What can I do to treat under eye dark circles?
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.
I’m Dr Amiya Prasad.
I’m a Board Certified Cosmetic Surgeon and Fellowship Trained Oculofacial Plastic & Reconstructive Surgeon.
I’ve been in practice in Manhattan and Long Island for over 20 years.
I’m well known as an eyelid specialist, and treat conditions such as under eye bags,
and hooded eyelids, as well as specialized procedures such as eyelid ptosis, revision
eyelid surgeries for complications originally performed by other doctors such as upper and
lower eyelid retraction, improving appearance after thyroid eye disease, and procedures
involving the lacrimal system.
I’m also well known for non-surgical eyelid procedures, such as the use of injectable
fillers for hollowing above and below the eyes, platelet-rich plasma to improve the
skin of the eyelids, and using different lasers to improve the delicate eyelid skin.
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.
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
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.
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
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.
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.
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
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
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 overtreatment 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
Depending on the techniques employed, there is generally very little healing time with
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.
The 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
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.
I hope you found this information helpful…thank you for your question.