With the rest of the Beauty Brains taking a break to work on their book, I thought this would be a good time for guest blogger Dr. Brett Kotlus to teach us about dark circles. Take it away Dr. Brett:
During consultations in my cosmetic surgery practice, patients commonly ask about dark circles under their eyes. Some have been asked by friends if they have a black eye, and others hear comments about how they look tired. I hear many stories about people who have tried all sorts of store-bought treatments and home remedies. The problem with each of these individual “fixes” is that there is a long list of reasons why the dark circles appear, each requiring different approaches for improvement. There is no single “magic bullet” for all under-eye circles, and I am wary of any product that claims to universally remove them.
What causes the dark circles?
Thin skin: Interestingly, the eyelid skin is the thinnest in the body, sometimes only several cells thick! In those with extremely thin skin, the underlying muscle (orbicularis oculi) and/or blood vessels may become visible. This muscle is composed of reddish, circular fibers that be seen through the skin as a blue to purple area. This skin may become thinner with age, dehydration, and with long-term use of topical retinoids to name a few causes. Remedies in this situation include the use of concealers, maintaining body and skin hydration by drinking plenty of water and using moisturizers, and skin thickening therapies.
Dark shadows: Sometimes those dark circles are illusions caused by shadowing. In people with extra skin, bulging fat, excess fluid retention, or under-eye hollowing, lighting from above will cast shadows under the eyes. The way to fix this is by correcting the underlying cause of fluid retention (sleeping with your head elevated can help), adding fillers or fat grafting to eliminate hollow grooves, skin tighteningsuch as resurfacing procedures, and lower blepharoplasty, to remove or reposition fat pouches.
Blood vessels: The eyelids have a rich blood supply by way of many vessels found under the skin. Prominent, dilated, or superficially located vessels, or blood pooling in networks of veins can sometimes be seen through thin skin, and this blood may be apparent as dark areas or lines. Again, concealers may disguise this problem. Surgical closure of these vessels, sclerotherapy, and laser treatment are more definitive options, but may be somewhat riskier.
Skin pigmentation: An accumulation of pigment in the eyelid skin (melanocytosis) is another cause of dark circles. This pigment can be present at birth or develop later in life. Others develop hyperpigmentation after episodes of inflammation or allergy, the so-called “post inflammatory hyperpigmentation”. It can also be related to medications such as glaucoma drops and oral estrogens. Sun exposure can also worsen patches of facial pigment, sometimes called “melasma”. The first step in treatment is identifying any offending agents and eliminating them. Other steps include topical depigmenting agents, Q-switched lasers, intense pulsed light, and fractional photothermolysis.
What should you do?
The first step in treating those annoying dark circles is identifying the problem. The best way to do this is by enlisting the help of a doctor who has special training in this area, such as an oculofacial plastic surgeon or a dermatologist. They can suggest a skin care regimen that might include hydroquinone (a skin-lightener), a moisturizer, and a sunscreen. If a surgical option such as blepharoplasty or laser treatment is appropriate, ask them about their specific training in that procedure and how many they have performed. Most importantly, be suspicious of products and infomercials that claim to eliminate all dark lines because you now know it can be a complicated problem requiring a complicated solution, like many things in life.
Brett S. Kotlus, M.D., M.S. is a cosmetic and oculofacial plastic surgeon at Allure Medical Spa in Michigan. He can be contacted at [email protected]
Loading ...
{ 6 trackbacks }
{ 12 comments… read them below or add one }
I recently started using Revision Teamine Eye Complex. It is sold by many dermatologists and plastic surgeons. A quick Google search pulls up all the specifics about the product and customers’ reviews give it high marks. Revision says its ingredients “build stronger capillaries, decreasing permeability and eliminating the pooling of blood causing dark areas under the eye” and also “helps form thicker and firmer skin, making the skin less transparent”. It’s explained in the product’s directions that while the skin around your eyes will feel smoother and firmer quickly, with fine lines minimized within a few weeks (I can vouch for that), you must use it for two to three months to see improvement of dark circles.
I’m curious: Has anyone else tried it?
Dr. Kotlus: Is this a product you are familiar with and if so, do you recommend it for your patients?
Green tea has been known to have antioxidant properties. I have suggested that patients use pre-steeped green tea bags placed on the affected area for eyelid edema and postoperative redness, and have seen some benefit. This product likely works in the same way, but again, is not a miracle, and I am skeptical about the company’s claim of 23% reduction of wrinkles in one month. The fact that a specific percentage is used is an indication that they are trying to quantify an effect in a pseudo-scientific way to garner legitimacy.
Dark circles are also caused by health and dietary issues such as adrenal fatigue, toxic overload in the liver, food allergies or too much wine due to the sulfites in the wine. To often women ignore what’s happening to their body and what they are eating, instead, they take unnecessary risks of going under the knife or spending thousands of dollars on pricey treatments when sometimes, all they have to do is find the source of the cause, treat it, and find much more long-term, better solutions for treating the problem along with avoiding any other potential disaster that can happen to the body due to ignoring an internal problem. The beauty of our face is not only in appearance, but it is also an early warning sign of something going on in the body and if we just learn how to read the signs such as dark circles rather than running for a quick fix, we can preserve our beauty and youth a lot longer as well as save thousands on medical costs in years to come.
Dark under eye circles can also develop due to hereditary factors, lack of sleep, illness, stress and some nutritional deficiencies.
Therefore, along with external treatment, it is advisable to take these aspects into consideration in order to establish the cause and bring about the necessary changes.
I am 34 years old I have dark circles under my eys. I have had them most of my life and it seems the older I am getting the darker they are getting. I do beleive my dark circles are hereditaryybecause my Father has them and his mother has them. If this is the case what do you do about hereditary?
Should I contact a dermattologist or do I suffer with it?
I also have spent more money than I would have liked on treatments, in the hopes that one would work.
I get the comments “You look tired.” “Are you feeling okay?” this is one I have no make up on or not enough make up to cover the circles.
I am 34 years old I have dark circles under my eyes. I have had them most of my life and it seems the older I am getting the darker they are getting. I do believe my dark circles are hereditary because my Father has them and his mother has them. If this is the case what do you do about hereditary?
Should I contact a dermattologist or do I suffer with it?
I also have spent more money than I would have liked on treatments, in the hopes that one would work.
I get the comments “You look tired.” “Are you feeling okay?” this is when I have no make up on or not enough make up to cover the circles. EWven when I do have make up on it does not cover the circles 100%.
i having probelm dark cirlce undereye more than 6 yrs plz tell get rid of
dark cirlce, at present using loreal but there is no effect and any laser
treatment.
Thank u
Wow! Jessica’s words are my experience exactly.Really looking forward to an experienced response.
i’ve seen a doctor who was a friend of the family and he is a plastic surgeon but specializes in hair transplantation but i think other things as well… he said that filling my eyes wouldnt do much because my problem was on the surface, as in my skin.
he gave me a prescription of hydroquinone and RetinA one to whiten and one to peel. and Elocon if it begins to irritate. im very desperate because they are just out of hand but im worried that my skin will be all blotchy and discolored and ill be worst off. is this subscription about right? and is there anything i can do to make sure it comes out even. im also using 100 spf and wear big sunglasses.
Thank You
try hylexin
I used to order LifeCell (Yes, it was sooo expensive!!) but it expired quickly – and the effects were OK, but I expected more.
I saw a difference in about 15 minutes when I tried Made From Earths Vitamin Face Firming Serum. Its a 2 ounce bottle with a pump, and less expensive than LifeCell and works so good!
About the best that I have tried..
Happy to have found it. I would recommend it. My puffiness is moderate but extreme around allergy time. When my puffiness is moderate it totally gets rid of the bags.. ..this is my experience…
While sclerotherapy is occasionally used to remove facial veins, the procedure carries the uncommon but serious possibility of the injected solution travelling into the network of veins inside the skull or the ophthalmic artery, resulting in loss of vision. Facial vein laser removal performed by a specialist; on the other hand, is a safe procedure for the removal of facial veins and under eye dark circles caused by blood vessels.