Dark Brown Circles, Under Eyes: What is the most effective treatment without breaking the bank? (Photo)

With make up, at best I look exhausted rather than deathly ill. I think 80% of my problem is pigmentation around my eyes ( eyelids are as dark too) and about 20% due to the hollow tear trough, which is more hollow as I have got older. I'm looking for the most cost effective, and I hate to say cheap but money is an issue, which will show the most results. In order of steps, what can I do? Help!!!

Doctor Answers 4

Dark circles: the bane of many eyelids!

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Many of us dislike the "dark circles" under our eyes. This makes us look tired, old and worn out. The reasons are many: thin skin, pigmented skin, bluish vessels just beneath the skin surface, protruding fat pockets, crepey skin texture and other factors contribute.     Often we see this in families, a trait carried on from parent to child.      The remedies depend on the reason. Fat can be removed or repositioned. Darker skin can sometimes be lightened. (Makeup does this temporarily.). Some depressions can be softened with fillers. Sometimes superficial vessels can be lasered. Wrinkled skin can be resurfaced with lasers or peels.    An experienced  cosmetic/plastic surgeon can evaluate your eyes & discuss the pros and cons of strategies that are unique for your "circles". 

Louisville Facial Plastic Surgeon
5.0 out of 5 stars 75 reviews

Dark circles under eyes

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Hollowing, hyperpigmentation, blue veins under the eyes, are the 3 most common cause. Each can be treated very effectively. The first with filler, I like Vobella from Allergan, Pigmentation is the most difficult, but creams, sunscreens and non-ablative lasers can be used. Lastly Nd:YAG can be successfully used for the blue veins under the eyes and temples. 80% patients required only 2 treatments.

David A. F. Ellis, MD
Toronto Facial Plastic Surgeon

Filler for under eye dark circles

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The main reason for your dark circles is hollowness, with resultant shadow.  By filling the hollowness, it should improve significantly. There are a variety of fillers present, but the best for under eyes are Belotero and Restylane, since they cause less swelling and are reversible.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

The cheapest solution is use an under eye concealer.

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Next most effective solution is cover your circles with glasses.  I know-not very appealing.

You are wrong to assume that your dark circles is a pigment problem.  Well you are partly right but the pigment is not melanin-the pigment that makes us look tan or dark.  No that is the wrong pigment.  The correct pigment you are having an issue with is myoglobin.  That is the protein that makes muscles work and is inherently red.  Under the very thin skin of the lower eyelid is a thin muscle called the orbicularis oculi muscle.  Here is your skin optics physics less for the day!  A percentage of light incident to the skin is transmitted to the deeper layers.  Now on the cheek, this light is reflected back to the skin by a big yellow layer of fat making the skin look lighter relative to the adjacent eyelid skin.  The light transmitted though the eyelid skin does not hit a layer of yellow fat.  No it hits this muscle which contains an abundance of myoglobin.  Much of the light is absorbed by this muscle pigment and not available to bounce back into the eyelid skin.  So the thin eyelid skin looks dark relative to the cheek skin.  

Now this is important information because you are not going to be able to laser out, use topical creams to lift out or otherwise remove this darkness.  I guess you could cut out the muscle but trust me when I tell you that is not a workable solution.

That leaves us to mess with how the light interacts with the thin lower eyelid skin.  Concealer (I call it liquid photoshop) does this but it does not fill the lower eyelid hollow.  Glasses hide this area but you know what they say about girls who wear glasses (work with me here:  boys don't make passes.…).  Honestly, surgery is inappropriate for your issue.  What has proven very successful is filling the under eye hollow with hyaluronic acid fillers. The rub is that you may feel that is "breaking the bank."  So there you have it.  The good news is that under eye Restylane, the product I would recommend for this can last up to two years for someone your age.  The bad news is that for your circles, you might need a milliliter (1 ml) of filler under each eye.  

Hope this helps.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 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.