age, my first choice would be to consider filler such as Radiesse, Juvederm, or Restylane. If these do not work, my preference is surgical blepharoplasty with fat repositioning to transfer fat across your nasojugal and palpebro-malar creases. The results will be permanent, and have been very gratifying for our patients.

Catherine Winslow, MD · Answer

At your age it would be unusual to require surgery for eyelids but it does look like you have prominent hollows under your eyes (tear trough deformity). A filler such as Restylane or Juvederm will nicely soften the hollow and eliminate the shadow that this hollow causes. This is a no-downtime, instant result sort of procedure! However, get an injector experienced in this area! Good luck.

Anita Mandal, MD · Answer

It difficult to tell from your photos but it appears that you have hollows under your eyes as well as fat bags. In such case, both problems are contributing to the darkness under your eyes. Improvement in the hollows can be achieved by injecting a fillers such as restylane which may reduce the darkness as well. You may however need to have the fat bags removed through a transconjunctival blepharoplasty for further improvement. The proper treatment approach would be determined during a thorough consultation with your facial plastic surgeon.

Brooke R. Seckel, MD, FACS (retired) · Answer

Sarah Nicole,

Thank you for your question.

Some of the common causes of Dark Circles Under The Eyes are;

Pigment and sun damage
	
		Very Thin Eyelid Skin-allows color of muscle underneath to show
	
		Hollow Eye 
	
		Arcus Deformity or Tear Trough causing a deep depression beneath the lower eyelid
	
		Excess small blood vessels in eyelid skin

Common treatments for Dark Circles Under eyes are:

IPL-Intense Pulsed light removes pigment and vessels
	
		1540 Laser for dark Skinned people pigment removal
	
		Transconjunctival Arcus release and Fat grafting to correct deep depression

Topical Creams such as Retin A and Hydroquinone can help excess pigment caused by sun damage. Other advertized creams dont work-save your money.

Avoid filler injections. I have seen so many patients who had filler injections around the eye and they look worse after. Very few doctors know how to do the filler technique properly around the eye. If you choose this approach find an expert.

Your photos are not clear but I do not see a dark depression and assume your problem is thin skin and vessels. Try to find an expert who knows how to use IPL around the eye. You must have a shield placed over the eye during treatment!

How Can I Fix Dark Circles? I've Had Them My Whole Life

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