The term “dark circles” is a term that refers to problems that have a vast range of genetic, environmental, medical and skin causes.
The management of dark circles begins by finding the cause or precipitating factor, then, we choose the best treatment or procedure based on the cause.The problem of “dark circles under eye” can be divided into the following heads to understand the management better -
1. Infraorbital fat pad protrusion (“bags under my eyes”)
The fat may be removed by performing a lower lid Blepharoplasty. Blepharoplasty is the best solution for fat pad prominence. If there is also significant tear trough deformity, fillers may be placed in the tear trough to help “camouflage” the appearance of the fat pad protrusion but it does not rid the patient of the fat pads.
2. Infraorbital edema (“puffiness”)
The Infraorbital skin is very thin and highly sensitive to fluid compartmentalization. Seasonal allergies, sinus infections, crying, or water retention from high blood pressure or consumption of high sodium foods are some of the reasons the loose & thin epidermis becomes edematous. To avoid this:
- Treat seasonal allergies or possible sinus infections.
- Switch your sleep position. Sleep position can be contributing to under-eye bags through gravity
- Avoid rubbing eyes frequently
- Anything that irritates the eyes can cause fluids to pool. Sleeping in eye makeup can irritate eyes, causing under eye edema.
- Eye bags might be a sign of an underlying medical condition. Thyroid, cardiovascular, or kidney problems can cause under-eye fluid.
- Place an ice pack, or slices of cucumbers, on eyes this can constrict leaky blood vessels and lessen the Periorbital Edema.
- A few topical eye creams have been developed, such as Neotensil, that temporarily reduce the appearance of lower eyelid puffiness.
3. Periorbital hyperpigmentation (“dark circles”)
Pigmentation of the periorbital skin is very common in skin of color because of the increased melanin content. Genetics, rubbing, and inflammatory skin diseases such as eczema may play a role in exacerbating the pigmentation of the thin under-eye skin. Recommendations for patients:
- To avoid rubbing the area – chronic rubbing can lead to dark, thickened under-eye skin.
- Retinoic acid creams can help slough the dark pigmented skin.
- Skin lightening creams with azaleic acid, kojic acid, and glycolic acid, can be used. Hydroquinone creams have demonstrated success in lightening under-eye Hyperpigmentation.
- Chemical peels: Light chemical peels such as glycolic acid and Jessner’s peels will assist in lightening dark under-eye pigmentation.
- Intense pulsed light (IPL) can help minimize under eye pigmentation, particularly UV-induced pigmentation.
4. Infraorbital tear trough depression
Most of the times, the dark circles aren’t about changes in the color of the skin. Instead, they’re created by a loss of volume in the area around the eye. This exposes the underlying blue veins and orbital bone, creating a hollow trough that shows up as a dark circle. These changes are often caused by genetics; however, significant weight loss and aging with resorption or displacement of the Infraorbital fat pads can also expose under-eye tear trough depressions.
5. Periorbital vascular prominence
With age, the skin around the eye becomes thinner, and thereby exposing the small capillaries and venules just below the thin epidermal layer. Vascular prominence can leave a bluish undertone to the Infraorbital skin which can cast dark shadows and make the area appear dark or sallow.
- Eye creams that contain caffeine can constrict the underlying blood vessels and temporarily diminish small vessel prominence.
- For large blue veins, vascular lasers such as a long pulse Nd:YAG lasers can be recommended. But in darker skin types these lasers can cause Hyperpigmented scars if not used with adequate skin cooling techniques. Proper eye protection should also be used.
6. Periorbital static and dynamic rhytids(wrinkles)
- Botulinum toxin placed in small amount around the orbital rim will reduce the dynamic rhytids in this area. Treatments spaced 3 months apart will ensure long-lasting benefits as botulinum toxin often wears off.
- Laser resurfacing with CO2,or fractionated CO2, may also be used to treat periorbital rhytides.
- For most of the types of infraorbital issues, makeup can help conceal some skin imperfections. Patients should choose a concealer that matches or is slightly lighter than their skin tone.
- Recommend that patients avoid smoking, which dehydrates the skin and causes premature aging and collagen degradation.
- Apply a sunscreen around the eye area. Hyperpigmentation and tear troughs can accentuate with UV-induced skin pigmentation.
- Apply a moisturizer to the eye area nightly to keep the skin from becoming dry, irritated, and dehydrated.
Our experts at Cosmo Derm Clinic Faridabad, Delhi NCR can help you find the most appropriate treatment for the best results.