Dark circles under the eyes are among the commonest reasons people, mostly women, seek help with as early as their late teens and early twenties.

Among the reasons cited- well meaning but unhelpful comments from family, friends and even colleagues about looking tired such that people become self conscious even looking at themselves in the mirror.

Over time, this issue can become consuming enough that it can affect ability to socialise, to go out and to especially engage in certain activities that are usually makeup free, such as swimming.

There are so many "quick fixes" promised out there, it is easy to get confused and to end up spending a lot of money with minimal results if the person treating you does not fully understand the cause of YOUR dark circles. 

This explainer talks you through what a trained doctor looks for when assessing someone concerned about their under-eye area, so you can be aware of some factors at play and what might be possible to do  so you can decide if it is worthwhile  to pursue an appointment with a professional to get a personalised treatment plan and quote for you. 

What are the cause of MY dark circles?

No two faces are alike, not even identical twins, and it makes sense that no two causes for a common problem, will therefore be the same.

The area around the eyes is a complex one and multiple causes contribute to give you the dark circles that bother you:

GENETICS

Some people have dark circles even as young children, ie it may be an inherent characteristic of their under-eye area

SKIN QUALITY  

Thinner, paler skin  may show underlying blood vessels more prominently, especially with age, giving rise to a faint bluish/ purplish hue that gives you an "always tired" look.

In such individuals, as we age, we lose fat pads around the eyes, leading to hollowing of these areas, together with loss of collagen, which thins the skin, worsening the appearance of tired, sunken eyes. 

MEDICAL CONDITIONS

Allergies, if untreated, may contribute to darkening of the delicate skin around the eyes as well as abnormal thickening leading to puffiness, discolouration and in skin of colour, pigmentation here. 

HEREDITARY CAUSES

Genetic deficiency of the tear trough, as well as a tendency to pigmentation around this area may contribute to a marked discrepancy in skin colour in ethnic skin from a young age. 

DIET AND LIFESTYLE

Chronic lack of sleep, poor diet, habits such as smoking all contribute to dark circles. It is imperative to sleep 7-9 hours/ night as it is when we are resting that the skin repairs itself and generates collagen. Similarly, in addition to chronic unintentional sun exposure that breaks down collagen, smoking is also linked to faster collagen breakdown, leading to hollow, shadowed eyes no matter your age. 

AGEING

As early as our twenties, fat pads in our faces, especially under the eyes and in our cheeks, are lost and descend, giving rise to a more hollowed, gaunt and tired appearance. Additionally, bony changes to the eye socket leads to loss of support, with deepening wrinkles and in some people, may lead to some fat protrusion in this area.

In skin of colour aka ethnic skin, this is often compounded by pigmented skin, which is often slightly darker in areas where the skin is thin and folds, such that in someone with ethnic skin, they seem to achieve the trifecta of volume loss + folding pigmented skin + wrinkling, giving rise to seemingly overnight, a marked difference in skin colour between their eyes and their face, which can often be very distressing for patients. 

HAPHAZARD TREATMENT PLANNING

Usually intended to help with the dark circles, lack of adequate planning of treatments or even the wrong treatments without understanding underlying cause(s) may on occasion, lead to unintended consequences, especially in skin of colour, with hyperpigmentation due to unexpected burns, or other injuries.

WHAT CAN YOU DO?

1. Lifestyle changes are the cornerstone of any longterm changes. Just as you would not expect to attain to and maintain a strong body by running once or twice, so it is with skin.

The best treatments are the ones we can undertake as small daily changes at home with personalised skincare, and in-clinic treatments as and when needed to maintain results.

Realistic expectations are key as treatments can take up a fair bit of time and money initially.

Aim to get 7-9 hours sleep most nights. Our skin repairs itself and builds collagen during sleep so skimping on this important and free step is a bad idea.

Watch alcohol intake and when you do drink, follow it up with water whenever possible.

Quit smoking! Smoking accelerates the ageing process.

Daily SPF 30+ 365 days/ year. Get into the habit of wearing SPF daily no matter what the day holds, and you will see the difference in a year even if you do nothing else.

Consult a doctor for a personalised skincare regimen suited to you and your skin and the age and stage of your life, based on your concerns or as a preventive. It may seem cheaper to simply buy at the latest sale or bundle or kit, but many people find they overdo it; contact dermatitis from overuse of over-the-products is real and common, and it is far easier to have a doctor talk you through what your skin needs. I call it skin coaching.

In addition to SPF daily, have the other basics covered - a sunhat, sunglasses to protect the delicate area around the eyes, and whenever possible, cover up as much of your skin as possible from the UV or use SPF on exposed skin, and seek shade whenever and wherever possible.

2. Seek help with any medical conditions that may be contributing to your dark circles.

Another reason to see a doctor! Your doctor can take a comprehensive history to help determine if your dark circles are due to genetics, your skin type, or underlying medical conditions and advise appropriately.

It is completely fine to go in with an idea of what you want, but please go in with an open mind, as the cause of your problem may not at all be what you think it is. That is, after all, why you are paying someone to help and educate you to resolve your problem! 

If due largely to skin of colour, you would also expect them to be upfront with you about the cost to improve this issue and the degree of improvement you can expect (hint; it is not 100%, and you may well decide simply using concealer is good (and cheap) enough)

If your condition is contributed to by chronic allergies, your doctor will almost certainly be able to help you manage this, to help you calm the skin down and get the condition under control before any targeted undereye treatments to address other contributing factors such as volume loss and ageing skin.  


3. In-clinic treatments and at-home treatments.

Most eye creams contain common ingredients intended to address many of the complaints we hear of regularly - caffeine to help with puffiness, humectants to help plump fine lines and wrinkles and a gentle form of retinol to help with cell turnover. Additionally many also contain optic enhancers that reflect light better and may camouflage dark circles better.

For longer lasting results, it is better to speak to your doctor about personalised treatments for you, based on your medical history including pregnancy and breastfeeding status if applicable. 

In skin of colour, many in-clinic skin therapy treatments designed to induce collagen and thereby partially improve the appearance of the delicate skin here, require a prep period with targeted prescription creams anyway, so it is best not to simply jump when the impulse takes you, but to rather plan it with your doctor and allow for improvement over several weeks to months. 

Lastly, depending on your willingness, hyaluronic acid fillers may be great options to replace lost volume under the eyes and cheeks if appropriate to help improve the appearance of chronically tired eyes. 

I tend to approach the problem as one that usually has multiple factors that contribute to the underlying problem such that the best results will be achieved by using multiple modalities to address the concerns, and using only 1 or 2 of the options will likewise yield a more limited result. As always, this is where the consultation with your doctor is key, to help you decide if you can work well together, to set realistic expectations around budget and timeframe so that you can decide if it is an option worth pursuing. 

Ready to get started? Head on over to book an appointment and let's start a conversation!