Dark Circles

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Dark circles under the eyes are a very common concern and can be quite a difficult problem to treat. Dark Circles give the appearance of looking tired, stressed, aged and unwell. They can occur across a large range of ages, skin types, affect both men and women and tend to worsen as we get older.

Our Approach

The key to the successful treatment of Dark Circles under the eye is a proper assessment to work out the nature of the darkness and the causes. A medical history and examination is needed to determine hereditary factors, general medical health and any presence of sinus disease or allergies.

In particular, it is critical to determine if there is Wrinkling, Swelling, Pigmentation, Increased Vascularity and/or a Tear Trough Deformity.

About the condition

Dark circles under the eyes are common due to a number of factors:

The skin under the eyes is very thin and translucent so underlying blood vessels are more visible.
The thin skin under the eyes is very sensitive and susceptible to irritation and environmental damage.
The eye area is one of the first to show signs of ageing with fine lines being one of the earliest signs.
Any congestion in the nose and sinuses creates back pressure which can contribute to swelling as well as cause dilatation of blood vessels and darkening of the skin.
Loss of the fat pad under the eye can result in a hollow depression that extends from the inside of the lower eyelid to under the eye and is called a Tear Trough Deformity.

Often with Dark circles several factors are present in the same person.

Treatment options

Treatment depends on the nature of the Dark Circles and the main underlying causes.

Wrinkling: Can be softened with Anti-Wrinkle Injections in younger patients. In older patients where there is more skin laxity can consider PRP or skin needling. Topical creams such as Elastiderm or Rationale DNA eye cream can help.
Swelling: If swelling is due to ‘bags under the eyes’ which is caused by herniation of the under eye fat pad this can only be fixed by surgery (Blepharoplasty). If due to local irritation or allergy this needs to be managed.
Pigment: If part of a more generalised pigment issue, the under eye area can be treated at the same time. If pigment is just localised to under the eyes can consider topical treatments (peels and depigmenting creams) but need to remember that the thin skin under the eye is very sensitive and if the treatment is irritating itself this may actually worsen the darkening. It is also important that when treating under the eyes that care is taken to avoid any products getting into the eye itself.Creams containing green tea are thought to be helpful in reducing eye pigmentation (eg Teamine) but strong scientific evidence is lacking. Some patients rather than buying green tea extracts put wet green tea bags in their fridge and then use for 10-15 minutes each day as a mask.In the clinic we have found the BBL in the right patient is very successful in treating under eye pigment.
Vascularity: Increased blood vessel congestion needs to be treated by addressing the cause just as in treating swelling under the eye. Creams containing caffeine can constrict blood vessels and give short term improvement.
Larger blue veins can contribute to darkness as well as congestion and can be treated by the long pulse YAG laser (EXCEL V) but can only be treated if they are over bone and not the eye itself and eye protection is important when treating these veins.
Tear Trough: Is treated with Dermal Filler. An experienced injector is important as results are dependent on technique and choice of filler. Fantastic results can be achieved with Tear Trough dermal filler treatment and the results often last 1-2 years.

FAQs

What lifestyle things can help Dark Circles?
Whatever the cause of Dark Circles under the eye there are some general things to remember that can help in managing and reducing the condition.
- SMOKING: Don’t smoke and avoid passive smoking as it damages collagen, dehydrates the skin and causes premature ageing and will worsen bags under your eyes.
- SUNSCREEN: Daily sunscreen around the eyes is important as ultraviolet light worsens pigmentation. Physical sunscreens such as Titanium Dioxide and Zinc Oxide are usually better tolerated under the eyes as they are less irritating to the skin than chemical sunscreens.
- SUNGLASSES: Wear sunglasses to protect your eyes and the skin around your eyes. Larger lenses are better as they protect the sides of your eyes as well. Sunglasses with an EPF (Eye Protection Factor) rating of 9 or 10 are best.
- SLEEP: Lack of sleep, excess alcohol, caffeine and sugar can stress the adrenal gland and contribute to swelling under the eyes. Aim for 8 hours of sleep a night. If have regular swelling in the morning consider sleeping on your back or with an extra pillow. Late nights followed by too little sleep can result in dark circles under the eyes.
- SCREEN TIME: Excess Screen time on computers and phones may also worsen dark circles and eye puffiness.
- DIET: No definite evidence but it has been suggested dark circles and puffiness may be associated with a lack of Vitamins K and B12 and antioxidants. Eating plenty of green leafy vegetables and a daily multivitamin supplement are good nutritional advice in any case. If swelling consider less salt intake as excess salt can cause fluid retention in some people.
What skincare best helps Dark Circles?
There are many products that make many unsubstantiated claims but certain things are known:
- MOISTURISER: Using a daily moisturiser at night helps prevent dryness, dehydration and irritation.
- CLEANSER: Only use a Gentle cleanser.
- CONCEALER: Is important to match the colour of a concealer to only slightly lighter than your skin tone. If more severe dark circles use a concealer cream but if mild use a liquid. Certain colours will work better to conceal certain skin discolouration: for brown use orange, for red use yellow or green and for blue use peach colour concealer. A breathable product is best eg LYCOGEL.
  MAKE UP: Never leave make up on overnight and when removing use a gentle pad.
What about Home remedies?
Various home remedies have been tried as soothing treatments to reduce under eye puffiness presumably through constriction of leaky blood vessels. Some of the most popular home remedies for dark circles are:
- Chilled tea bags (eg Green tea bags (caffeinated) left in fridge overnight then applied for 10-15 minutes next day),
- Cucumber slices. Place thick slice from fridge over closed eye lying down for 10-15 minutes daily.
- Frozen Peas. For 10-15 minutes over closed eye with a cloth (direct ice on the skin can cause an ice burn). Peas are used as they can mould very well into uneven surfaces like around the eye.

Before and after

Before and after images are presented purely as a reference point of the results that can be achieved. Everyone is unique and outcomes will vary and realistic expectations need to be discussed on a case by case basis.

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