Dark circles under eyes

tear trough before and after
Dark circles, hollowing, puffiness and loss of skin quality around the periorbital area is a very common problem and can be psychologically distressing to many. 

Although a common cause of dark circles under the eyes is facial ageing, this can affect both men and women of all ages and be caused by a number of different factors.

As a result there is no one treatment to fix this common problem and a multi-factorial approach is needed. We offer a number of different treatment modalities at Youth Lab to help rejuvenate the eye area. 

Feeling and looking tired is one of the most common presentations we see at Youth Lab and often the eyes are the focus of our assessment. However every person experiences different symptoms which depend on their individual anatomy, age, genetics, ethnicity and medical history. 

Symptoms of eye problems we see in the clinic may include:

  • Puffiness around the eyes, especially in the morning and when unwell
  • Loose and lax skin under the eyes
  • Fine lines and wrinkles
  • Festoons – bulging areas of fat under the eyes and cheeks
  • Deep tear troughs and hollowing around the eye
  • Flattened cheeks 
  • Dark , grey discoloration to the skin
  • Enlarged blood vessels 
  • Irregular pigmentation and hyperpigmentation 


What causes dark circles and hollows under the eyes?


One of the most common causes of dark circles and sunken under eyes is due to facial ageing. As we age we lose volume and fat in the cheek and under eye area, as well as changes to the bony skeleton, causing the skin to fall loosely and shadows to fall over the cheeks. In addition, the skin of the eyelids and under eye skin is very sensitive becoming lax and thin with age related reduction of collagen and elastin. Some people are also affected by bulging of the under eye fat pads causing puffiness and a swollen appearance. 


The tear trough area is often genetically determined, there are also predispositions to malar bags, thin skin and dermatological conditions around the eyes. 

Lifestyle factors 

Smoking, excess caffeine consumption, alcohol, dietary deficiencies, dehydration, sleep deprivation and stress can also contribute to dark circles, puffiness and shadowing under the eye area. Modifying these are the first steps in managing this common problem. 

Medical factors 

Patients who suffer from chronic sinusitis and congestion, allergies, hay fever, eczema and thyroid disease may be prone to developing skin changes around the eyes. Persistent rubbing of the eyes or use of cortisone creams in eczema for example will prematurely damage the skin. 

Vascular changes 

Veins under the eyes can become congested which in turn can give the appearance of a blue/grey discolouration of the skin. 

Pigment changes 

Hyperpigmentation to the skin as a result of sun damage, melasma or hormonal changes can make the skin appear darker. Those with darker skin types are also more prone to hyperpigmentation around the eye which has a strong genetic link. 

Poor lymphatic drainage 

This is due to change associated with ageing and genetics. Fluid can pool in eye and under eye area and cause puffiness and swelling, this is often worse in the morning and can be made to appear worse when patients have had dermal filler to the area.

How can I prevent dark circles and under eye hollows?

The first step is always lifestyle modifications and prevention as this will assist long term.

Some helpful preventative strategies include: 

  • Sleep and rest
  • Cool compress for blood vessel dilation
  • Sun protection and sunglasses
  • Sleep elevation to prevent fluids collecting under the eyes
  • Lymphatic massage for fluid collecting under the eyes
  • Smoking cessation
  • Nasal decongestants and treatment of allergies, hay fever and sinus congestion
  • Avoid rubbing the eye are as this can cause blood vessel congestion
  • Appropriate treatment of eczema or dermatitis

How do we treat dark circles at Youth Lab?

Treatments are targeted to the underlying cause of dark circles, under eye hollows, puffiness and skin changes. A thorough consultation is essential to establish a treatment plan which may include a few different types of treatments.

Ultimately targeting the eye area early and looking at preventative treatments and lifestyle modifications will deliver the best long term results. 

Simple treatments such as medical grade eye creams are also useful. Generally cosmetic and over the counter eye creams are an expensive gimmick. These generally sit on the top layers of the skin without penetrating.

A high quality cosmeceutical eye cream can help to increase collagen, firm the skin and target damage from hyperpigmentation by lightning and brightening the skin. We offer products containing active ingredients such as vitamin A, Niacinamide, vitamin C , antioxidants and peptides.

In- clinic treatments can then be recommended according to the primary concern. Unfortunately for many with periorbital concerns, surgery (a procedure called a blepharoplasty) is often the most effective way to improve the appearance of the eye area from excess skin laxity and fat ptosis and may be recommended as the first line by our team. 

What are our recommended treatments?

As with many of the treatment recommendations at Youth Lab, a combination of treatments may be required for optimal results.

Please note that the below is a reference point and full treatment recommendations will be made following a consultation. 

Dermal fillers
The use of dermal fillers can improve the appearance of the tear trough area which is a result of volume loss. Dermal fillers can give the skin a tighter appearance and smooth the contours of the under eye area. 

Platelet rich plasma is used to stimulate cellular rejuvenation and results in collagen and elastin stimulation. This will improve skin quality and thickness. 

BBL Corrective
Broadband light can be extremely effective in treating the hyperpigmentation and darkened blood vessels under the eyes as well as contribute to collagen stimulation and overall improvement in skin quality.

Skin Tightening
Skin Tightening is helpful with skin tightening and collagen stimulation to provide firmer and more elastic skin.

Halo Laser
Laser resurfacing with the Halo can dramatically improve skin thickness, improve skin quality though collagen induction and reduce fine lines.

Radiofrequency Microneedling
Radiofrequency microneedling can increase collagen production, improve the appearance of pigmentation, improve fine lines and wrinkles, help with overall skin rejuvenation and tightening.