Treating Dark Circles – How Lasers can Treat Some Causes, and Other Treatments to Improve Color

Thank you for your question. You submitted a single photo with your eyes
closed and you’re asking will laser help remove the dark spots under your eyes. And the photos are taken at a distance so
I actually can see more of the broad picture and not so much the detail of the eyes but
I think I understand what you’re asking. So, I’ll give you a sense of how I counsel
patients like yourself who come to my practice about this type of situation. A little bit of background, I’m a Board-certified
cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan and Long
Island for over 20 years. And the challenge before us every day in our
practice is dealing with people who are concerned about dark under eye circles and I think that’s
really the core of your issue is you have dark circles under the eyes and you want to
know if laser will remove those circles. It is understandable why you are asking this
question. We are immersed with incredible claims made
about the benefits of laser and unfortunately that tends to confuse a lot of people because
we have to differentiate what a laser does and how does it fit into this type of issue. So let me just get through the steps of how
I evaluate patients like you and what I want to do first and first is to find the problem
and then define the solution. So let’s start with the under eye area. What do I see when I see the under eye area? First, I noticed some puffiness. So understanding that the puffiness is not
a skin issue but rather something called lower eyelid fat prolapse. Lower eyelid fat prolapse means that the fat
pockets that are normally around the eyes have pushed forward and created these bulges. Now if this puffy area is really not something
that is constant and is either fluid or just happens to be the way as the photo was taken,
we can at least understand that if there is puffiness that a laser doesn’t really specifically
remove, that without its application in a more interventional approach, for example,
when we deal with under eye bags and puffiness, we perform a procedure called transconjunctival
blepharoplasty. This is a procedure where the fat pockets
that create this type of puffiness are reduced from the inside of the eyelid. Now, I prefer this technique especially for
people who have, let’s say, darker skin types and that means anybody who has like
a light olive skin tone and darker. The reason for that is generally there is
no evidence of extra skin and you avoid issues with incision in terms of discoloration or
scarring even though those are not major but it doesn’t justify making decision if you
can avoid it. Now beyond that and on the topic of skin type,
that is where one of the major decision points about choosing a laser treatment or alternative
treatment becomes absolutely critical. Laser is the use of a particular wavelength
for certain amount of time to target a particular type of chromophore. And the three major ones are blood, water
and melanin. Now when you look at someone with dark circles
under their eyes, we have to ask ourselves what of those elements are related that can
potentially have a role with laser. But beyond that, I would say, it is very important
that you also consider what kind of impact laser has when you do a treatment. So there are lasers that, let’s say, target
water. Well those are the lasers that can be done
fractionated or ablative to remove top layers of skin. The top layers of the skin can also contain
some pigment that could help make the dark circles look better. There are also lasers that target the pigment
itself called melanin and there are other lasers that also target blood. Now, the point of this is understanding whether
or not a laser would potentially cause someone with a darker skin type to actually make the
area look even more darker. So in that respect, you have to be mindful
of where laser fits in. For example, when we treat under eye circles
and if it’s in combination with or without addressing puffy under eye bags, we routinely
actually first do a combination of platelet-rich plasma (PRP) which is derived from your own
blood and has a concentration of wound healing and growth factors that stimulates collagen
and improves the appearance of dark circles . We’ve done this very successfully as a
standalone procedure without laser and basically getting the benefit of improving skin quality,
improving the texture and health of the skin and it’s actually been shown that platelet-rich
plasma (PRP) prevents hyperpigmentation and actually can be used in situations where there
is hyperpigmentation and that’s been shown in formal studies and we’ve seen these clinically
for years. So, I think that although there are a lot
of options, I think laser may be something that could have a place in your treatment
plan but I think that you can also consider other options before going with laser. I think it’s natural to ask this question
because people are so fascinated by lasers and certainly this industry of aesthetic medicine
really continuously hypes new lasers and there’s some basis but unfortunately, a lot of times,
the hype and the usability doesn’t always go together. A laser is a tool and it may have a role in
your treatment but it cannot be a standalone type of tool in my opinion. If I do a laser, I often combine it with platelet-rich
plasma (PRP) because I want to get the benefit of the laser as a resurfacing tool and the
platelet-rich plasma (PRP) as to way to improve skin quality and texture. And sometimes even injectable fillers can
also have a role in improving dark under eye circles. So if you understand, there are a lot of different
elements that can be used to address particular anatomic issues. I think that you have to, at this point, make
some decisions about choosing a doctor to meet with and have a proper consultation and
learn about what the recommended options are and I would even go so far to say that when
you meet with several different doctors, you are going to get a lot of different opinions. So you are going to find a doctor that you
feel comfortable with it and you feel makes sense with your unique situation. Remember, skin type is very important. Same modality that I would use for a lighter
skin type for a person like an Irish blue-eyed person with dark circles is very different
from what I do from let’s say an Indian or Arab skin type, someone who is brown and
then further and even darker skin type like of someone with African origin. So it really has to be customized. So I hope that was helpful, I wish you the
best of luck and thank you for your question.

23 thoughts on “Treating Dark Circles – How Lasers can Treat Some Causes, and Other Treatments to Improve Color

  1. Hello Dr.Aditya
    Greetings from India !
    Thanks for the informative video
    However I have become somewhat more confused on what is the best treatment.
    I'm 22 and I'm sure that my dark circles are due to genetics mainly , as I see them in my family tree. Would you recommend only laser for me especially since I doubt the PRP treatment would be available over here.
    Thanks in advance !

  2. Hello sir,I m 28 year old girl I have massive dark circles around my both eyes…I mean it is extremely dark brown n black from last 8-10 years i m suffering from dis…wht is the best treatment for me can you plzzz suggest me ??

  3. Hallo Doctor, thank you for a very imformative video. I had an operation that left me with dark circles, its been 3 years now. My eyes were swollen, the swollen went down so well after 2 days but the dark circles still exist. Could it be am Allergic to anesthesia? Please advise me, do i need laser treatment? Thanks

  4. Dr. Aditya! Thank you so much for sharing your knowledge! I have a question. I am indian and my skin is light brown. I have very dark hallow circles and it does not match with my lighter complexion. I look tired and depressed with the extreme hyper-pigmentation around my eyes. What treatments would you recommend for my very dark circles around the entire eye? I also have hollowness very similarly to this picture:….0…1c.1.64.psy-ab..18.4.777…0i67k1.0.6Le_NuiDR4c#imgrc=GFm8AbhO_vPj5M:

    the girl in the picture has similar eye problems, very dark and hollow but my skin is more light olive.

    Any suggestions?

    thank you!!

  5. Hey doctor I reached out before
    My dry eyes are so bad
    The circles and bags are worse
    But I don’t know what to do because dry eye syndrome
    They ruled out sjorgens
    It’s accutane 10 years ago
    Either deficient in a or toxic amount
    Cell death I heard it ruins immune and endocrine system

    Bottom line I have bad bags 10 years since dry eye set in
    And nothing works for dry eye
    Not sure what to do for circles and bags if I can even do anything

    I also don’t sleep good
    So I’m
    Not sure if they’ll come back if I got them treated

  6. Hello Doctor I suffered a pretty bad car accident where I received staples on my head and really bad black and blue even though I healed really well I was left with dark skin on my eyes where my bruising was what can heal my skin to get my initial skin back being laser or skin products? Thank you

  7. Greetings Doc, i decided to take steps regarding my circles (i got them from my grandma who was of Greek ancestry). What would you do based on picture link i provided below? they seem to progress on yearly basis. *I did a full checkup kidneys urine… flying colors. Whole family has them some darker some lighter tint.

  8. Dear Mr. Prasad, what Laser would you recommend for brown skin with hyperpigmentation under the eyes? I tried soft IPL Lasers like the EMAX Laser, but it didnt work. Some doctors are afraid to treat this area with Lasers for darker skin. Please help me, I tried so many things.

  9. hi there Dr Prasad, id like to ask ur opinion on what to do about dark circles that come and go due to the capillaries in the lower eyelid skin. These dark circles come and go throughout the day based on alot of factors water, stress, etc. is there a way to treat this/ maybe remove the tiny capillaries? i have olive skin, and generally shallow sockets in general.

  10. Hi Dr. Prasad, I recently broke my nose and had to get it fixed. All the blood caused dark under eyes that haven’t gone away. I’m 2 months post op. I don’t have bags or anything, it’s just the dark under eyes from the break and the surgery. Do you suggest laser? It’s getting hard for me to go out, because I look sick and tired all the time 🙁

    I am Indian with a medium skin tone

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