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Introduction to Dark Circles


Dark circles under or around the eyes is caused by many factors. The following are the most common causes of dark circles.


  • Heredity
  • Nutrient deficiency- Anaemia( Folic acid, B12,Niacin,Fe etc)
  • Fatigue, lack of sleep,
  • Pregnancy & hormonal changes
  • Faulty life style, excessive smoking or alcohol consumption
  • Medical problems such as diabetes, hypothyroidism, allergic diathesis
  • Medications

These factors may lead to the following:

  • Excessive pigmentation
  • Thin, translucent lower eyelid skin overlying the orbicularis oculi muscle
  • Shadowing due to skin laxity and tear trough
  • Prominent vasculature below the lower lid

Diagnostic test for Dark circles

Stretch the eyelid:

  • If the dark circle improves, it is because of skin laxity.
  • If the dark circle worsens, it is because of subdermal vascularities.
  • If no change is seen, it is because of dermal pigmentation.

Wood’s Lamp Examination:

  • If dark circle improves, it is because of dermal pigmentation or vascularities.
  • If dark circle worsens, it is because of superficial pigmentation.

Polarized light:

  • If dark circle worsens, it is vascular in origin.


Modalities of treatment

Treatment of underlying cause- antoxidants, iron caps, etc.

Topical agents: hydroquinone, retinoic acid (0.01% to 1%), azelaic acid, kojic acid, pidobenzone, Vit. C etc.

Home Care – regular moisturizers, sunscreen, application of lightening creams.


Clinical treatments such as:

  1. Glycolic Peels – Acts on the superficial pigmentation around the eyes by exfoliation, which lifts away dead skin cells, thus fading away the uneven pigmentation. It penetrates deeper and causes a rearrangement of the pigment, thus lightening the skin.
  2. Combination Peels – Glycolic & lactic, Arginine, Vit. C serums.
  3. Lactipeels
  4. Iontophoresis – by using galvanic & lighteneing agents like hydroquinone, kojic acid, moisturizing agents like aloe vera, vit .c serums, natural substances like liquorice etc.

Newer Modalities of Treatment

  • Mesotherapy using small quantities of glutathione and Vit.C if melanosis is predominant.
  • If puffiness is predominant, PDC can be injected in small quantities. The depth of penetration is 4mm.
  • Mesobotox for Periorbital melanosis with wrinkles
  • In case of Darkcircles with sunken eyeballs Temporary Fillers are preferred.
  • Intense Pulse Light therapy and Lasers
  • Surgery—Laser Blepharoplasty
  • Autologous fat transplantation and fillers.

Clients are divided into two major categories:

More of puffiness under the eyes and less pigmentation.

More pigmentation and less of puffiness under the eyes.


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