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Causes of Dark Circles Under Your Eyes & How to Treat ItTrillium Plastic Surgery

January 2nd, 2020

Causes of Dark Circles Under Your Eyes & How to Treat It

Dark circles under the eye are a common complaint from our patients and are caused by many different things from poor sleep hygiene to allergies to good ole mom and dad’s genetics. Treatment for under eye circles can include: eye creams, chemical peels, lasers (intense pulsed light or a resurfacing laser as Profractional), injectable fillers (Restylane and Voluma), or surgery.

Many people want improvement with facial aging and would like to improve their “tired eyes” or “drooping eyes,” but it is important first to determine the cause.

Causes of Dark Eye Circles

Dark circles can be caused by aging, or lifestyle as well as the following:

  • Fat of the lower eyelid lowering down cheek
  • Volume loss or in cheeks
  • Under eye volume loss
  • Laxity of lower eyelid
  • Thinning under eye skin
  • Bulging under eye fat pad

Under eye circles can by caused by the following lifestyle choices:

  • Smoking
  • Lack of sleep
  • Alcohol
  • Caffeine
  • Dehydration (orally or topical)
  • Dietary deficiencies
  • Hyperpigmentation (dark pigment): hereditary or sun damage

Other causes of dark under eye circles include:

  • Allergies
  • Nasal congestion
  • Hyperpigmentation of skin
  • Other medical conditions (eczema, thyroid problems)
  • Venous congestion in blood vessels under the eye
  • Environmental exposure

Dark Circles or Under Eyes Treatment

Before undergoing treatment, it is important to know exactly what is the origin of the under eye circle. Treatment from our practice varies due to the condition causing the problem. In some cases, multiple factors are causing the dark circles, so a combination of treatments might be in order. Below is a list of common products/procedures we use in our office to combat dark circles (least invasive listed first):

Dark circle eye cream

Topical bleaching agents such as hydroquinone and Lytera are available for skin lightening. These products help to brighten the skin as well and treat hyperpigmentation, sun damage, and melesma. Other products include: TNS Essential Serum, TNS Recovery Complex, and TNS eye cream. Other ingredients that are known to improve pigment include: Vitamins C and K, green tea, licorice, and kojic acid.

Laser for eye circles

Reduction of under eye circles and pigment can be accomplished with the Cutera Excel V 532 laser. This laser is a more advanced version of the IPL, but with a more concentration wavelength for pigmentation. Laser is appropriate when blood vessels are visible as dark purple or blue under eye circles. With correct eye shields and it experienced provider hands, lasers are very effective and safe for treatment of under eye circles.

Skin resurfacing for under eye circles

Laser resurfacing (Profractional and Total Skin Resurfacing) can reduce dark circles by increasing college production, treatment of pigmentary problems, improvement of overall skin quality, and fine lines and wrinkles. These treatments are most effective when used with combination treatment such as skin care, Botox and sometimes fillers.

Hyaluronic acid facial fillers for dark circles

Injectable fillers containing hyaluronic acid are often used to correct dark circles created by tissue loss under the eyes and upper cheeks and thinning of under eye skin. Restylane is the most common recommended hyaluronic acid filler for restoring volume to the tear trough, but our recent experience has been with using Voluma (which has a much longer duration of +2 years) to restore cheek volume and use in the tear trough. In addition to improvement in the tear trough, improvement of lateral cheeks, crows feet, lifting of the nasiolabial folds and corners of the mouth are also seen.

Fat grafting to get rid of dark circles

Like fillers, a patient’s own fat can be harvested (liposuction or fat grafting) from another body area and injected in the tear troughs to treat dark circles. Typically recommended for correction of dark circles caused by tissue loss of cheek and under eye or thinning skin under the eye, fat injections are a more permanent treatment option for loss in the under eyes or upper cheeks. Unlike hyaluronic acid fillers, fat injection results may be permanent, however results are not guaranteed, as fat cells don’t always survive the fat transfer process.

Surgery for eye circles

Blepharoplasty, or eyelid surgery generally one of most effective way to permanently get rid of dark circles. There are multiple approaches to lower eyelid surgery, consulting with Dr. Hall to discuss if you are a candidate for surgery.

Cheek lift to correct darkening under eyes

Mid-face lift or cheek lift can effectively treat dark circles caused by drooping or descent of the cheek due to aging. A mid-face lift can also improve deep nasiolabial folds and reduce under eye puffiness.

Dark Eye Circle Prevention

There are simple things patients can do to alleviate dark circles under your eyes. Sometimes the problem is minor or temporary, in which case an inexpensive home treatment may be appropriate.

  • Stop or refrain from smoking.
  • Get enough rest.
  • Cold compresses can reduce blood vessel dilation.
  • To decrease pigmentation, protect against the sun by wearing (large) sunglasses.
  • Slight elevation when sleeping can improve puffiness.
  • Antihistamines can help reduce swelling under eyes in some patients.
  • Nasal decongestants, such as saline spray or a saltwater solution, can help prevent blood vessel dilation.

If you are ready to schedule your consultation or simply want to learn more about the various treatments Dr. Jason Halls offers patients to resolve the dark circles under their eyes, give his office a call today at (865) 973-9500.


Contact us today to schedule your appointment with renowned plastic surgeon and face, body & breast specialist Dr. Jason Hall. Take your first steps to a more confident and natural you.

9239 Park W Blvd #202, Knoxville, TN 37923