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Ask the Doctor: How do I treat under eye circles?

If you’ve tried tea bags, cucumbers and every miracle cream under the sun to no avail to treat your stubborn under eye circles, you are not alone. In order to find the most effective treatment for your particular problem, it’s necessary to get to the root of its cause, according to dual-board certified plastic surgeon Dr. James C. Marotta of NYC. If this is a persistent problem for you, a board certified facial plastic surgeon can make the proper diagnosis and propose the best treatment plan for you.

Causes of Under Eye Circles
Marotta says under eye circles can have many different causes.  Most commonly, they are a result of small bulges of fat develop in the lower eyelids with age. These fat deposits which people typically refer to as “bags” are like small hernias that have formed through a weakened membrane of your lower eyelid. A shadow is cast when light hits you from above, and your bags then cause dark circles under the eyes.

Under eye hollowness or loss of fat are a couple other causes for dark circles.  Ironically, just below where fat bulges occur, fat loss occurs with age, too. Fat loss in this area causes the bony rim of the orbit of the eye to become more visible. This hollowness is a result of either bone loss and enlargement of the orbit with age, or drooping of under eye and cheek fat that leaves a hollow where the cheek used to be.

Thinning of the skin and visibility of the underlying muscle can lead to yet another kind of under eye circles that can be accompanied by a blue hue or tinge to the eyelid. In this case, leaky capillaries or blood vessels in the eye contribute to the dark blue color.  Finally, brown pigment, what doctors refer to as “hyperpigmentation” can develop in the lower eye lid area causing dark circles. This hyperpigmentation occurs most commonly in patients of Middle Eastern or Mediterranean decent and is caused by genetics and sun damage.

As you can see, dark circles can have many different causes. Also, one or more of these problems can occur in the same patient all at once. For example, an individual may have fat bulges, orbital hollowness, thinning of the skin and hyperpigmentation simultaneously.

Treating Under Eye Circles
Because the causes of under eye circles are so varied, the most successful treatments are those which target the root causes. To remove the unwanted fat of bulges or bags, Marotta recommends a lower blepharoplasty or eyelid lift. “Hollowness of the orbital rim can be filled with micro fat transfer, fat injections, re-positioning of the orbital fat bulges, a mid-face or cheek lift, or by injection of soft tissue fillers like Restylane or Juvederm,” he says. Blue hue and thinning of the orbital skin can also be helped by these methods.

Non-Surgical Solutions
Some topical creams that contain Arnica and Vitamin K can help with leaky capillaries. Brown pigment under the eyes will respond to topical treatment with Vitamin A and skin lightening agents like hydroquinone or Kojic acid and chemical peels. “Beware of under eye miracle creams which claim to eliminate all signs of dark circles.  No cream can do that,” he warns.

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Lauren Stewart
By: Lauren Stewart

Lauren Stewart is a freelancer writer from Michigan. She enjoys writing about beauty, health and fitness! She is passionate about learning new ways to take control of her health and wellness and is a makeup and skincare junkie! You can contact her by emailing