Dark Circles around the Eyes
Dark circles (medically known as Periorbital Hyper pigmentation) are a common cosmetic concern in men and women of all age groups. Discoloration around the eyes is universally considered unaesthetic as it makes a person appear tired and unwell, instantly ageing them beyond their years. However dark circles are not always a sign of inadequate sleep or poor health.
Hereditary, medical, dietary, anatomical and lifestyle related factors may singularly or together contribute to the appearance of dark circles. A detailed assessment and multi-pronged plan of action can treat such periorbital hyper pigmentation.
Causes of Periorbital Hyper pigmentation include:
- Fatigue, stress or inadequate sleep
- Anemia due to dietary deficiency or medical reasons
- Shadows cast by hollows under eyes, which worsen with advancing age. These are due to loss of the fat pads and thinning of skin. Thus translucency makes underlying structures more visible though the skin is not pigmented.
- Shadows cast by puffy eyelids, due to age or underlying medical conditions. These give the false impression of dark circles under the eyes
- Hereditary dark circles, which are seen in several members of a family
- Smoking and excessive consumption of alcohol, which lead to poor nutrition and sluggish circulation in vessels under the eyes
- Predisposition to hyper pigmentation as seen in Asian and African people
- Sun exposure leading to excessive melanin production and hyper pigmentation
- Ageing leads to loss of fat pads and thinning of skin under the eyes. Due to this the bluish vessels appear more prominent, giving the impression of dark circles under the eyes.
- Allergies, eczema or persistent rhinitis leading to constant rubbing of eyes. This friction further causes irritation, damage and darkening of skin.
Management of Dark Circles:
- The use of concealers and make up can hide dark circles to some extent. Concealers and foundation must be selected appropriately to match the skin tone and not appear white. Make up should be removed gently and diligently every night before going to bed.
- The use of sunscreen under the eyes should not be omitted. Daily use of sunscreen prevents skin darkening, photo damage and signs of ageing.
- Darkness of skin may be treated with combinations of skin lightening creams, chemical peels and laser resurfacing treatments. Crow’s feet around the eyes can be treated with Botox injections, Fraxel laser and collagen remodeling with radiofrequency treatments.
- Puffiness and eye bags can be reduced with radio-frequency treatments which boost collagen. These include the exclusive US FDA approved treatments: Thermage CPT and Exilis, performed only by licensed doctors.
- The dark areas due to loss of volume called tear trough can be treated with hyaluronic acid fillers.
- Gentle chemical peels containing lactic acid or arginine done in clinic, are best suited to the sensitive under eye skin. Lightening creams containing kojic acid can be used two to three times a day as prescribed by the dermatologist.
- Topical preparations containing vitamin K and vitamin C further help improve dark circles. Long chain peptides and tretinoin also improve pigmentation, fine lines and signs of ageing.
- Hollows under the eyes and in the tear troughs are treatable with injectable fillers that are hyaluronic acid preparations. (Such as US FDA approved Juvederm fillers) which fill the hollows and reduce shadowing.
- Treatment of any underlying conditions is essential. Anemic patients would require iron supplementation. Allergies and rhinitis are treated to reduce irritation and frequent rubbing.
- Lifestyle changes including 6-7 hours of sleep, intake of a balanced diet and adequate hydration. If required, spectacles or contact lenses must be used as prescribed by an ophthalmologist.
- Gently pressing chilled teaspoons or cold used teabags over closed eyes can soothe the skin and temporarily reduce dark circles by improving the circulation of blood vessels under the eyes.
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