Young man pulling down eyelid checking his eye looking in mirrow feels unwell has black circles

The progression of dark circles beneath the eyes makes you look tired. Some folks develop dark circles with aging, while others have had them from when they were young. Dark circles occur as often in Caucasians as they do in more darkly pigmented folks. Dark circles, contrary to popular notion, isn’t because of being tired, stressed, or worn out. (regardless of how you feel!)

Reasons

Dark circles develop as a result of discoloration of the thin eyelid skin from pigments which have leaked out from the blood cells. The blood cell pigment, also called hemoglobin, oxidizes as it gets near the skin’s surface as a result of light exposure and turns a bluish red shade. (the hemoglobin turns to hemosiderin, an iron-based pigment) This discoloration then resembles a bruise and is easily seen because the lower eyelid skin is quite thin and almost transparent. Once the dark circles appear from the pigment deposits, they may probably be permanent.

What can one do to dark circles?

First of all, eyelid surgery won’t remove dark circles. Lower blepharoplasty, which eliminates excessive lower eyelid skin and fat, doesn’t directly target the pigment-staining issue. In the short term, it might actually make it look worse because of the bruising from surgery and has the capability to put more blood products close to the skin to be broken down. Sometimes, there’s some improvement in the look of the dark circles because the lower eyelid is tightened and there’s less of an undereye hollow for shadowing to look in. But one should not experience lower blepharoplasty if your primary objective is to eliminate the dark circles. Any improvement in the darkened circles should be regarded as a bonus but not the major objective of the operation.

Secondly, peeling, burning, or exfoliation of the lower eyelid skin does not typically work well either. Whether it’s accomplished by means of a chemical peel or laser treatment, the removal of the outer layer of the lower eyelid skin doesn’t reach the region where the pigment residue lies. Resurfacing eliminates the outer epithelium of the skin but doesn’t, or if not, reach the dermis or the bottom of the skin. (if it does, the lower eyelid will scar) While I do not think there’s a lot of damage to some lower eyelid peel, with a 25 percent or 35% TCA solution, it’s not particularly helpful in most cases. And runs the possibility of an additive problem called hyperpigmentation which can give rise to the shadow of the lower eyelid skin.

Potential leaching of the skin through hydroquinone topical preparations seems like a reasonably secure strategy, although how it works does not necessarily specifically target the pigment dilemma. Hydroquinone works by curbing the melanin or colour production of the skin so it’s easy to understand how this might be effective for hyperpigmentation or age-related (sun exposure) brown spots. But this bleaching chemical isn’t known to break down and clear hemosiderin pigments stains. So bleaching the skin seems like it’d work, but the chemistry would indicate otherwise.

Lastly, many topical skin creams assert dark circle enhancement and a few are labeled as dark circle repair serums. These contain agents like arnica, haloxyl, and other enzymes which supposedly break down the pigments and assist the dark circles fade. While theoretically appealing, there’s hardly any good clinical or research information that would support these claims. Even if successful, it could be a slow process where it would takes weeks to start to see improvement. (which is OK if advancement actually happens )

Strategy Factor

My frustration with dark circles has led me to try another strategy. I am using light therapy (intense pulsed light( especially broad band light) with vascular filters in conjunction with topical dark circles serums. It strikes me that something is necessary to initiate the pigment break-up and light therapy can specifically target that without damaging the overlying skin. And with no recovery for the individual. I am doing a set of 3 light treatments spaced one month apart with nightly applications of this topical serum. It’s too early to tell if this really is a magic approach but some patients are already undergoing improvement from the first month.