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Under Eye Dark Circles

For some people, dark circles may be due to simple-to-treat problems such as iron deficiency, lack of sleep, or hyperpigmentation. However, these cause the darkness, but not the shadowing due to a sunken or hollow look. Dark circles may be enhanced due to an atrophied suborbicularis oculi muscle (the muscle of the lower eyelid) or due to loss of fat in this area.          

Here are several conditions that can contribute to a darkened or sunken look under the eye:

• Lack of sleep
• Iron or other vitamin deficiencies
• General illness
• Smoking, which can give a sallow unhealthy look to the skin under the eyes
• Hyperpigmentation
• Excessive vascularization (due to medications such as Retin A)
• Visible blood vessels due to fat loss, thin, aging skin or hereditary thinness or superficial vessels
• Fat loss in general which causes a sunken look

It is possible to have more than one of these problems and they can contribute to each other. If you have been ill and lost a lot of weight, your eyes could look shadowed and sunken, for example.

How To Get Rid Off Dark Circles?

Whether your eye circles can be treated depends on what is causing them.  Some you very well may be able to handle, some you may not be a candidate for. The first step is consulting with a qualified surgeon or dermatologist to determine the cause for your dark circles and then go over your options for a solution. (Actually, a good first step might be to have a physical exam with your general physician. This is especially true if you haven’t had a physical in a while and if the dark circles have developed recently.)

Treatment for dark circles, once underlying health problems have been ruled out, can be a bit of a laundry list. Not people and not all skin types will respond to the various techniques or treatments.  Success depends on your skin type and how well you heal. Ethnicity is also a factor. People with darker skin tend to form keloids, which are a type of overgrown scar tissue, and hypopigmentation or hyperpigmentation problems, which can eliminate some treatments.

In any event—and especially for surgical applications—you must be in good health, not have any active diseases or pre-existing medical conditions, and you must have realistic expectations of the outcome. It is quite possible your dark circles may be relieved somewhat with some of these treatments, but not entirely. It is also possible that the only thing that will help you is some corrective makeup. You need to be able to communicate your issues with your under eye circles to your physician if he or she is to understand what your desired results are.

You must be mentally and emotionally stable to undergo any cosmetic procedure or treatment. Some of these treatments require patience and stability as you go through the healing period.

Dark Circle Treatments

Let's go over the causes again and list possible treatment options.  Remember not all options will be suitable for all individuals. Only an experienced physician can help you determine the best course of treatment.  You may need to get several opinions.

• Lack of sleep or too much sleep: You can usually tell which one is your problem. Either increase or decrease your sleep time as needed. Yes, you may already be stressed out and have no time, but if you are regularly not getting enough sleep (or too much), under eye circles will be the least of your problems.
• Iron or other vitamin deficiencies:  See your general practitioner for a check-up or consider taking a good quality vitamin and mineral supplement. Individuals with anemia may notice dark shadows under their eyes, but not all anemia is due to not getting enough iron. You may need to get a check-up.
• Smoking: Quit smoking.
• Sickness: Usually, under eye circles and shadows will subside after you get well. Be sure to get plenty of rest and eat a well-balanced diet. If your illness caused you to lose some weight, gaining it back may help alleviate the circles.
• Hyperpigmentation: Dark circles under the eyes are often seen in people with darker skin.  The skin under the eyes is healthy, but is a darker shade than the rest of the face.  Topical hydroquinone is a good option as it can lighten the skin, if that is the problem. Hyperpigmentation can also be alleviated by using various laser treatments or intense pulsed light. Chemical peels may help as well.
• Excessive superficial vascularization under the eye: This can be caused by some medications such as Retin A. When this is the case, superficial vessels can be removed or zapped using various laser treatments or intense pulsed light. This must be done carefully, since you do not want to destroy all the vessels in the eye area. 
• Visible blood vessels: This can be due to fat loss or thin or older skin. The facial fat loss we experience with aging can significantly reveal the blood vessels around the eye and give the eye a darker look. Fat grafting works very well for this type of under eye circle.
• Fat loss in general: Fat loss around the eye can cause a sunken or hollow look. The facial fat loss we experience due to aging can make your eyes look sunken and shadowed and also show the highly vascular area of the eye. This can also be remedied with fat grafting or with some injectable fillers.

What to Expect at Your Consultation

If your general health checks out, you can make an appointment with a cosmetic surgeon or a dermatologist for a consultation. This is your chance to meet with these physicians and discuss your goals. You must disclose all information regarding your health, whether you smoke, what medications or vitamins you presently take, etc., all of which is very important.

You will discuss your problem and concerns and you and the doctor will discuss how much your under eye circles can be improved.  Your doctor will explain the techniques or treatments most appropriate for you.  He or she should discuss the risks associated with the specific treatment types with you, as well.

If you are having a surgical treatment, you will also discuss anesthesia. Most noninvasive procedures require either no anesthesia or light, topical anesthesia.  More invasive procedures, such as fat grafting, are performed under either light sleep sedation or regional anesthesia, but some may be performed with local anesthesia and oral sedation.  However, some procedures called for general anesthesia. Either way, you must discuss this beforehand. All anesthesia carries some risks. Check out our Anesthesia Page. You must make a fully informed choice.

If you would like more information on consultations or a list of questions to ask your surgeon, please visit our Consultation Page. 

Your Pretreatment Appointment

For surgical treatments and some minimally invasive cosmetic treatments, you may see the physician or surgeon again before your treatment. This appointment addresses more questions you may not have thought to ask at the initial consultation.

You will also discuss preoperative instructions and recovery period instructions and what to expect in the months ahead. You may be given prescriptions for antibiotics and pain relievers, if applicable.

Do not hesitate to address any concerns that you may have. If you remember something when you get home or the next day or even the day of surgery, don't be afraid to ask.

Preparing for Your Treatment

You should be given a preoperative information packet that explains everything you should do and know before your surgery date. The packet should include a list of any medications you should not take for a week or two before your surgery. These medications will include, but are not limited to, products containing aspirin or ibuprofen. We have a list of such medications here but follow your doctor’s instructions.

It is quite possible that you will need to have blood tests performed. This is done to check levels of white and red blood cell counts to check for disease or conditions such as anemia and is normally an extra out-of-pocket expense. If you are a woman, you may be asked to take a pregnancy test. Some surgeons ask that you have general physical if you have any underlying conditions such as hypertension or asthma. This will probably be another out-of-pocket expense.

How These Treatments Are Performed

For more information about hyperpigmentation and its treatments, see our Hyperpigmentation section. We also have sections on laser treatments, intense pulsed light, and fat grafting. Those sections also include information about risks and recovery. 

The Average Price of Treatment for Under Eye Circles

The average prices for treating dark under eye circles varies a great deal with the technique used, the region of the country, and surgeon. Actually, giving a range for prices for treating under eye circles is almost meaningless, since it ranges between $15 for buying new under eye concealer to $4,000 for surgery around the eyes!

Concealers and Other Cosmetics

It may end up that the best treatment, and even the only treatment, for circles under your eyes is makeup. Concealers come in liquid, stick, and pancake type creams and can be applied and reapplied throughout the day.  Some concealing products use a two-step process that calls for applying a setting powder over the product to help to keep the concealer on all day.

As with all types of cosmetics, some may work better for you than others. Some products may be very drying and other may tend to gather in fine lines and wrinkles. You may need to go through a process of trial and error finding what works best for you. Be sure to thoroughly moisturizer before using drier formulations. For cosmetic products to help you reduce dark circles visit www.newimage.com.