Question: What can I do for dark circles under my eyes?

Answer: Essentially, you have four choices: makeup, skin treatment, injection, or surgery.

Makeup

No matter the reason for your dark circles, concealer is always an option. Of course, if you don’t want to use make-up, that may not be your solution of choice.

Skin Treatment

Skin treatments can lighten the dark circle area under the eyes. The active ingredient in the strongest topical creams is a skin-lightener, usually a chemical called hydroquinone. It acts to tone down the pigment in the skin. It doesn’t work for everyone and it can take several weeks to see a change in the skin color tone. Skin treatments of all kinds: peels, toners, masks, serums are different from makeup. Skin treatments work by changing what is going on under the surface: in the skin cells. Makeup, as all women know, creates an illusion of change. Skin treatments, injections and surgery create change – either for a period of time or permanently.

Injection & Surgery

Both injections and surgery can produce a change that is powerful enough to change the appearance of the dark circles dramatically. Both options are invasive. While most of us think that injections, even lasers are “non-invasive” because there is less or no scar, this is deceptive. The worst that can happen with skin treatments is that the skin will react to the cream. With injections and surgery, there are real risks: blindness, infection, lumps, discoloration, asymmetry. While most of these risks are small, they are real and can cause permanent disfigurement. What can also happen is that the injection makes you look different, but not better. Injections and surgery are both “invasive” options. “No scar” does not mean “no risk.”
Injections around the eyes are particularly complicated and should only be done by a specialist (a Board-certified plastic surgeon). While there is comfort in knowing that the common fillers used for injection are FDA-cleared, they are only approved for specific indications or areas. There is no injectable that has been FDA approved for filling around the eyes. Treating dark circles with fillers is an “off-label” indication; meaning that the professional doing the injection is choosing to use the product in an area not reviewed by the FDA.

Further Questions You Should Ask:

Dark circles in young people are not the same as the dark circles and under-eye bags that appear with age. Just as common sense would tell you, things that are different should not be treated the same. Some of the questions that must be answered before any injection:

• Why do I have dark circles? (Is it extra skin, the color of my skin or my cheek bones?)
• Which option is best for me? (Will skin treatment make enough improvement?)
• Am I a candidate for injections? (Where and how much do I need?)
• Is surgery best? (Will injectables give me a result as good as surgery?)

Remember, there is usually more than one option that will address your frustration. My role as an experienced board-certified plastic surgeon is to:

1. Explain the different options, including the risks, expectations and costs in a way that is understandable and enables you to make an educated decision.
2. Recommend a plan that will give you the most predictable result.
3. Give you a change that addresses the frustration, without making you look different.

I cannot recommend the solution best for your dark circles without a face-to-face consultation and the opportunity to ask and answer these questions. Contact my office today to schedule a consultation so we can determine your best plan of action together.