Is there a permanent way to get rid of my dark circles? Concealers and creams don't work for me. (Photo)

Hi, I have dark circles since I was born. Concealers and creams don't work for me.. Is there a more permanent way to get rid of them? I am 26 years old. Thank you in advance.

Doctor Answers 1

Treating the pigmentation and relative hollowing of dark under eye circles

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Dark under eye circles are caused by genetics. As an oculofacial plastic surgeon, I didn’t really have that many options to offer my patients with this problem 20 years ago. We would do things like glycolic acids and retinoids to improve the skin quality but they were still limited. With the introduction of hyaluronic acid fillers around 2005, we started to see some possible options even though they weren’t initially used for dark circles under the eyes.

One approach to dark circles is looking at the anatomy - I assess if there is relative hollowing. If that hollowing is genetic or volumetric loss from aging, it’s part of the decision-making plan. If there is a volume loss, we use a hyaluronic acid filler like Restylane to augment or to restore some volume under the skin at a level that’s closer to the bone called the tear trough. That has to be done very carefully and meticulously. Unfortunately, a lot of people don’t get the best results so they come to me and I actually dissolve the hyaluronic acid filler with a material called hyaluronidase.

The second option is using platelet-rich plasma (PRP). This material is also used in orthopedic and oral surgery. It is derived from your own blood. We spin your blood and concentrate the growth factors and platelets which are the critical cells for healing. When platelet-rich plasma is injected under the skin in the appropriate candidate, it improves skin quality, blood supply and collagen. We follow our patients every three to four months and then we re-evaluate. If the skin quality looks improved and the patient is satisfied, then we just basically wait and see how long this particular treatment lasts for them. There are some patients who come in for PRP treatments once a year, others come twice a year and others come three to four times a year. It’s very individualized because there are factors such as age and environmental factors.

Both hyaluronic acid and platelet-rich plasma are not permanent solutions. In a way, that’s an advantage because unlike surgery, it’s something that you don’t have to live with forever. You can see how you can respond to it and then decide if you want to integrate that as something in your lifestyle.

For people with lighter skin type, we also have other options including lasers. For somebody with a darker skin type, lasers are usually not an option because there’s a risk of hyper or hypopigmentation. In addition, I wouldn’t completely discourage moisturizers as a solution to dark under eye circles because they do have a role. They don’t completely resolve the problem but they work in combination with other solutions. For example, I have a patient who benefits from hyaluronic acid injection, platelet-rich plasma and a good topical cream.

I think it’s probably a good idea for you to meet with some doctors now that you’ve learned more about these options. You can actually ask more specific questions, look for examples of before and after pictures and see if it’s an option for you to give this a try. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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