Dark eye circles are known as periorbital hypermelanosis or periorbital hyperpigmentation, which affect both eyes and typically the lower eyelid skin. Some people who have this condition often feel they look extremely tired or sad.

What causes dark eye circles?

Causes for prominent circles can be the result of excessive pigmentation in the skin, loss of fatty tissue in the eyelid or around the eye, puffy eyelids, thinning of the skin and prominent shadowing due to skin laxity. There are other factors that can be partly controlled by one’s genetics, other factors such as aging, smoking, fatigue, dehydration and even menstruation can also have a part to play. There are a number of potential causes which tend to be more common in ethnic skin types, those with a genetic predisposition and increasing age. However, it can be the result of other skin problems or medical issues. Such as allergy, eczema, melasma, thyroid disease, or hay fever.

What treatment are be used?

We always recommend to be assessed first by a dermatologist or doctor so that other medical causes can be ruled out.

Treating for dark eye circles can be challenging and often one treatment is not enough. Individuals usually need different treatment types to produce significant results.

Some might address their lifestyle before jumping into medical treatments. It might be as simple as getting at least eight hours of  night of sleep at night, lack of sleep can worsen eye circles. Your diet should be a healthy one with limiting alcohol and salty foods, which causes dehydration and puffiness. You should use SPF daily, knowing that ultraviolet light can make pre-existing dark circles worse.

Let’s get down to some types of medical treatment that can be used. The most convenient treatment some individuals used is topical, such as creams and gels. If using over-the-counter brightening products check that they contain some of the following ingredients which can be helpful vitamin C, niacinamide, azelaic acid, retinol, liquorice extract, mulberry extract, arbutin, kojic acid, and aloesin.

Prescription products are likely to contain hydroquinone (2 to 4 percent) and retinoids. These may have the ability to produce irritation around the delicate eye area, and therefore use should be built up gradually under the guidance of a dermatologist.

You have the option of using chemical peels to treat a variety of facial pigmentation problems including melasma and age spots. You should avoid deep peels in the under-eye area due to the risk of scarring and worsening of pigmentation, using lighter peels can help to some degree over time. Commonly used peels in this area include trichloroacetic acid 3 to 6 percent, lactic acid, mandelic acid and glycolic acid.

Some use microneedling, which is a minimally invasive skin procedure which uses a device with small needles to make tiny punctures in the skin, it is used after applying numbing cream. This treatment can often be combined with chemical peels, as it increases the penetration and therefore activity of the peel. There will be redness and swelling after the procedure which can take a few days to settle, as the skin around the eye area is thin.

Lasers which target pigment, can be used as well. Laser treatments produce variable results, and often multiple courses are required. Because the eye is vulnerable to laser injury, treatments should only be carried out by an experienced practitioner. It is vitally important to have proper eye protection such as eye shields.

If natural aging is the cause of dark eye circles, then small volumes of dermal filler can be used. Derma fillers usually containing hyaluronic acid, can be injected or placed under the eye with a blunt device known as a cannula. Filler can smoothen out the skin and add volume, resulting in an improved appearance. With this treatment there is a risk of swelling, bruising and bumps, and a theoretical risk of blindness. This latter complication is incredibly rare, however, and the procedure is very safe when done correctly by an experienced practitioner, make sure to ask the person about their training backount and how many procedures they have carried out. This procedure is not permanent and are likely to last about twelve months.

Another option is fat transfer. If dark circles have developed due to significant loss of fat under the eyes, and there is marked hollowness as a consequence, then fat transfer can be an option, keep in mind it will not directly help the pigmentation. Fat is taken from another body site and grafted or injected to the under-eye area. This should only be carried out by a plastic surgeon.

Some individuals simply do not want to try any of the above mentioned treatments and simply opt for covering up the dark circles with color correctors and concealers. Products that are applied need to be waterproof, have holding power and provide high coverage. Pink and peach tones will help neutralize darkness and visible veins in fair skin; orange and red tones can help darkness in deeper skin tones. For a natural result, these need to be blended.

Treating dark eye circles is complex and requires patience. Multiple sessions and combinations are required to see what works best. The key is to see a knowledgeable cosmetic dermatologist with access to a range of treatments, who can assess the underlying cause of dark circles before initiating a treatment plan.