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Dark Circles Under Eyes

Dark circles and puffiness under the eyes are a very common complaint seen at Lazaderm. This is a complaint from the young and old, men and women and even all ethnicities. Many have been told that they look tired or they look in the mirror and see the dark circles. In most cases, this is a cosmetic concern and not a medical problem.

dark circles under eye

Causes:

  • Allergies – it is very common for allergies to cause swelling of the lower lids and also congestion of the blood vessels of the lower lids.
  • Fatigue – Lack of sleep can increase the amount of swelling and hollowing seen around the eyes.
  • Heredity – It is very common for family members to have the same concerns.
  • Sun Exposure- The skin acts a little like a girdle to the fat and vessels of the lower eyelids. Sun exposure destroys the collagen and elastin in the skin.
  • Loss of Facial Volume – as we age we lose collagen and elastin in our skin but also the fat that supports the cheek and the areas below the brim of the eye.
  • Veins- Some patients have very large facial veins that run from the lateral edges of the eye under the orbit of the eye and give the skin a bluish color.
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  • Treatment:

  • Allergy Medications – If you feel that you have puffiness in your lower eyelids, it is usually worth a two-week trial of allergy medications. I would recommend an over-the-counter oral medication such as Claritin, Zyrtec or Allegra. Another option is one of the nasal sprays such as Flonase or Nasacort.
  • Sleep – If you are burning the candle at both ends, try to get on a better sleep cycle. We recommend at least 7 hours of sleep at night.
  • Sun Protection – Wearing a broad-brimmed hat, sunblock (EltaMD) and sunglasses.
  • BBL – The BBL can help with pigmentation and small vessels of the lower lid.
  • Vascular Lasers – the Cutera 1064nm laser can treat veins of the lower lids.
  • Lasers – Fractional lasers such as the DeepFX or ActiveFX can show benefit to the lower lids but will require multiple treatments. The ablative lasers such as the Sciton Erbium and the Lumenis Ultrapulse CO2 lasers give the best results. The lasers will tighten the skin under the eyes so that the skin will act like a girdle holding the fat and tissue in.
  • Dermal Fillers – Many of the fillers can be used in this area to build up the orbital rim and also the tear trough. The only fillers that should be injected into the tear troughs are Restylane or Bellafill. The other fillers such as Juvederm Ultra Plus and Voluma are better suited for adding volume to the cheek area.
  • Surgery – Some patients have such significant puffiness and excess skin. These patients will require surgical removal of fat and some will require the removal of fat and skin.