Dark circles under the eyes can make a person look old and tired. They usually occur due to sleep deprivation but some people have dark circles that are more pronounced for various reasons. Aging results in thinning of tissues which causes the area between the eyes and cheek bone to hollow out attracting shadows. Bagging of tissue may develop in the lower eyelid due to fat infiltration. The area bordering the eye bag often appears dark. Other reasons for dark circles include genetic dark pigmentation of the skin and thinness of skin through which the veins are seen.
Mild cases can be concealed with makeup or treated using topical creams. Prominent dark circles may be treated by a procedure called blepharoplasty which involves making an incision in the eyelid to remove or reposition tissue such that the dark circles or bags are eliminated. Surgery however carries risks and is not reversible.
Non-surgical treatment for dark circles includes the use of an injectable filler such as Restylane or Juvaderm which contain hyaluronic acid. To ensure comfort, a topical anesthetic is applied prior to the procedure. The injection itself contains a local anesthetic. The filler is carefully injected to raise and level the hollowed area so that the shadows are eliminated. The filler also stimulates collagen production which helps regenerate skin improving tone and texture. The effects of treatment are long lasting (>18 months). The filler can be dissolved by injecting an enzyme enabling your doctor to make minor adjustments or reverse the procedure if necessary.
Following treatment, tenderness, bruising or swelling may occur which usually resolves in a few days or weeks.