Many patients come to the office and ask for treatment for their dark circles underneath their eyes. The treatment for these dark circles must be individualized for each patient as they are due to a variety of causes.
Very commonly, the circles are due to fat. There is a significant amount of fat in our orbits (eye sockets) that surrounds our eyes and other vital structures in our orbits. Over time, this fat can come forward and cause a bulge in the lower eyelids. This bulge, which often looks like swelling, can cast a shadow directly below it, causing a ring or circle around the lower eyelids. Excess protruding fat can be treated with eyelid surgery.
Conversely, another common cause is volume loss underneath the eyes. This can lead to hollowing which appears as a depression around the lower eyelids. Treatment for this type of dark circle typically involves dermal filler injections.
Skin pigmentation and the thinness of the eyelid skin are two other causes of dark circles. Because the eyelid skin is the thinnest skin in our bodies, the underlying muscle layer can be somewhat visible through the skin, causing the eyelids to appear darker in color. Topical medications are often helpful for skin pigmentation whereas cover-up is typically the best method for decreasing the appearance of darkness due to thin eyelid skin. Finally, allergies can occasionally also cause darkening below the eyes. Appropriate systemic treatment of allergies can be helpful.
Due of the variety of causes of lower eyelid dark circles, it is important to be evaluated by a surgeon with significant experience in eyelid procedures in order to determine the best, customized treatment plan to help rejuvenate your eyelids.
Dr. Henry Lee has completed an ASOPRS fellowship and specializes in eyelid procedures.