Bright eyes are said to reflect vitality, intelligence and warmth. One of the first things we look at when we meet a person is their eyes. Is she fatigued or energetic, interested or distant, charming or cold? If you slept late, you might develop tired-looking dark eye circles. Though possible to hide with make-up, they can be all too apparent the next day, just when you need to impress a client or to look your refreshed best at that class reunion. Certainly, dark eye circles are a frequent subject of patient consultations at my clinical practice.

Which type of dark circles could you have and how can you treat them?

There are 3 types of dark circles. They do not normally occur alone. Their prevalence is listed as follows:

We will examine each one, their causes and what recommendations there are for treating them.

1. Pigmented Dark Circles and How to Treat Them

This is common in my clinical practice in Asia, where we have people of non-white ethnic origins of darker skin types. Discolouration below and around both eyes are due to melanin which give the brown or black colour that are commonly seen in people of Asian origin.

Causes

• Genetics

• Frequent sun exposure

• Rubbing or scratching the eyes due to allergies.

How to Treat Pigmented Dark Circles Doctor’s Suggestions Treating these takes effort and cost but are worth the while:

• Sun-protection: minimise sun exposure; avoid tanning, use sunglasses. Use oral and/or topical sunscreen.

• Treat sensitivity/itchy eyes: get treatment for allergies/sensitivities to avoid rubbing your eyes, such as antihistamine eyedrops. Take care when using skincare not to irritate your eyelids which are usually more sensitive than the surrounding skin.

• Chemical peels to reduce surface pigmentation

• Laser, Intense-Pulsed Light (IPL) or Broadband Light (BBL) treatments.

• Cosmetic camouflage

2. Vascular Dark Circles and How to Treat Them

Oxygen-depleted blood, poor blood circulation and fluid buildup can contribute to puffiness. If the blood leaks into the skin, it can lead to discolouration. In addition, with age, the body produces less collagen, which makes the under-eye skin thinner, rendering dark blood vessels more visible. Some people have superficially located blood vessels. Dehydration can be a cause as well. Understanding the causes of vascular dark circles helps make clear what is necessary to treat them.

How to Treat Vascular Dark Circles

Doctor’s Suggestions:

• Adequate sleep and water intake

• Smoking cessation

• Cold compresses to minimise the appearance of prominent blood vessels

• Less alcohol

• Consult an aesthetic doctor for topical lotions/creams containing ingredients that stimulate exfoliation and lighten pigmentation such as glycolic acid and hydroquinone respectively.

• Get an eye product with ingredients that stimulate blood circulation around the eyes.

• Aesthetic medical procedures such as hyaluronic fillers thicken the skin and camouflage the blood vessels below.

3. Structural Dark Circles and How to Treat Them

Structural conditions can lead to shadowing, giving the appearance of dark circles. Such changes come with ageing, because our skin thins, and facial structure changes. The bones around the eyes widen, creating a sunken look. The fat pad around the eyes now protrudes, accentuating the hollowness below it creating a tear trough which in turn causes shadows. This is why persons who have never had dark eye circles before complain about it in their later years. Puffy eyelids also cause a shadowing.

Other Causes

• Genetic factors

• Bulging fat and muscle loss

• Puffy eyelids (periorbinal oedema) due to conditions such as dermatitis, allergy or thyroid disease

• Smoking

• Lack of sleep

• Dehydration (sunken eyes).

How to Treat Structural Dark Circles

Doctor’s Suggestions:

• Sleep with an extra pillow for head elevation to reduce eyelid swelling

• Massage temporary swelling while applying a cold compress

• Treat health conditions. Get checked for thyroid disease, dermatitis and allergies.

• Loss of tissue (hollowing) and tear trough can be managed by aesthetic medical and surgical procedures:

• Fillers (dermal implants) eg hyaluronic acid injections or fat grafts

• Surgery to remove excess fat, muscle and skin (surgical blepharoplasty or laser eye-lifting procedure).

• Use a quality product that has ingredients which promote collagen stimulation and reduce the appearance of dark circles like this.

Conclusion Mixed Causes of Dark Circles

Since 78% of dark circles are due to mixed causes, a combination of the above 3 types, the best advice to treat dark circles is

• Sensible lifestyle: sun-protection, adequate daily water-intake, sufficient sleep, smoking cessation and reduced alcohol.

In Asia, the best sun-protection is often sun-avoidance, if you are serious about reducing your dark circles. Although sun-avoidance sounds extreme and people may wonder if there might be an issue with vitamin D deficiency, rest assured it is virtually impossible to totally avoid sun exposure here, unless perhaps you work and live in an underground-mine! Even on an overcast sky, we get dark after a day at the beach. I always tell my patients to take sun-protection seriously.

• Prioritise health: get help for illness, allergies and dermatitis

• Consult an aesthetic doctor if you want to treat your dark circles: get topical creams/lotions which include ingredients to help you manage or reduce the dark circles, or consider in-clinic treatments such as lasers and dermal fillers.