Kenneth Beer, M.D. is a board-certified dermatologist and dermatopathologist in Palm Beach, Fla., and the director of, an online skincare company. He is also the director of The Cosmetic Bootcamp, which trains physicians in best practices for cosmetic medicine. Dr. Beer is an instructor in dermatology at the University of Miami, and he is an A.B. Duke Scholar at Duke University. He obtained his medical degree from the University of Pennsylvania School of Medicine, and received his dermatology and dermatophathology training at the University of Chicago. Visit Dr. Beer's office at

Help for Under-Eye Circles

Tuesday, 24 May 2011 04:34 PM

One of the most frequently read and viewed articles from the Journal of Dermatologic Surgery discusses the causes and treatments of dark under-eye circles.
Basically, they divided the reasons for these into three categories: pigment in the skin, blood vessels, and hollow troughs under the eyes.
Some of these are easily corrected while others are more difficult. Treatments ranges from topical medications and topical cosmeceutical products (such as eye cream) to lasers and soft tissue augmentation product such as Restylane and Juvederm.

Pigment in the epidermis is usually formed after minor irritation, hormones, or after procedures. This pigment is melanin and it can be treated with medications known as hydroquinones. Many of these are produced in concentrations of 4 percent and will gradually help the pigment dissipate.
Stronger products can be custom formulated and for many of my patients I order them to help promote more rapid lightening. A prescription product called TriLuma combines this bleaching agent with hydrocortisone and a vitamin A derivative. When used correctly, it works beautifully to lighten the dark circles caused by melanin.

Hollow spaces under the eye cause shadows that appear as dark circles. In some patients, they can be easily filled using soft tissue fillers. To correct these tear troughs, I use injections of clear fillers to lift the skin and fill the hollow. Although this can result in bruising, patients treated with these fillers often have results that correct the dark circles.
The correction typically lasts for six to eight months and can easily be repeated. Some of the complications that can occur with this treatment include lumps and bumps, therefore the injections should be performed by very experienced injectors.

The last category that causes dark circles are related to blood vessels. When the vessels are near the skin or congested, they can make the area look dark. Allergies can make this situation worse and be alleviated by antihistamines. Lasers can help treat blood vessels that are near the surface.
Treatments require several visits and are typically not covered by insurance. Other laser treatments that can lighten the skin (and tighten wrinkles in this area as well) include the Fraxel and CO-2 lasers. In my practice, I employ them for patients who have fine lines with pigment in the area around the eyes.

People with dark circles around the eyes should ask their dermatologist or plastic surgeon about their specific cause and what treatments are available to them. For most patients in my practice, I design a program that makes the circles much less noticeable. No matter what the cause, there are treatments available to help.

© HealthDay

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