Options for Treating Undereye Dark Circles

The undereye area can speak volumes. Based on the appearance of this part of the face, people may be perceived as being tired or unhealthy when neither are true. Due to genetics, however, the under eye area may appear dark and this simply is an inherited trait and not a reflection of our health. This can be annoying–  to not be seen for how we actually feel. There are ways to treat dark eye circles once we understand the particular cause for the inherited disposition. This week I present options for treatment, referencing the paper Infraorbital Dark Circles: Pathogenesis, Evaluation, and Treatment.

The first step in treating the undereyes is identifying why the area is darkened.  This happens either from: structural changes that lead to shadowing, visualizing the vasculature, visualizing blood breakdown products, and skin darkening. 

Changes to the structure 

Changes happen to the undereye anatomy as we age.  The ligaments and bone of the face provide a framework for soft tissue; ligaments that connect bone to skin, makeup compartments for fat pads to reside.  Changes occurring in the midface and to the orbital rim lead to a tightening of ligaments and to the overlying skin.  This is potentiated by fat pad descension and atrophy which leads to a hollowing and shadowing of the undereye area. 

Changes to the soft tissue 

The thin undereye skin provides little camouflage to the robust network of vasculature and underlying muscle; this can lead to a darkened appearance of the undereyes. The undereye area can accumulate fluid, such as after a salty meal, and this can take on a darkened appearance from the muscle beneath. In some, changes to vascular permeability leads to pigment changes.

Changes to the skin

The quality of the undereye skin can contribute to dark circles.  The lower eyelid skin is some of the thinnest in the body and therefore accentuates even small changes.  With minimal to none tissue between the skin and the muscle, age related changes like loss of collagen and elastin become exaggerated. Sometimes the actual pigment of the skin can be darkened.

So what to do…

The first step to treatment is understanding what is causing the darkness.  From there, treatments range from minimally invasive to surgery.  

Minimally invasive options: Cosmetics and Topicals 

Concealers: Even the medical literature discusses the role of concealers to address this issue!  Getting fit for the right undereye concealer can work wonders. 

Retinoids: These topicals help build collagen so that the underlying vasculature is less visible while also addressing skin discoloration. 

Hydroquinone: This is a topical skin bleaching agent that can be used when the undereye skin is darkened. 

Topical Caffeine: Can help with under eye edema and darkness from vascularization. 

Peptides: can help with dark circles by improving skin quality.

Non-Invasive treatments include: IPL, RF frequency, and lasers.  These are not treatments that I offer, however they are available and accessible. 

Minimally Invasive Treatments 

Chemical Peels: Can aid in dark circles caused by skin changes by helping to resurface the part of the skin containing melanin while also promoting collagen to camouflage the underlying vasculature. 

Hyaluronic Acid Fillers: are an effective treatment for dark circles that are caused by volume deficiency in the undereye area.  Addressing the volume deficiency decreases the shadowing that occurs.  Fillers can also serve as an added layer between the skin and the underlying vasculature 

Invasive Treatments: include fat transfer, lower eyelid blepharoplasty, and implants.

When we put effort into maintaining a healthy lifestyle and nourishing ourselves, it can be frustrating to have that social feedback of, are you ok? Are you tired? and other questions that can feel, on an emotional level, like you shouldn’t look the way you do. Small improvements to this experience can make a big impact. So if you find yourself contending with inherited dark undereye circles, know that you have some options with which you can experiment and find some relief. 

Thanks for reading.
With love,
Heather