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Sarasota Dermatology Blog

Dark Circle Under Eyes… What To Do?

Posted on 14. Feb, 2011 by in Chemical Peel, Cosmetic Treatments, Fillers, Lasers, Skin Care

How to remove dark circles under the eyes?

How to remove dark circles under the eyes?


Dark circles under the eyes are many times very distressing for people because it makes them appear tired, sad or hung over. Usually these circles worsen with age and lack of sleep.
Possible causes include excessive pigmentation, thin lower eyelid skin overlying the eye muscle, patients with allergies, and patients with very little eyelid fat thus showing the vascular plexus (blood vessels) in the underlying muscle creating dark circles.

What are the treatments available to remove dark circles under the eyes?
Treatment options for correcting dark circles abound in the over the counter genera including topical creams, gels and ointments. However, there is little evidence to support their effectiveness. The most important point before trying to correct dark circles under the eyes is ascertaining the underlying cause. There are many treatment options available ranging from topical creams, chemical peels, lasers and fat transplantation.

Dark circles under the eyes can be removed using topical retinoic acid or Retin-A

Prescriptive medication includes topical bleaching agents, (Hydroquinone) which causes destruction of melanocytes and Topical retinoic acid or Retin-A which works by inhibiting tyrosinase transcription the process in forming melanocytes. These topicals have proven to be effective but improvements are not apparent for at least 24 weeks of continued use of the treatment.

Chemical peeling agents include trichloroacetic acid at various percentages, and alpha-hydroxy acids such as Glycolic acid. These acids work by destruction of the epidermis and dermis thereby helping to reduce pigmentation. It is important to be very cautious when using chemical peeling because if the peel used is too strong it may cause darker circles or even very light circles.

Lasers have been successful to help reduce dark eye circles. These lasers include the Q-switched alexandrite and the Nd:YAG.  Although laser treatments have shown positive results on some patients, the treatments do not always completely remove the dark circles. It is recommended to consider this modality only in the hands of a skilled dermatologist.

Restylane or Juvederm are soft-tissue fillers used to treat dark circles under the eyes

Restylane or Juvederm are soft-tissue fillers used to treat dark circles under the eyes

Fat Transplantation can be helpful for patients who have thinning and translucent lower eyelid skin. Many times very thin skin will reveal the underlying vascularity of the vascular pexus within the underlying eye muscle resulting in dark circles. One study showed an average of 78% improvement after fat transplantation.

Another option besides fat transplantation is using soft-tissue fillers hyaluronic acid gel such as Restylane® and JUVÉDERM® . These fillers yield great results improving dark eye circles and last up to a year. It is advised to choose a dermatologist who has many years’ experience with soft-tissue fillers and is an expert on advanced injection techniques especially under the eyes to avoid the filler to be placed in the incorrect area thus causing a blue discoloration.

In conclusion dark eye circles are a common problem that affects many people and can be quite cosmetically bothersome. The most important part in treating this problem is finding out and identifying the underlying problem. Only then can one approach the many different treatment modalities in a sensible and logical manner. There are many treatment options available with benefits and side effects so choose your treating physician wisely.

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2 Responses to “Dark Circle Under Eyes… What To Do?”

  1. Earl

    06. Apr, 2011

    Hello, I wonder if you’ve heard of or are personally familiar with a skin condition called dissecting cellulitis. It’s a condition of the scalp (although it is possible that it may affect other areas of the body) that causes patches or complete areas of the scalp to completely go bald because it kills the hair follicle in those areas. I hear that it is a fairly rare condition and not much is known and/or studied about it.

    My most recent dermatologist tells me that there is no cure for it. Have you ever known anyone suffering from this condition to have success with a hair transplant??? Thanks in advance for your time and I welcome all responses.

  2. Bradley J. Abrams, D.O.

    25. May, 2011

    Check out our article posted to this blog about Dissecting Cellulitis: http://sarasotadermatologyblog.com/2011/05/scalp-dissecting-cellulitis/

    Let us know if we can be of further help.

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