Dark Circles Treatment

There are many conditions that contribute to the colloquial name of dark circles. These include-

Anatomy:  This overlaps with genetics, as a deep tear trough can give rise to dark circles. Age related volume loss makes it worse. 

Vascular: Thin skin can result in prominent blood vessels. Treatments are aimed at modulating blood flow. 

Genetic: Dark circles are almost universally seen in darker skin types. Pigmentation demarcation lines overlaps with constitutional pigmentation.

Post inflammatory: Allergies and rashes can increase pigment.

The ideal treatment depends on the cause, these include-

• Hydrating treatments: are useful for volume loss and tear trough treatments
• Lasers: are great if there is associated skin laxity
• Tixel: is good for mild laxity
• Surgery: is indicated for severe laxity
• Anti-Inflammatory medications: are best for atopic dermatitis, irritant or contact causes
• Eye creams: can marginally help some cases caused by pigment or vessels

Lasers can work via two mechanisms. 

1. Tightening skin through remodelling of collagen. This is achieved with fractional ablative lasers like CO2 & erbium. One to two sessions are required.
2. Decreasing pigmentation of the lower and upper eyelid. Pico lasers do a good job. 2-4 sessions are recommended for best outcomes. 

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Book a free* nurse assessment with our nurses at Cutis. They can examine your dark circles & provide you with a safe, effective & tailored treatment plan. *Fee redeemable on treatment only. T&C apply.

In some cases, yes. We employ deeper peeling agents for this task. The three main peels are-

1. TCA 
2. Jessner (Salicylic, lactic acid, resorcinol) TCA
3. Phenol peels

Recovery following deep peels ranges from 6 to 16 days. 

Surgery is indicated if there is significant laxity of the eyelids, or if there is significant fat prolapse. Partial removal of the eye bags can give a good result. 

Devices such as Thermage, RF Pelleve, Tempsure & others can help improve laxity. These devices work better in darker skin types as collagen contraction is brisker. 

Heating skin can tighten & contract collagen, thereby reducing shadows around the eyes. 2-4 sessions depending on age, ethnicity, & clinical presentation.

*Please note we do not offer these RF treatments in our clinic.

No. Microneedling is not a good solution for eyelid skin. Trauma & blood can lead to post inflammatory hyperpigmentation, often worsening pigmentation. Better, safer & cheaper options include Tixel. 

*Note: We do microneedle daily, but not around the eye area. Microneedling is best for delivering skin actives into the deep layers. 

Tixel is a form of skin resurfacing using controlled heating. Tixel can improve dark circles associated with skin laxity. Tixel can treat the upper and lower eyelids, with downtime ranging from 1-4+ days.  It is best suited for mild to moderate laxity. 

Creams can treat vascular & pigmentation causes of dark circles. The results are marginal at best. Look for the following ingredients. 

• Hyaluronic acid; acts as a moisturiser & humectant. Good for dry-sensitive skin
  
• Retinol; can increase collagen & may marginally improve some cases of vascular-thin skin.
  
• Alpha hydroxy acids, such as glycolic, lactic, and citric acids; can speed up exfoliation of dead skin cells.
  
• Botanicals such as green tea, bearberry, liquorice are antioxidants as well as pigment inhibitors.

• Caffeine, vitamin K are well-known modulators of blood flow. It can help some cases of dark circles due to vascular causes.
  
• Peptides; these are frequently added to more expensive creams. In theory may increase collagen production, in practice, questionable
  
• Argan oil; acts as an agent to reduce pigmentation, tyrosinase inhibitor
  
• Niacinamide or vitamin B3; acts as an anti-inflammatory agent. One of the safer skin care actives on the market
• Tocopherol is an antioxidant; generally banal as an eye cream

Dark circles can be secondary to inflammation, a term known as PIH or post inflammatory hyperpigmentation. This can be due to –

• Atopic eczema, allergic conjunctivitis
• Allergic contact dermatitis
• Irritant contact dermatitis 

Medical patch testing may be indicated in some cases to exclude allergies. If you have symptoms such as itch or irritation and eyelid concerns, your first port of call is a medical dermatologist.