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Dark Circles Under The Eyes

Dark circles under the eyes are a significant cosmetic issue. Though harmless,  they impact your self-concept and quality of life, making you appear older or tired. Dark circle treatment options include skincare creams, Tixel, factor 4, laser and undereye fillers. There are various causes of dark circles, which are often of mixed origin. The treatment approach should be customised to the underlying condition, so determining this is critical. Improving skin texture and quality with skincare is advised as an adjunct to all therapies.

  1. Tear troughs causing dark circles under the eye are best treated with dermal fillers. Tixel can also help.
  2. Under-eye bags are best treated with blepharoplasty or under-eye filler.
  3. Excessive pigmentation should be treated with topical creams, Tixel, or lasers.
  4. Vascular dark circles and thin skin may be treated with lasers, skin booster dermal fillers or fat transfer.

Because there are so many options, it is best to start with an assessment with our Nurse, Christine, who can refer you to our Doctors if needed.

Please book online or call 07 33505447 for a free consultation with our nurse Christine.

*Treatment dark circles with under eye filler – results are individual.

*Treatment dark circles with under eye filler – results are individual.

*1ml tear trough filler + cheek filler – individual results vary.

Cause of Dark Circles Under the Eyes & Treatment Options

Under-eye dark circles can affect people of all ages, genders, and races. In addition, lack of sleep worsens the appearance of dark circles under the eyes, and they tend to decline as we age. So, what causes the appearance of dark circles under the eyes and what can be used to treat them? The cause of dark circles under the eyes can be broken into four categories.

  1. Under-eye Hollow or Tear Trough: The shadowing in tear troughs formed from redistribution of facial volume down the face. This is a structural rather than skin colour change and occurs when volume loss in the under-eye area results in the formation of an under-eye hollow. The dark circles are a shadow effect because the hollow is lower than the surrounding skin.
  2. Under-eye bags: The appearance of bagginess results from fat pads under the eye bulging forward with age. Under-eye bags are also from structural changes to muscles, ligaments, and tissue below the eye, not skin colour changes.
  3. Excess pigmentation:  Pigmentation deposited in the skin causes skin colour changes and dark circles. Most commonly, pigmentation is from sun exposure and increases melanin pigment in the skin. However, there are other causes.
  4. Vascular dark circles:  Vascular dark circles are caused when the hue of blood vessels becomes visible through the thin under-eye skin. Vascular dark circles present as a bluish, purplish discolouration due to visible blood vessels. Once again, there is no change in the actual colour of the skin.

It is essential to differentiate the cause, as the treatment approach varies for each. Diagnosis is helped by the presenting colour of the skin and applying a skin tension test. In addition, skin analysis using wood and polarised light may help differentiate between pigment and vascular causes of dark circles under the eyes. Dark circle treatment options include skincare creams, peels, laser, undereye fillers, fat transfer and surgery. First, we will go over the causes of dark under-eye circles before giving an overview of the available treatments.

Please book online or call 07 33505447 for a free consultation with our nurse Christine.

*Treatment dark circles with under eye filler – results are individual.

*Treatment dark circles with under eye filler – results are individual.

*Treatment dark circles with under eye filler – results are individual.

*Treatment dark circles with under eye + cheek filler – results are individual.

*Treatment dark circles with under eye filler – results are individual.

*Treatment dark circles with under eye filler – results are individual.

*Treatment dark circles with under eye filler – results are individual.

Tear Troughs Causing Dark Circles Under the Eyes

The tear trough is an age-related depression in the lower eye rim caused by a hollowness from fat loss in the area where the lower eyelid and cheek meet. Tear troughs develop through changes in connective tissue in the already thin tissue of the eyelids and under-eye area. Collagen and elastin in the eyelids decrease with age resulting in skin laxity. In addition, the pull of gravity causes lax tissue and fat pads under the eyes to redistribute down the face. Fat pads are present in the face and usually give plumpness and contour to areas. So when they sink, a hollow appears in the area.

  • The malar fat pad, responsible for the curve of your cheek at the lid cheek junction, moves down the face.
  • The dark appearance results from a shadow cast as light falls across the under-eye hollows.
  • Eye bags and thinning of the skin often accompany tear trough formation.

Applying tension to the undereye skin lessens the dark circle appearance as the tear trough becomes more shallow. Tear troughs can be accompanied by under-eye bags, eye wrinkles and thinning of the lid skin. The best treatment for tear troughs is replacing the volume loss and plumping out the under-eye hollows. Under-eye fillers are the most straightforward in-clinic procedure, whereas fat transplant can be used as a surgical correction.

Under-Eye Filler Treatment of Dark Circles.

  • Under-eye filler can help reduce the appearance of dark circles.
  • Dermal filler can be placed in the cheek area, directly in the tear trough or both. The aim is to replace volume in the lid/cheek junction, and often, cheek filler assists in correction.
  • The filler will improve the cosmetic appearance of bags under the eyes.

New skin booster dermal fillers are an excellent choice for under-eye fillers. They contain filler to replace the volume in the hollow area and skin nutrient components to improve the skin texture and address laxity and fine wrinkles in the under-eye area.

Under Eye Bags Causing Dark Circles

Aging tissue changes also cause under-eye bags, once again, there is no change in the colour of the skin, but the bulging eyelids cause a shadow appearance on the skin. They commonly occur alongside tear troughs. The cause of under-eye bags is the laxity of the eye muscle and connective tissue around the eye. Because of the loosening of eye muscle fibres, gravity and weakening of eyelid connective tissue,  the fat pads around the eyes (periorbital fat pads) can protrude forward. This can occur in the upper as well as lower eyelids.

If you apply traction to the under-eye bags,  the appearance of the shadow decreases, but the bulge will worsen as you pull lax tissue down.

Under-eye bags are best addressed with surgery, although sometimes the careful placement of undereye filler can help by decreasing the accent of the shadow in the tear trough, diminishing the appearance of under-eye puffiness, and reducing the appearance of dark eye circles.

Dark Circles from Excess Pigmentation

Excess pigmentation in the eyelid skin also causes dark circles under the eyes. The pigment can be from melanin which causes a brown or brown-grey pigmentation, or haemosiderin, which causes a blue-brown colour. When tension is applied to the lower eyelid skin, the area of pigmentation spreads, and there is no lessening of the dark circle appearance.

There are several causes of excess melanin pigmentation, causing dark circles from genetic or environmental factors under the eyes. Birthmarks and congenital forms of hyperpigmentation are not as common as environmental causes, which include

  • Allergic skin reactions cause increased pigmentation by trauma caused by repeated rubbing due to itchiness.
  • Excessive sun exposure.

Dark Circles Under the Eye From Sun Exposure

Your skin naturally produces melanin when exposed to the sun. Especially in climates like Brisbane, with sun most days of the year, it is vital to wear sunscreen. If your eye area is exposed, some people have a genetic predisposition to darkening around the eyes from melanin. The critical factor in decreasing these dark circles is wearing concealer, sunscreen, hats and sun protection. In addition, it is essential to get a non-chemical sunscreen as these irritate eyes.

When dark circles under the eyes are caused by melanin pigmentation, the best treatment approach is depigmenting agents such as skin care, peels or lasers.

Dark Circles from Haemosiderin

There is also a rarer cause of excess pigmentation, which is haemosiderin staining. Haemosiderin is caused by blood leaking out from blood vessels and can occur after trauma and bruising. Unfortunately, it appears to the very little help with treating pigmentation due to haemosiderosis, though there are anecdotal reports that Vitamin K does. Fortunately, haemosiderosis is very rare.

Vascular Dark Circles Under the Eyes

Vascular dark circles occur because the underlying blood vessels of the eye muscles become visible through the thin, more translucent lower eyelid skin. As a result, dark vascular circles are present with bluish, purple discolouration. Applying tension to the lower eyelid causes the darkening to become more extensive, and the colour intensifies as the skin is thinner.

Sometimes visible vessels are detectable, but generally, the purple, dark circles under the eyes are simply because of the hue of the network of blood vessels visible through thin skin. Vascular dark circles worsen with aging; however, some people begin with naturally more delicate skin. Therefore, any factor that causes blood vessels to dilate will exacerbate the appearance of dark circles. These include stress from poor sleep.

Treatment Of Vascular Dark Circles

Treatment for dark vascular circles aims to increase the skin thickness to hide the vascularity,  decrease the vessels themselves or camouflage them.

  • Treatments aimed at improving the thickness of the skin include skin booster dermal fillers, PRP and fat transfer.
  • ND Yag lasers such as Excell V also target dark vascular circles by decreasing vascularity. 

Please book online or call 07 33505447 for a free consultation with our nurse Christine.

Dark Circle Treatment

Dermal fillers are commonly used to restore lost volume and return a more precise contour for tear troughs. Because the skin on the eyelid is thin specialised fillers such as new skin booster fillers are best. If dermal fillers are injected too superficially, lumps can occur. Therefore, it is best to use specialised fillers in this delicate area. Dermal fillers are also used to improve under-eye bags and dark vascular circles.

There are multiple cosmetic products to disguise or camouflage the appearance of under-eye circles. There are also depigmenting creams, including hydroquinone, vitamin A and vitamin C. They must be used for several months to achieve significant results and must be used with extreme care (not to get too close to the eye)

  • Hydroquinone is the most common bleaching again, and its effects appear about six weeks after initiating treatment. It can cause redness and irritation, and milia formation.
  • Topical retinoids decrease excess pigmentation and work for 6- 12 weeks. However, redness, peeling and skin stinging can be side effects.
  • Vitamin K-containing creams may help break down haemosiderin pigment.

Chemical peeling must be used with extreme care in the lower eyelid area. Peels increase cell turnover, and superficial peels such as glycolic, vitamin A peel, lactic, jessner or salicylic are appropriate.

Lasers can be used in a variety of ways for dark circle treatment. However, the eyes are incredibly vulnerable to an eye injury, so eye goggles or shields must be used. When treating right above the eye rim, metal eye shields must be placed over the eyeball.

  • Excess pigmentation can be treated with ND Yag (1064 laser), Q-switched ruby (694 nm), or alexandrite (755 nm) lasers.
  • Vascular dark circles are also addressed with Nd: YAG laser at 1064 nm
  • Skin laxity can be treated with a CO2 laser.

Surgical blepharoplasty is indicated for dark circle treatment caused by under-eye bags. Fat transfer assists with lessening dark vascular circles and tear troughs.

Please book online or call 07 33505447 for a free consultation with our nurse Christine.