4 Causes of under eye dark circles and treatment options

In order to get a result with your dark circle concern, the right diagnosis must be made of what is actually causing them. Not all dark circles can just be treated with one treatment modality

In a study on what causes, and treatment for infraorbital dark circles, the authors concluded 4 things, which may be one, more, or all of the below:

1. Hyperpigmentation. Excessive pigment under the eyes, especially pigment under bulging oribital fat pads, cause a shadowing effect, giving the appearance of dark circles. I get so many Fitzpatrick skin type IV, V and VI patients present to me concerned with darkness under their eyes, but 9/10 the cause is pigmentation and injectables cannot help with this. Depending on the skin type, the authors suggest depigmenting agents, peels and lasers.

2. Thin, translucent skin can cause the vascular structures to be visible under the eyes from the subcutaneous vascular plexus, or vascular structures within the obicularis oculi muscle. The authors stated that injection of fat under the skin and above the muscle could act as a shield to prevent visible vascular structures within the muscle.

3. Skin laxity causing shadowing. Over time, we lose collagen and elastin during the aging process and UV damage causes collagenases, further contributing to aging. The authors suggested ablative and non-ablative lasers (CO2) to help address skin laxity.

4. Orbital fat loss causing a tear trough. Due to the aging process, subcutaneous fat loss, thinning of the skin over the ligament creates hollowness under the eyes. Pseudohernination of the fat pad under the eye accentuate dark circles.

DOI: 10.1111/j.1524-4725.2009.01213.x