What is the best treatment for dark eye circles?

Thank you for your question on dark eye circles. I am starting to see increasing numbers of young patients like yourself at my clinic with problems of dark eye circles or eyebags. Indeed, this is a real problem that is not just confined to older patients and I understand the frustrations the come with it.

There are numerous causes for dark eye circles - skin pigmentation, thin eyelid skin, prominent orbicularis oculi muscle (muscle under the eyelid skin) , stress and allergies to just list a few. As you can probably start to see, the problem of dark eye circles is actually quite complex. To treat the problem, we have to identify the underlying cause for the dark eye circles. Usually, the dark eye circles would be due to a combination of these factors leading to increased increase blood flow to the underlying muscle, which shows up through the thin lower eyelid skin.

Staying up late does contribute to this increased blood flow due to the increased stress you have placed on your body. You have done the first right step which is to change your habits and improve your sleep hygiene.

The other treatment options that may help include eye creams, minimally invasive procedures such as resurfacing lasers, injection of fillers or structural fat grafting to the lower eyelid. These have to be tailored to the individual patient. If you haven't already, then speak with an experienced plastic surgeon to examine you and review options with you in person.

I hope I have answered your questions. Have a great week ahead!

Hi! To answer your question accurately, I would first like to assess what “kind” of “dark under eye circles” you really have. This is because different people have different ideas about their dark eye circles. Identifying the real cause of your dark eye circles is important as treatment options differ based on different conditions.

For starters, the muscles, ligaments and fat pads around the eyes are complex structures with complex attachments.

“Tear trough” deformities are due to volume loss in the soft tissue around the eyes and these are best treated with a “soft” undereye filler. There are many brands available, but in general hyaluronic acid based fillers are preferred for this delicate area for a natural-looking appearance.

People with prominent “eye bags” due to hypertrophic tarsal muscles may benefit from small doses of botulinum toxin injections. This can also be used to treat peri-orbital and undereye wrinkles which may give a person a “tired” look.

Venous congestion around the eyes often appears as a purplish-blue discoloration in the undereye area and can worsen the appearance of tear trough deformities or prominent tarsal muscle bulges. Treatment for this includes medical-grade creams and procedures such as medical lasers by a trained professional. Skin-tightening devices such as HIFU (high intensity focused ultrasound) and radiofrequency devices such as Thermage can also be of some benefit.

Do seek out a consult with a trusted doctor for more information to find a solution that fits your needs best!

Regards,

Dr Joanna Chan

Dark eye circles is one of my favourite topics as I have a keen interest, when discussing treatment modalities with my patients. The treatment(s) depend on the cause of the dark eye circles.

Dark eye circles occur as a result of a combination of the following factors:

1. Volume Loss

2. Thin Skin

3. Pigmentation

4. Vascular Changes

5. Undereye Wrinkles

6. Eyebag

1. Volume Loss

With age, there is resorption of bone and decrease in soft tissue density around the eyes resulting in tear trough hollowness.

Solution- Fillers.

In my practice, I use customised low-viscosity fillers depending on severity and extent of tear trough hollowness. Injecting fillers at the correct depth will yield optimum natural results with no to low downtime (swelling, bruising).

2. Thin Skin

Thin skin below the eyes are a result of loss of collagen caused by sun damage and ageing. As a result, blood vessels can become more prominent.

Solutions- Eye creams, Lasers, High-intense focused ultrasound (HIFU).

Medical grade eye creams containing a combination of retinol, vitamin A and C, peptides, ceramides and hyaluronic acid, can help to stimulate collagen formation. Creams in combination with lasers and HIFU yield a synergistic effect in improvement of skin laxity as a contributing factor of dark eye circles.

Lasers using customised long-pulse settings can help to stimulate collagen and thicken the skin below the eyes,

Skin laxity can be tightened using medical grade HIFU to target the deep, fat layers of the skin to stimulate collagen formation, resulting in skin tightening.

3. Pigmentation

Undereye hyperpigmentation can be caused by sun-damage.

Prevention- SPF 50+ broad-spectrum sunscreen for both UVA and UVB protection.

Solution- Pigment Laser.

Pigment Lasers with customised settings by an experienced physician can effectively reduce dark eye circles resulting from sun-damage.

4. Vascular Changes

Medical conditions such as sinusitis and allergy cause congestion of blood vessels and fluid retention below the eyes.

Solution- Oral Anti-histamines.

Oral anti-histamines taken at a low dose short treatment course can help to treat sinusitis and allergy, reducing the appearance of dark eye circles caused by vascular changes.

5. Undereye wrinkles

Undereye wrinkles give the appearance of an aged look. Dark contours and shadows caused by undereye wrinkles worsen the appearance of dark eye circles contributed by the other factors.

Solution: Botulinum Toxin

After examining the patient, if he/ she is suitable for for treatment of undereye wrinkles using Botulinum Toxin, I inject minute amounts of Botulinum Toxin precisely to relax the pre-tarsal muscles to reduce undereye dynamic wrinkles. This is safe and effective in reducing undereye wrinkles and therefore the appearance of dark eye circles.

6. Eyebag

Eyebag refers to the undereye orbital fat that can protrude more in certain patients.

Solution: Eye threads

I perform eye threads to help flatten and reduce the appearance of undereye orbital fat. This is a quick procedure with minimal discomfort and downtime.

In summary, peri-orbital rejuvenation in the treatment of dark eye circles require first identifying the contributing factor(s), In my practice, I tailor a customised treatment plan with a multi-pronged approach to yield optimum aesthetic results. Hope this helps!

Cheers,

Dr David Deng

Dark eye circles are a very common problem which bothers many young people. They can make you look tired, dull, and older than your age.

The causes of dark circles under the eyes vary, and the treatment depends on the cause.

Common causes of under-eye circles are:

a. Pigmentation: Pigmentation is a common skin condition in which patches of skin become darker than the surrounding skin. This is caused by an excess production of melanin. While mainly genetic, factors such as sun exposure, nasal or skin allergies, inflammation from acne or injury can increase pigmentation around the eye.

b. Loss of undereye volume: Aging reduces bony support and superficial fat around the eyes, making the eyes appear hollow and sunken. The resultant depression creates a shadow under the light resembling a dark circle. Although it is age related, there are some who have them as a natural deformity from a young age.

c. Loose skin: Loose skin causes fine lines and crinkling of under-eye skin, giving the appearance of dark eye circles.

For most people, I would recommend trying PicoSure laser treatment. PicoSure is a picosecond laser treatment approved by the US FDA, which is effective in reducing pigmentation and tightening skin. It reduces pigmentation by delivering an ultra-short pulse of energy to the skin in picoseconds (trillionths of a second), shattering the pigment into tiny dust-like particles, which are then absorbed by the lymphatic system and eliminated naturally. PicoSure also has a unique focus lens, which is effective in tightening the skin through stimulation of collagen. It works by creating LIOB or laser-induced optical breakdown though photomechanical disruption.

Fillers containing hyaluronic acid is a good option to replace lost volume around the eyes. Hyaluronic acid, which is naturally found in the skin, fills the depression under the eyes and hydrates the skin, reducing the appearance of dark eye circles. Fillers such as Juvederm and Restylane are safe and ideal for under-eye rejuvenation.

Skin resurfacing lasers like Fraxel Dual laser and ultrasound-based devices like Ultherapy can also help by renewing and revitalising tired skin. These treatments are effective in dark eye circles caused by loose skin.

Hope the above helps!

Dr. Terence Tan

Dark eye circles is one of my favourite topics as I have a keen interest, when discussing treatment modalities with my patients. The treatment(s) depend on the cause of the dark eye circles.

Dark eye circles occur as a result of a combination of the following factors:

1. Volume Loss

2. Thin Skin

3. Pigmentation

4. Vascular Changes

5. Undereye Wrinkles

6. Eyebag

1. Volume Loss

With age, there is resorption of bone and decrease in soft tissue density around the eyes resulting in tear trough hollowness.

Solution- Fillers.

In my practice, I use customised low-viscosity fillers depending on severity and extent of tear trough hollowness. Injecting fillers at the correct depth will yield optimum natural results with no to low downtime (swelling, bruising).

2. Thin Skin

Thin skin below the eyes are a result of loss of collagen caused by sun damage and ageing. As a result, blood vessels can become more prominent.

Solutions- Eye creams, Lasers, High-intense focused ultrasound (HIFU).

Medical grade eye creams containing a combination of retinol, vitamin A and C, peptides, ceramides and hyaluronic acid, can help to stimulate collagen formation. Creams in combination with lasers and HIFU yield a synergistic effect in improvement of skin laxity as a contributing factor of dark eye circles.

Lasers using customised long-pulse settings can help to stimulate collagen and thicken the skin below the eyes,

Skin laxity can be tightened using medical grade HIFU to target the deep, fat layers of the skin to stimulate collagen formation, resulting in skin tightening.

3. Pigmentation

Undereye hyperpigmentation can be caused by sun-damage.

Prevention- SPF 50+ broad-spectrum sunscreen for both UVA and UVB protection.

Solution- Pigment Laser.

Pigment Lasers with customised settings by an experienced physician can effectively reduce dark eye circles resulting from sun-damage.

4. Vascular Changes

Medical conditions such as sinusitis and allergy cause congestion of blood vessels and fluid retention below the eyes.

Solution- Oral Anti-histamines.

Oral anti-histamines taken at a low dose short treatment course can help to treat sinusitis and allergy, reducing the appearance of dark eye circles caused by vascular changes.

5. Undereye wrinkles

Undereye wrinkles give the appearance of an aged look. Dark contours and shadows caused by undereye wrinkles worsen the appearance of dark eye circles contributed by the other factors.

Solution: Botulinum Toxin

After examining the patient, if he/ she is suitable for for treatment of undereye wrinkles using Botulinum Toxin, I inject minute amounts of Botulinum Toxin precisely to relax the pre-tarsal muscles to reduce undereye dynamic wrinkles. This is safe and effective in reducing undereye wrinkles and therefore the appearance of dark eye circles.

6. Eyebag

Eyebag refers to the undereye orbital fat that can protrude more in certain patients.

Solution: Eye threads

I perform eye threads to help flatten and reduce the appearance of undereye orbital fat. This is a quick procedure with minimal discomfort and downtime.

In summary, peri-orbital rejuvenation in the treatment of dark eye circles require first identifying the contributing factor(s), In my practice, I tailor a customised treatment plan with a multi-pronged approach to yield optimum aesthetic results. Hope this helps!

Cheers,

Dr David Deng