How Certain Ethnic Skin Types are More Prone to Under Eye Dark Circles, and How to Treat Them


Thank you for your question. You submitted several photos and you describe
in your history that you exercise once or twice a week, that you sleep 6-8 hours a day
and you’re generally in good health and you are someone who feels generally well. And you’re wondering why you have the appearance
under your eyes of dark circles. Well, I can certainly share with you my approach
to answering this type of question which occurs in our practice every day. A little bit of background, I’m a Board-certified
cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long
Island for over 20 years. And helping people with the under eye area
whether it’s dark circles, hollows and puffy under eye bags, it is a significant percentage,
a high percentage of what we do in our practice every day. So to begin with, certainly without a proper
examination, a physical exam, and seeing you at different angles and looking at the quality
of the skin, etc., I would say that what you are most likely dealing with is first, genetics. Certain ethnic types tend to have this issue
with dark under eye circles. In my general perception, it is basically
people with Mediterranean to darker skin types. So that includes anybody from Italian, Greeks,
people from the Middle East, Indians. It is an extremely common issue. When we look at the under eye area, basically,
we’re looking at how much of the dark circle is contributed by pigmentation, the actual
color of the skin, how much of it is contributed by relative hollow. In other words, the position of the skin as
it relates to the area of the bone called the tear trough and infraorbital rim. And then of course, there are other issues
whether it’s allergies or vascular issues where you can actually look through the skin
and you have something called allergic shiners. Now that being said, it is common practice
for us to discuss certainly the options. But very importantly is that you have to decide
how much does this bother you and are you willing to now do something that’s going
to require maintenance. A famous dermatologist said that in dermatology,
you never cure anybody but you make everyone better and you try everything to make people
better. It’s actually about management and not about
cure. So in a situation like under eye dark circles
and hollowing, together, it is routine for us to address the hollowing with an under
eye filler and usually, it’s in the hyaluronic acid family. And basically, it’s a filler that is similar
to the natural hyaluronic acid that exists in your body. So it’s very well tolerated, does not require
any type of allergy testing. And in addition, with the skin quality, we
have a lot of success in helping people with something called platelet-rich plasma (PRP). Platelet-rich plasma is derived from your
own blood and it is a concentration of the wound healing factors required for when you
have an injury like a cut. What happens is you get an increase in collagen,
blood supply and basically the color and the melanin production is actually affected and
this has been shown in studies with PRP. And so, it actually has a nice holistic lightening
effect in the skin. It doesn’t eliminate the darkness. We cannot bleach the skin. But I would say that it can make the eyelid
skin look healthier. So the typical or the general concept of the
whole is greater than the sum of the parts, when you add volume correction with the PRP,
basically volume correction with skin quality improvement, there’s a nice result. Now, the only issue here is of course is that
you have to repeat this. And depending on the age of the patient, it
is something that I really prepare them for especially when people come in who are in
their 20s or early 30s and see if they are ready to really embrace this kind of ongoing
maintenance. A lot of times, it’s worthwhile to just
try it. You know, with a procedure like this which
is relatively safe and is non-surgical even if it’s still an invasive procedure, you
can at least see if you like the results and if it’s justifiable to you in terms of your
allocation of time, energy and resources to actually do this. So learn more about this. I would say meet with experienced, cosmetic
doctors who do a lot of this type of filler in the under eye area as well has experience
with PRP. There are lot of people who still remain stubbornly
skeptical about the benefits of PRP but slowly the dermatology literature and other medical
literature in the aesthetic field is recognizing the benefits. It has already been established well in other
specialties and other fields. So it’s important to at least learn about
these options and see if it fits for you. So I hope that was helpful, I wish you the
best of luck and thank you for your question.

5 thoughts on “How Certain Ethnic Skin Types are More Prone to Under Eye Dark Circles, and How to Treat Them

  1. Hi Dr Prasad after watching u 0n UTUBE .I am already sold. The problem is that i live in Texas .I am sixty yrs old .my eye bags are already preventing me from seeing properly on my left eye. pls tell me where to go I need ur help Remain Blessed .

  2. Ummm, I'm white (no Mediterranean or Middle Eastern descent that I know of) and I have had hollow, purple under eyes my entire life!

  3. Hello Doctor. Do you know of any Physicians in the Houston, Texas area that you can recommend for the hyaluronic acid filler w/ PRP?

  4. Hello doc I’m 19 years old boy and i have some kind of line under my eyes and i used everything to remove them but thry are non removable.tell me what can i do for it

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