What causes dark circles, and how are they treated?

The three causes

Dark circles are a sign of what is happening underneath the skin, and the cause decides the treatment.

“When we talk about dark circles, it's just a sign of what's going on underneath. It could be multiple different reasons that could cause dark circles. One is that you have very translucent skin, so you can see all the veins and capillaries underneath, and you can see that bluish discoloration. The second one could be because of sun damage. If you have dark skin to begin with, every time you go in the sun, that area keeps getting darker, and you end up with darker discoloration underneath your eyes. Third one is that you may have hollowness under your eyes.”

Matching the treatment to the cause

“So, each of them I treat it differently. If it's discoloration, I use cool laser. If it's veins or capillaries that are showing a lot, I use a blue light or substitute treat the veins. And if it's hollowness, I treat it with a new stem to address this hollowness under the eyes.”

Many patients have more than one cause. He treats the hollow first, then the pigment.

“so what we're doing is that we're gonna get to the hollowness around your eyes so that the shadow is not going to show as much and then afterwards we're gonna get rid of the actual discoloration with the laser cool laser”

Why hollows look dark

Light hits an uneven surface and leaves a shadow. The goal is a smooth plane from the lower lid to the cheek, so light falls on it evenly.

“All I'm doing is that to try to hold the skin back, make the cheekbone a little bit higher, make this area a little bit more more even with the rest of the face, so it it has the same plane. And the light diffuses from it in the same way, so you don't see the dark circles.”

Why this area is different

Colleagues often call the under-eye area dangerous. He agrees it is difficult, and says the answer is anatomy and a gradual approach.

“I've been doing this treatment for under eyes for the past 20 years. And one of the things that I hear from doctors, from my colleagues who say this area is very dangerous and should not be treated, this is partly true. It is a very difficult area to treat.” “You cannot do the fillers under the eyes like it's a sausage, you're just filling it up. You have to do it slowly.”

He also avoids puffing the area up with volume. The aim is to even the surface, not to add bulk.

Bags and lids without surgery

For patients not ready for eyelid surgery, Coolaser can tighten the skin around the eye and reduce some of the fat beneath it.

“So, Coolaser is one of my favorite treatments for people who are not ready to get eyelid surgery or blepharoplasty for whatever reason.”

Who is a candidate

Age is not the deciding factor. People in their twenties come in with dark circles they have concealed for years.

“I don't care how old you are. There are people who are in their twenties and they have to conceal the dark circles.”