4 Types of Dark Circles and Treatments

Dark circles under the eyes contribute to a tired, aged, and even sad appearance.

Infraorbital dark circles result from various factors, including deep facial anatomy, soft tissue changes, and contributions from the skin.

Different treatment options exist, and a customized management strategy works for the particular anatomic changes.

What is the most contemporary and resultative treatment to remove dark circles?

A 2020-2021 study shows that the most resultative treatment for dark circles removal is platelet-rich plasma. Injections of PRP remove dark circles and erase wrinkles around the eyes.

A clinical trial of Platelet-rich Plasma use for facial rejuvenation was done in May 2021. It shows that 60% of clients who participated in the study evaluate their result as "excellent improvement for dark circles ." 78% say that they see an excellent improvement in the wrinkles around the eyes. The study's conclusion underlines that face rejuvenation with PRP is a noninvasive and promising technique. The best results were observed in improving dark circles and wrinkles around the eyes.

The study in November 2020 compared how different types of plasma work under the eyes for dark circles removal.

Participants evaluated the result as significant clinical improvements. They mentioned the substantial reduction in the degree of dark circles under the eyes. 

What else is possible with the dark circles to make them less visible or remove them?

We only discuss treatments that give the visible result and Medvspa used for all skin types.
Concealers with Bio Revitalizant and Skin Booster Injections.
Optical diffusers are a useful adjunct in the concealment of dark circles. Hyaluronic acid, no cross-linked or low-density cross-linked, reflects light away from the skin. Injections perform with the cannula, and the result is visible right after the treatment. The treatment requires repetitions, the number of sessions, and the time between them depending on the product. Side effects include swelling and rarely bruising. The result lasts 6 - 9 months.
Radiofrequency
Radiofrequency (RF) devices use energy to create a thermal effect that results in collagen contraction and new collagen growth. RF energy treats deep tissue layers such as the dermis and subcutaneous fat without thermal burns. RF devices treat various skin types because they do not use light-based power. 
World leaders RF systems, like Reaction and Scarlet, tighten the skin around the eyes. 
 Hyaluronic acid gel soft tissue fillers
Hyaluronic acid (HA) fillers address volume deficiency in the periorbital region, resulting in shadowing in the under-eye. 
Separate periorbital hollows benefit from adding additional volume in three areas around the eyes : 
1) the orbital rim hollow, 
2) the check bone area
3) the tear trough grove. 
Filling directly into the deep ligamentous structures and replacing the bone volume can lift these areas. Profound improvement in infraorbital dark shadows can be achieved using HA filler alone.

What is the difference between the four types of dark circles?

Various anatomic factors may contribute to the appearance of dark circles, including the changes of ligamentous architecture, the bony structure, midface soft tissue gravity, the prominence of the muscle and veins under the eye, thin eyelid skin with minimal to no subcutaneous tissue.

TYPE 1:  LIGAMENT AND BONE STRUCTURE CHANGES

The function of the facial ligament and bone structure is to provide a framework for supporting facial soft tissue., These structures reflect how young the face looks.

Facial ligaments are attached between the bones and the soft tissues, supporting facial fat compartments. The structure of bones, ligaments, and soft tissue has changed with age, and as a result, the supporting activity is changing as well.

Age-related changes in the middle part of the face and bone result in relative orbital rim depression. When structures in the mid-face lose volume, it leads to tightening of the orbital ( lower eyelid) and facial retaining ligaments.

The relatively inflexible ligaments result in tethering as the facial fat volume decreases and drops down. Signs of aging, like the orbital rim, become visible and facial hollowing appears. These hollows lead to worsening shadowing.It is good to know who you take pictures, that overhead lighting can worsen the appearance of dark circles, while direct light may mask the appearance.

TYPE 2: VESSELS AND MUSCULE

The thin and transparent eyelid skin barely camouflages to the prominence of the robust subcutaneous vascular network and the orbicularis oculi muscle. Vessels and muscles are relatively dark blue and dark red, appearing as darkness under the eyes.

TYPE 3: FLUID RETENTION

Infraorbital eyelid fluid may accumulate in the soft tissue under the eyes, especially for TIRED and DEFORMATIVE types of aging. It contributes to the darkened and aged appearance in this area. 

Darkness under the eyes could be the result of one more aging process. Vessels permeability is increasing with age. It means that dark substances, like hemoglobin breakdown products, easily leak through the vessels into the surrounding tissue. Cutaneous and subcutaneous layers deposit them. It is called under-eye darkness or hyperpigmentation.

The lower eyelid tissues may have an increased tendency to accumulate fluid. Due to local processes such as age atopy, it could also be systemic fluid retention. This fluid often takes on a purplish color due to the muscle prominence in the lower eyelid.

Age-related anatomic changes of the midface soft tissue include subcutaneous fat atrophy and volume loss. Orbicularis oculi muscle increases the tension. False herniation of soft tissue in the lower eyelid area and volume loss in the malar region further accentuate the appearance of dark circles.

TYPE 4: CONTRIBUTIONS FROM THE SKIN

The quality of the skin around the eyes may also contribute to the appearance of dark circles. The lower eyelid skin is one of the thinnest parts of the body, and the Orbicularis muscle becomes visible. Skin loses elasticity and turgor due to collagen and elastin loss. Furthermore, thinning of the skin, color changes, prominent veins, seborrhoeic skin changes, and actinic changes contribute to skin aging.

CONCLUSIONS

Infraorbital dark circles are caused by various anatomic features, with contributions from the skin, subcutaneous tissues, orbicularis muscle, vessels, and ligaments of the lower eyelid. Platelet-rich plasma is the most contemporary treatment of dark circles removal, proven by recent publications and MedVSPA clinical experience. 

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