Dark circles may make you look tired, older, and unhealthy. To get rid of them or lessen their appearance, people use a number of methods – both natural and medically prescribed. Although these treatments are not permanent but with maintenance and consistency, they can help to reduce the appearance of dark circles.

In this article, let’s learn about the medical treatments of under-eye dark circles from a Mumbai-based dermatologist, Dr. Rinky Kapoor. But before we get into it, let’s learn from Dr. Kapoor their causes and types.

Causes of Under-Eye Dark Circles

Although dark circles under your eyes are mostly due to lack of sleep and fatigue, there are other causes as well. These include:

• Heredity
• Pigment demarcation lines
• Allergies
• Sun damage
• Hormonal disturbances (eg. Acanthosis Nigricans)
• Deficiencies (eg Anaemia)
• Medications
• Alcohol/ Smoking
• Dehydration
• Excess screen time
• Stress
• Ageing

Types of Under-Eye Dark Circles

According to Dr. Kapoor, dark circles under the eyes can be divided into four categories depending on the appearance and the reason which causes them.

• Pigmented - These types of dark circles occur when there is an overproduction or poor distribution of melanin in the skin. Moreover, as the epidermis and dermis are very thin around the eyes, it makes excess pigments very visible. They appear brownish in colour and are either caused due to heredity, hormonal disturbances, or stress.
• Vascular - These types of dark circles are caused due to poor microcirculation of the blood and lymphatic liquid around the eye. As lymph ensures that blood drains and is well circulated, a poor lymphatic system will lead to improper elimination of pigments in the blood. And as this pigment accumulates under your eyes, it makes them look darker than the rest of the skin. They appear a bit bluish or purplish with some amount of puffiness under the eyes and are mostly caused due to allergies.
• Structural - Dark circles of this category mostly occur due to collagen loss, volume loss, or bony changes. They manifest as wrinkles, under-eye tear troughs, or valleys and are generally seen in the ageing group.
• Mixed - These types of dark circles are a combination of the above three types. People with such under-eye dark circles may have pigment, lines as well as hollowing under the eyes.

How to prevent Under-Eye Dark Circles

Dr. Kapoor gives a few suggestions that can help you to prevent dark circles under the eyes. These include:

• Lifestyle Improvement
• Screen time management
• Correct metabolic causes
• Proper diet
• Avoid smoking/ drinking alcohol
• Sun protection
• Apply cold compress
• Topical applications (like moisturisers/ retinoids/brightening agents/ collagen/ peptides/ antioxidants/ decongestants) 

Treatments for Under-Eye Dark Circles

Depending on the predominant variety of dark circles a patient has, the treatment is offered by a dermatologist. Dr. Kapoor explains the procedures followed under different categories.

• Pigment Reduction - Three types of procedures are preferred – Peels, Mesotherapy, and Lasers & EBD. Peels can either be Regular peels or Multi combination peels. 
  • Regular peels - These include Trichloroacetic (TCA), Lactic Acid, Arginine peel or Vitamin C peel. In case you opt for regular peels, you have to go through multiple sessions. 
  • Multi-combination peels - If you go through this treatment, you will just have to go through two sessions. This chemical peel is a combination of a number of alpha and beta-hydroxy acids like Arginine, Kojic, phytic, azelaic, retinol, lactic and glycolic.
• Vascular Decongestion - To treat dark circles under this category, Lasers & EBD are preferred.
• Structural Correction - Depending on the type of problems you have; different treatments are available. For treating wrinkles, Botulinum toxin is preferred, for troughs and valleys, you can go for fillers, and for texture and tone correction, Lasers & EBD are the best. One can also go for a surgical operation if required.

The under-eye dark circles are among the toughest conditions on the face to treat well but with proper diagnosis of aetiology and treatment selection, they can be reduced to a great extent.

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