What treatment do my dark circles require?
I have hereditary dark circles that I am really self-conscious about and I’m thinking of
getting them treated.
Which treatment would best fix them?
I have hereditary dark circles that I am really self conscious about and thinking of getting
them treated.
Which treatment would best fix them?
Thank you for your question.
You submitted a single photo that’s a little bit dark and you described that your concern
is about hereditary dark under eye circles.
Well, I would like to tell you a little bit about how I approach dark circles in my practice
and how things have changed over the years in terms of this situation.
If you go to any retailer that offers creams of various kinds, you’ll see a tremendous
number of solutions for dark under eye circles and of course they’re all basically moisturizers
some with tint.
So when we look at dark circles what makes it so difficult to treat?
Well first, figuring out the origin and when it comes to dark circles they’re basically
some categories and of course it could be combinations.
Genetics which means pigmentation within the skin that runs in families.
So if it runs in the family clearly that’s genetic thing where there is darkness from
the pigmentation from melanin.
Then, there is the skin quality.
A lot of people have very thin skin when the skin is very thin you actually see the underlying
structure; it may be a bluish appearance, it might be a little bit dark like you can
see the vessels.
So skin quality is an issue.
Anatomy, sometimes the shape of the eye and the bones around the eye; the way the skin
drapes it accentuates various areas of hollowing.
And the, of course, there are environmental and age-related changes.
As we get older or if we are in an environment such as excess sun exposure or wind, collagen
breaks down.
The skin becomes crepier and the skin quality diminishes and you can get thinning of the
skin and the skin can look dark or look like dark under eye circles.
So when we approach a patient, we look at our patient and first we decide are we dealing
with any other issues that are also contributing to the overall appearance of the eyes.
For example, if someone has puffy bags under the eyes.
Well, that’s one part of what makes their eyes not look so good.
And at the same time, we look at skin quality and the volume effect of that skin quality
in that area.
So, when we think of volume there is an option now of doing some type of filler like Restylane
or Hyaluronic Acid filler along the tear trough area and along the rim to try to add some
thickness to the tissue underneath the skin to give a less of a hollow and in many ways
it can improve the dark circles.
Now doing this requires proper patient selection as well as finesse in the technique.
As a Cosmetic Oculofacial Plastic Surgeon specialist of 20 years of experience, I do
see almost every week people who come, who actually got this treatment done elsewhere
who we need to actually dissolve it because they got too much or it became irregular but
that is one option.
Another option that we’ve had a lot of success with even for hereditary dark circles is the
use of platelet rich plasma.
Platelet rich plasma is derived from your own blood and what we do is we do a blood
draw like we typically would do for a lab test and what we do is we centrifuge it or
spin it and we get the growth factors and the platelets concentrated and that’s why
we call it platelet rich plasma.
Even in hereditary dark circles and even in some younger people we find that improving
collagen, skin quality as well as the blood supply will actually be a benefit.
So that even if it’s genetic, we have had very nice results with platelet rich plasma.
Now, of course, we draw the line when it’s someone that is too young the skin quality
is really fine and we’re not going to make much of a difference, we’re not going to
treat that patient.
But a lot of times, it’s a multifactorial issue where it’s not only genetic but there
are also maybe some other lifestyle-related and environmental triggers.
For example, we have patients who do a lot of water sports and they’re out in the sun.
They’re young but they get a lot of ultraviolet light exposure which results in breaking down
the collagen.
The skin becomes very dry, very crepey and so they do benefit in platelet rich plasma.
So I think that on top of that a good moisturizer even though I do mention with a bit of humor
with all the topical moisturizers used for under eye circles there is still a role for
proper hydration of the skin.
Eyelid skin is only half a millimeter in thickness and so for a lot of patients who come in they
have dark circles, they wear a lot of makeup and then they’ll use a lot of makeup removal
solution in order to get rid of the makeup.
So what happens well they’re placing thick makeup to cover the dark circles and then
they’re traumatizing their skin and they’re drying it out.
A lot of these astringents really have alcohol and they can be, you know somewhat drying
and irritating.
So we can’t understate that moisturization does play an important role.
And then so, thinking of it in different levels; thinking at the foundation as volume then
at the skin level and in terms of quality and then on the top level of the dead skin
layer with moisturization.
Combination effect can have benefit and some people would even use retinoids but we do
it very carefully because a lot of people can be sensitive to the retinoids.
So to review from the foundational point of view we approach this with fillers like Restylane.
From the skin quality point of view, we use platelet rich plasma and then from the topical
perspective, we use topical moisturizer.
In our own practice, we actually have a particular moisturizer we call Eye Rescue, that’s a
combination of a moisturizer and some active ingredients that I wanted to see, that I found
would be helpful and definitely gave us a lot of good feedback from our patients.
So, think of it in different levels and get some opinions from experienced cosmetic surgeons
and physicians who do a lot of aesthetics to look at your options and just learn more
about the things I described.
Again, hyaluronic acid filler for foundation, platelet rich plasma for skin quality and
then topical moisturizer whatever works best for you.
So I wish you the best of luck.
I hope that was helpful and thank you for your question.