Causes of Dark Under Eye Circles And How to Treat Them

Amiya Prasad M.D. Dr. Prasad's Blog

Under dark circles are a fairly common problem that can affect people of all ages. There are several causes of under eye dark circles which makes it important to have the right strategy for your situation.

Dark circles around the eyes can make people look tired and weary, even if they actually feel great, and have a lot of energy. Having dark circles can give the wrong impression about you and how you feel. In a world where first and lasting impressions are so important, it’s understandable why people are seeking all kinds of solutions for this common issue.
man with dark circles under eyes

Under eye dark circles can be caused by several issues:

  • Thin eyelid skin revealing the anatomy underneath the eyes such as the orbicularis muscle and blood vessels
  • Lack of fat and bone structure under the eyes resulting in a hollow look,
  • Ethnic pigmentation
  • Hyperpigmentation from previous procedures, such as laser treatment
  • Iron deposits from the blood circulation such as allergic shiners

dark circles under eyes causes

Popular strategies used by many people is the application of over-the-counter creams which make claims which they never live up to. While creams can moisturize the skin, they are limited in addressing any other anatomic issues which if addressed can result in more significant benefit. Upper and lower eyelid skin is the thinnest in the body at 0.5mm thickness when healthy. When eyelid skin becomes thinner from aging, sun exposure or smoking, the challenge is to improve the quality of the skin without compromising the thickness.

man with obvious dark circles under eyes

With this principle in mind, I have focused more than 10 years on the application of regenerative medicine technology, specifically platelet rich plasma or PRP. I use platelet-rich plasma, or PRP, routinely to treat several causes of under eye dark circles. Platelet-rich plasma is the concentration of wound healing and growth factors naturally present in your blood for when you have a cut.

When concentrated, it can be used as an serum to improve skin quality, thickness, and overall skin health, while improving the blood circulation and blood supply in the area of treatment.

dark circles under eyes treatment with PRP

PRP is prepared from your blood, which is drawn in our office like you would have during a routine blood test. The blood is spun in a centrifuge to concentrate the platelets into a clear, yellow plasma, which can then be drawn into a syringe. The PRP is carefully placed under the eyelid skin. The regenerative process of this treatment is continuous, as increased blood supply and healing factors work after the injection to improve skin quality and thickness, stimulate collagen, and increased circulation.

dark under eyes circles treatment with PRP and Filler

In cases where the under eye area has concurrent hollowing, I can combine the placement of PRP with the deeper placement of a hyaluronic acid filler like Restylane to add volume. This combination treatment has a synergistic effect as both hollowing and skin quality are treated. For optimal, results, PRP is performed with regularly scheduled sessions. The frequency of these sessions depends on the conditions being addressed such as sun damage, wrinkles, and discolorations. PRP application helps change.

dark circles undereyes treatment with CO2 Laser

Lasers can also help with improving skin quality under the eyes, through resurfacing of the epidermis and collagen stimulation in the dermis. Lasers must be used carefully to avoid potential over treatment which can result in thinning of the under eye skin further, and possibly causing problems with pigmentation. When lasers used appropriately, they can be quite effective.

I routinely combine PRP with laser treatments to reduce to create maximal synergy to achieve best results.
PRP and Laser combined to treat dark under eye circlesDepending on the techniques employed, there is generally very little healing time with PRP treatment. Laser treatment for eyelid skin such as smooth eye long pulse erbium laser can be performed with no downtime. Fractional lasers such as fractional erbium or fractional CO2 laser may require a few days before the skin heals over.

This means that most patients can go back to work right after PRP treatment and some laser treatments with basic precautions related to sun exposure and skin protection.
A common question which comes up about every skin treatment is “how long will it last”. The answer is, it depends.
Laser and PRP combined for optimal resultsThe collagen response of your skin is affected by age, extent of sun damage, wrinkling and pigmentation as well as your lifestyle such as smoking and amount of time spent in the sun. I evaluate every patient and develop a customized treatment plan for them based on these and other important variables.

Dark circles can be treated without surgery, and results can really last. It’s important to note that ethnic pigmentation cannot be taken away, but you can improve skin quality so your eyes look more vibrant. As is important for any aesthetic procedure, knowledge and experience is important. In my experience, combining regenerative medicine technology such as PRP with advanced laser and radiofrequency technology has been successful for my patients.

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