The development of dark circles under one look makes you look tired. Some people develop dark circles with aging, while others have them when they were young. Dark circles are found as often in Caucasians as in darker pigmented people. Dark circles, contrary to popular thought, are not due to fatigue, stress, or wear. (no matter how you feel!) Dark circles develop due to staining of thin eyelid skin from pigments that have leaked from your blood cells. The pigment of blood cells, known as hemoglobin, is oxidized when it approaches the surface of the skin due to exposure to light and turns into a bluish-red color. (hemoglobin is converted to hemosiderin, an iron-based pigment). This discoloration subsequently looks like a breeze and is easily visible, since the skin of the lower eyelid is very thin and almost transparent. As dark circles appear from the deposits of pigment, they can be permanent.
What can be done for dark circles? First of all, eyelid surgery will not get rid of dark circles. Lower blepharoplasty, which removes excess skin and lower eyelid fat, does not directly address the problem of pigment staining. In the short term, this may make it look worse because of the bruises from the surgery and has the potential to place more blood products near the skin to be destroyed. In some cases, there is some improvement in the appearance of dark circles, when the lower eyelid is tightened, and in order for shading to appear, there is less unattainable void. But you should never be under the lower blepharoplasty, if your main goal is to get rid of dark circles. Any improvement in dark circles should have been considered a bonus, but not the main goal of the operation.
Secondly, peeling, burning or peeling of the skin of the lower eyelid usually do not work well. Regardless of whether it is done by chemical peeling or laser polishing, the removal of the outer layer of the skin of the lower eyelid does not reach the area where the deposition of pigment lies. Waxing removes the outer epithelium of the skin, but does not reach or should not reach the defective dermis or lower part of the skin. (if so, the lower eyelid will be a scar). Although I do not think that there is much harm to the skin with a lower sprig, with a 25% or 35% TCA solution, it is not particularly effective in most cases. And it risks adding an additive problem known as hyperpigmentation, which can contribute to the darkness of the skin of the lower eyelid.
Potential skin leaching with hydroquinone topical preparations seems reasonably safe, although the way it works is not necessarily aimed at a problem with the pigment. Hydroquinone works by suppressing melanin or color production of the skin, so it is easy to understand how this can be effective for hyperpigmentation or age-related (sunlight) brown spots. But this bleaching chemical, as is known, does not specifically destroy or stain the hemosiderin stain. Thus, skin whitening sounds like it works, but the chemistry behind it will suggest otherwise.
Finally, many topical skin creams require an improvement in the dark circle, and some are even labeled as serums to restore the dark circle. They contain agents such as arnica, haloxyl, and other enzymes that presumably destroy pigments and help dark circles disappear. Although theoretically attractive, there is very little good clinical or research information that will support these claims. Even if it were effective, it would be a slow process that would take months to begin to improve. (which is fine if improvement actually occurs)
My frustration with dark circles prompted me to try a different approach. I am currently using light therapy (intense pulsating light, especially broadband light) with vascular filters in combination with topical dark round serums. It seems to me that something is needed to initiate the breakdown of pigment and light therapy, which are specifically aimed at not damaging the overlying skin. And without any recovery for the patient. Currently, I am doing a series of 3 light procedures, spaced apart by one month with nocturnal supplements of local serum. It is too early to say that this is a magical approach, but some patients are already experiencing an improvement in the first month.
