Dark under eye circles are a common concern for many people, and they can be a frustrating issue for those who want to do something about them. Patients who visit me for under eye dark circles complain that they appear tired or worn down, even when they are vibrant and energetic.
Dark circles can be caused by superficial skin discoloration, ethnic pigmentation, and thin eyelid skin that reveals underlying anatomy such as the orbicularis oculi muscle and blood vessels, iron deposits from blood pooling under the eyes, and even post-inflammatory hyperpigmentation, or PIH, from previous laser or other treatments. I’ll talk about how I use lasers and other therapies to help people who come to my practice with dark under eye circles.
Which Laser Treatment is Best for Dark Circles?
There can be several causes of dark under eye circles, and more than one type of laser can aid in skin improvement. Lasers such as fractional CO2, Nd:YAG, and Erbium lasers, when used correctly, can stimulate collagen production, improving skin thickness and health. By increasing the relative thickness of the thin eyelid skin, which is the thinnest skin on the body at half a millimeter, the underlying anatomy that contributes to the appearance of dark under eye circles can be better covered, and the appearance improved.
Depending on the type of laser and the energy delivery settings, lasers can partially ablate the skin, or remove some of the top layer of skin to allow a new fresh layer of skin to come in, also known as skin resurfacing. Ablation can be very helpful if the top layer of skin or epidermis is discolored and contributes to the perception of dark circles.
The natural pigment in your skin is more concentrated at the junction of the epidermis and dermis, as well as in the dermis itself, which is the deeper skin layer. Proper judgment is essential when using a laser device because overly aggressive treatment can have a negative effect, making the eyelid skin thinner and worsening the problem.
Thinner eyelid skin from overly aggressive laser treatment makes the eyelids crepey and creates more wrinkles. The right amount of heat from laser or radiofrequency devices can tighten the dermis and stimulate collagen production, which improves the appearance of wrinkles.
Best Under Eye Laser Treatment
I’ve devised treatment plans to reduce the risk of laser overexposure. Since the goal is to stimulate collagen production as much as possible, I use non-laser technology to supplement the laser-induced stimulation of the skin. I frequently combine laser treatment for the lower eyelids with platelet-rich plasma, or PRP. PRP is derived from your own blood and is a concentrated form of wound healing and growth factors required for tissue repair, such as after a cut.
PRP is prepared by drawing your blood as you would for a routine blood test and spinning it in a centrifuge to concentrate the platelets, resulting in a clear, yellow serum. PRP stimulates collagen production while also improving blood supply and circulation, resulting in healthier and thicker eyelid skin without the use of heat energy. In the eye area, I find that PRP and laser treatment complement each other very well.
Dark under-eye circles are frequently associated with relative hollowing in areas such as the tear trough and cheek, which creates shadows and adds to the tired appearance. Since this is more of a volume issue, I routinely use minimally traumatic techniques with blunt cannulas to place hyaluronic acid fillers.
I find that frequently, volume correction has the most significant impact on the appearance of dark circles. On a related note, I’ve seen a good number of patients who came in concerned about dark under eye circles without recognizing that they had puffy under eye bags. Puffy under eye bags, make the discoloration aspect of dark circles more prominent and makes the shadow of relative hollowing under the eye bags appear even darker. The optimal strategy is therefore to address the under eye bags.
In my practice, I treat under eye bags with fillers as well as a minimally invasive surgery called transconjunctival blepharoplasty, which is performed from the inside of the lower eyelids with no incisions or sutures on the outside. This is a procedure that I perform in my office using local anesthesia and LITE IV sedation with minimal swelling and bruising so that our patients can return to work in about a week looking refreshed.
Is Laser Treatment for Dark Circles Safe?
Lasers are great tools to help address under eye dark circles. It’s critical to have a proper assessment to determine what the anatomic variables are which contribute to the appearance of your dark circles. I look at this area from the inside outward, so I look for hollowing, puffy under eye bags, vascular and muscle elements, melanin or ethnic skin pigmentation, and epidermal or superficial factors which contribute to this appearance.
As an experienced oculofacial plastic surgeon, I can assist my patients with lasers, injectable fillers, PRP, and surgery for under eye bags. Practitioners in the modern aesthetic marketplace have biases to sell procedures they can do and ignore procedures they can’t do, essentially not looking out for the patient’s best interests.
I can attest to this because patients frequently come to me for evaluation after being dissatisfied with treatments received elsewhere. If you are looking for a solution for dark under eye circles, it is critical that you are educated prior to your consultation and that the doctor you consult with spends time with you and provides you with a satisfactory explanation for the therapeutic strategy they recommend for you.
Laser Treatment for Dark Circles in Manhattan NYC and Long Island, New York
Dr Amiya Prasad is a Board-certified cosmetic surgeon, and a Fellowship-trained Oculofacial Plastic & Reconstructive Surgeon. He’s been in practice in Manhattan and Long Island for over 25 years. Dr. Prasad specializes in all types of eyelid surgery for both primary and revision surgery. He also performs non-surgical procedures for the eyes, including injectable filler placement, laser and radiofrequency treatments, microneedling, and platelet-rich plasma treatment. To schedule a consultation, fill-up the contact form below, or you may call any of our offices at (212) 265-8877 for Manhattan, New York City; (516) 742-4636 Garden City, Long Island; or (703) 356-1336 for Vienna, Virginia.