Patients will often tell me, “I’m so sick of people telling me I look tired all the time. Yes, I did get enough sleep last night!” The eyes have long been considered the window to the soul. As such, its pretty easy to see why the area of the face immediately surrounding the eyes is so important in terms of non-verbal communication. Think for a minute about how this delicate area of the face can so easily convey such things to others as mood, general health and welfare, stress levels, youthfulness, energy levels and fatigue, vitality, confidence, happiness, and so many other varied emotions. Having your eyes showing a fatigued appearance can have significant impact on your life, your work, your self-confidence, and your relationships. Why do dark circle form under the eyes? There are a number of different reasons that this can occur, and it varies greatly on an individual basis:
Hormones: Changes in hormone levels that occur normally with such things as pregnancy, menopause, childbirth, breast feeding, birth control, or even normal fluctuations within a woman’s typical monthly cycle can cause changes in the skin related to pigmentation. Sometimes things get darker. Sometimes things get lighter. Sometimes new pigmented spots can form in areas where none existed previously, and the area around the eyes is certainly not immune to this phenomenon.
Allergies: It is not uncommon for someone who has particularly difficult allergy symptoms to develop dark circles under the eyes. Commonly known as “allergic shiners,” these dark areas are frequently caused by sinus congestion which can slightly affect blood flow by causing pooling of blood in small veins in the area underneath the eyes. Histamine release also leads to dilated blood vessels and swelling. In addition, it doesn’t help that people with bad allergies typically rub the eyes a whole lot. These areas can appear purplish and tend not to signify a serious problem (other than the obvious cosmetic one).
Genetics: If you inherit thinner skin under the eyes, smaller blood vessels can tend to show through the skin easier, giving this area a purplish hue.
Vitamin/Mineral deficiencies: For example, iron deficiency anemia can make the skin look paler, which would allow darker tissue and blood vessels underneath to show more.
Medical Conditions (i.e. liver or kidney problems)
Fatigue/Lack of Sleep: Again, this typically results from dilation of blood vessels in the skin underneath the eyes and subsequent swelling.
Aging: Loss of volume in the face that normally occurs as a part of the aging process causes changes in the contour of certain parts of the face and a hollowing effect in others. This volume change can create a significant shadowing effect, which can give the appearance of dark circles underneath the eyes. This effect can be made worse by factors such as sun exposure and smoking, both of which cause loss of collagen and can thin skin even more in this area of the face.
Now what do I do about these dark circles?
Cover up makeup: This seems like a simple solution, but don’t underestimate the concealing power of a good makeup application!
Cool compresses: Will serve to constrict blood vessels and decrease swelling under the eyes.
Extra pillows (to prop your head up a little) or Extra sleep: When you sleep flat, all the fluid that would normally drain down in your body tends to pool in the face. Just a little bit of elevation will help gravity work its magic and continue to allow this process to work while you rest.
Diet: Reduced salt intake, adequate fluids, fruits and veggies
Skin care products: Medical grade skin care products are best, especially because they contain concentrated amounts of quality, anti-aging ingredients and do not have the additives of many over-the-counter creams and other beauty products that can cause adverse skin reactions. A variety of scientifically-proven products and eye creams are available, which contain such active ingredients as antioxidants, peptide and growth factor complexes, botanical lightening agents, and Retinoids. Through a variety of mechanisms, these products serve to tighten the skin, to constrict blood vessels and decrease puffiness, to promote synthesis of collagen and elastin, to improve skin texture and tone, and to cause the skin to appear more youthful and smooth.
Facial Fillers: Facial fillers such as Restylane and Juvederm are used to add volume to specific areas of the face, restoring some of the youthful contour and roundness to areas that typically show more of the effects of the aging process. This serves to lessen the appearance of dark circles and in many cases can make them go away completely. The results with facial fillers used appropriately for this purpose can be incredible and can take years off your facial appearance! Just make sure that you have a well-trained physician doing these injections who is specifically familiar with the anatomy of tissues around the eyes. The skin in this area of the face is characteristically thinner, and there is not much room for error here.
Surgery: Lower eyelid surgery (aka Blepharoplasty) is done to smooth out “bags” under the eyes that can lead to the appearance of neighboring dark circles due to shadowing. Blepharoplasty surgery can also improve the appearance of excess skin lines and wrinkles and is the best option for patients with more advanced changes from aging. Lower Eyelid Blepharoplasty surgery is typically done as an outpatient surgery and can be combined very easily with other procedures such as upper eyelid lifts, brow lifts, and mid-face lifts.
Other treatments: Some of the success of these treatments depends on the specific cause of an individual person’s dark circles. These treatments include such things as allergy medications, sunscreen and other forms of sun protection, cutting down on smoking and alcoholic beverages, and other similar lifestyle modifications.