What treatment do my dark circles require? (Photo)

I have hereditary dark circles that I am really self conscious about and thinking of getting them treated. Which treatment would best fix them?

Doctor Answers 4

Dark circles

It looks like you have a couple of reasons for the dark circles.  The skin appears a more pigmented here.  Some IPL should help this.  But you also have some hollowing which will create a dark circle and make the pigment look even darker.  Putting some filler into the lower lid, such as Belotero or Restylane should help with this.  

Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 27 reviews

The various causes of dark circles under the eyes and non-surgical treatments for them

If you go to any retailer that offers creams of various kinds, you’ll see a tremendous number of solutions for dark under eye circles. However, these are all basically moisturizers, some with tint. Dark circles are difficult to treat because they are caused by different factors including genetic causes of pigmentation within the skin from melanin, and this runs in families. Another factor that causes dark circles is the skin quality. A lot of people have very thin skin that you can actually see the underlying structure. It may be a bluish appearance or a little dark because of the blood vessels. Sometimes the shape and the bones around the eye, and the way the skin drapes it accentuates various areas of hollowing. Lastly, aging and environment such as excess sun exposure or wind causes collagen to break down, so the skin becomes crêpier and the skin quality diminishes.

In our practice, we look at our patient to know if we dealing with any other issues that are also contributing to the overall appearance of the eyes such as puffy bags under the eyes, skin quality and the volume effect of the skin quality in that area. If there is loss of volume, you can use a hyaluronic acid filler like Restylane along the tear trough area and along the rim. This adds some thickness to the tissue underneath the skin in hollow areas to improve the dark circles. This requires proper patient selection as well as finesse in the technique. As a cosmetic oculofacial plastic surgeon of 20 years of experience, I see people who actually got this treatment done elsewhere and I needed to dissolve it because they got too much or it became irregular.

Another option that we’ve had a lot of success with even for hereditary dark circles is the use of platelet-rich plasma (PRP). Platelet-rich plasma is derived from your own blood. We do a blood draw like a lab test and place it in a centrifuge to spin it to concentrate the growth factors and the platelets. This improves collagen, skin quality as well as blood supply that will actually help dark circles caused by genetics. However, if someone is too young, the skin quality is very fine and we are not going to make much of a difference even if we treat the patient.

Dark circles can also be a multi-factorial issue where it’s not only genetic but there are also some other lifestyle-related and environmental triggers. For example, we have patients who do a lot of water sports and they’re out in the sun. They’re young but they get a lot of ultraviolet light exposure which results in breakdown of collagen. The skin becomes very dry and very crêpey and so they do benefit with platelet-rich plasma.

There is still a role for proper hydration of the skin. Eyelid skin is only half a millimeter in thickness and a lot of patients who have dark circles wear a lot of makeup and then use a lot of makeup removal solution to remove it - this traumatizes and dries their skin. Many of astringents have alcohol and they can be drying and irritating. We can’t understate that a moisturizer does play an important role. People would also benefit with the use retinoids but we do it very carefully because a lot of people can be sensitive to the retinoids. In our own practice, we actually have a moisturizer called Eye Rescue which is a combination of a moisturizer and some active ingredients that would be helpful. Our patients give a lot of good feedback from this product.

Think of dark circles in different levels and get some opinions from experienced cosmetic surgeons and aesthetic physicians. Look at your options and just learn more about these treatments. I hope that was helpful, I wish you the best of luck, and thank you for question.

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Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

Filling dark circles under the eyes with filler

Facial fillers with products such as Restylane help add volume and reduce dark lower eyelid circles in appropriate patients. Office treatment takes minutes and last several months. If you haven't already, it's best to speak with a plastic surgeon to review optons.

Dr. Chaboki

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Treatment for dark circles under the eyes.

An in person examination or better focused photographs with appropriate lighting is necessary to better answer your question.

Generally speaking dark circles caused by pigment can be treated with IPL or the 1540 non-ablative fractional erbium laser.  Excess visible small purple blood vessels can be treated with the IPL.  The Hollow eye deformity which causes dark circles due to a shadow beneath the lower eyelid require either filler injection or fat grafting.

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.