What are the treatments for dark circles under the eyes?

Treatment for Dark Circles Under Eyes

The most effective treatment for dark circles under the eyes depends on the underlying cause, with options including topical agents containing vitamin C, caffeine and peptides, platelet-rich plasma therapy, fillers for tear troughs, and laser treatments for hyperpigmentation or vascular issues. 1, 2

Understanding the Causes of Dark Circles

Dark circles under the eyes result from multiple factors that should be identified before treatment:

• Vascular causes: Visible blood vessels due to thin periorbital skin
• Pigmentary causes: Melanin deposition or post-inflammatory hyperpigmentation
• Structural causes: Tear trough deformities, loss of fat, or skin laxity
• Shadow effects: Created by structural changes in the periorbital area
• Other factors: Allergies, contact dermatitis, edema, or systemic conditions 3, 4

Treatment Algorithm Based on Underlying Cause

1. Vascular Dark Circles

• First-line: Topical products with caffeine, vitamin K, and chrysin 1
• Advanced options: Long-pulsed Nd:YAG laser for visible vessels 2

2. Pigmentary Dark Circles

• First-line: Topical products with vitamin C (THD ascorbate), niacinamide, and botanical extracts 1
• Advanced options:
  • Q-switched Nd:YAG laser for melanin-related pigmentation 2
  • Chemical peels (with caution in darker skin types)
  • Topical agents containing hydroquinone, kojic acid, or arbutin

3. Structural Dark Circles (Tear Troughs)

• First-line: Hyaluronic acid fillers to correct volume loss 2
• Advanced options: Combination of fillers with lasers for comprehensive correction

4. Shadow-Effect Dark Circles

• First-line: CO2 laser for skin tightening in cases of skin laxity 2
• Advanced options: Radiofrequency treatments or microneedling

Emerging Treatments with Promising Results

• Platelet-rich plasma (PRP): Shows moderate effectiveness for periorbital hyperpigmentation, with 47.6% of patients showing good improvement 5
• Platelet-rich fibrin (PRF): Demonstrates promising results for periorbital rejuvenation with improvements in skin thickness 5
• Ozone therapy: Emerging as a potential alternative treatment with reasonable clinical improvement in limited studies 6

Treatment Considerations and Precautions

• Skin type assessment: Treatment selection should consider Fitzpatrick skin type, as darker skin types have higher risk of post-inflammatory hyperpigmentation
• Combination approaches: Most effective results often come from combining treatments that address multiple causes simultaneously 2
• Periorbital area sensitivity: This area requires special care due to thin skin and proximity to the eye
• Potential complications:
  • Bruising or edema with injectable treatments
  • Hyperpigmentation risk with laser treatments
  • Tyndall effect (bluish discoloration) with improper filler placement

Maintenance and Prevention

• Sun protection: Essential to prevent worsening of hyperpigmentation
• Consistent skincare: Daily application of targeted topical products containing vitamin C, caffeine, peptides and botanical extracts 1
• Lifestyle modifications: Adequate sleep, proper hydration, and allergy management when applicable

The multicorrective topical eye cream approach has shown significant improvement across diverse patient populations, making it a good first-line option before more invasive procedures 1. For structural issues like tear troughs, fillers provide immediate and significant improvement, while laser treatments are more effective for pigmentation and skin texture concerns 2.