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           Dark Circles under the Eyes

As a person ages the skin covering your eyelids thins out, which may cause the blood vessels to become more apparent. This gives the lower eyelids a darker appearance. 

 It is also possible that thin eyelids can be inherited. Dark eyelids can also be caused from swelling in your lower eyelids. When you're lying down, gravity causes fluid to collect in your lower eyelids, which may create shadows below your eyes. 
Dark Circles Under the Eyes can be  treated with bleaching creams, eye creams, chemical peels , injectable fillers, non-surgical cheek lift (fillers) to correct darkening under eyes. 

A non-surgical  cheek lift can effectively correct dark circles caused by cheek descent, or drooping, a common result of facial aging. This procedure can reduce  under eye puffiness and deep nasolabial folds. 

In some cases, a combination of treatments may be appropriate, especially if there are multiple factors causing your dark circles. 

The procedures that Dr. Gary would  recommend to get rid of dark circles is all determined by the cause or the sources of the problem.

There are so many factors contributing to the appearance of dark circles around the eye.  Some of of the causes are  
true hyperpigmentation (skin discoloration): bleaching creams (triluma cream), peels or lasers could help with the discoloration.

 When you are using peels you have to proceed with caution. Another cause could be the
  presence of deep lines under the eyes (tear trough).  Using Juvederm will help to decrease the optical illusion of discoloration and shadows.

If you do not want to go through the time and expense you might want to consider camouflage makeup.

One of the most common cosmetic complaints is a tired wrinkled appearance around the eyes. Whether its hollows under the eye or dark blue pigment, or just loose skin on the upper and lower lids, treating this area is essential to maintain a youthful, rested appearance. We now have non-surgical techniques that are safe, long-lasting, and make dramatic cosmetic improvements in your face and your life.

 Dr. Gary is a renowned expert in volume enhancement and laser surgery, particularly around the eyes.

Several hyaluronic acid fillers can be used in this sensitive area because of its non-traumatic result, its lasting effect, and its potential reversibility. Lasting a year or more, Eye Fillers like Juvederm or Restylane can give immediate, painless results and that night you can go out for a great dinner with no downtime!

 When used in combination with other treatments like Botox®/Dysport™, years can be taken off the appearance of your eyes and face in an office procedure with no downtime.

 For fine lines and loose skin the Fraxel Repair® and CO2 Laser offers a non-surgical eyelift result without the need for cutting, unsightly scars or general anesthesia.

 No downtime you can take 10-20 years off your eyes.

There is no best treatment for this area of the face. Often a combination of a few non-invasive treatments gives the best, safest and longest lasting result.

Dark circles affect many people and can be extremely frustrating. They give the impression of being tired, aged and unwell when in fact you may feel positively sprightly. Although difficult to treat there are proven non-surgical methods to help restore a fresher look.

When determining the most effective treatment, or combination of treatments, it is vital to identify the cause, of which there are many possibilities.

Hyperpigmentation Constitutional pigment: Your degree of pigment is genetic, which makes certain ethnicities with increased melanin-pigment production more susceptible, irrespective of outside factors – Black, Asian and Mediterranean skin types are examples of these.

True pigment:
Factors such as UV exposure, hormonal shifts (e.g. melasma through pregnancy or birth control) can cause pigmentation around the eyes. Also trauma (post inflammatory hyperpigmentation) from atopic eczema for example, or perfumed cosmetics can influence this.

Aging Volume loss:
Volume loss or fat descent in the cheeks, and under eye volume loss, gives form to what is commonly known as the “tear trough”. This is a depression under the eye, which creates a shadow, i.e. dark circle. Although most people form tear troughs as a result of aging, there are some who have them as a natural deformity from a young age.

Thinning under eye skin:
Eyelids present the thinnest skin on the body and with age, our skin naturally thins further. This translucent covering affords only a thin veil for the dark, underlying structures, such as the muscle and veins.

Skin Laxity:
An ever-decreasing ability to form fresh collagen and elastin sees the skin’s support network diminish. Bulging under eye fat: With age, bone reabsorption speeds up and with an enlarged eye orbit, the fat in which the eyeball resides herniates downwards and outwards.

Lifestyle While everyone needs their vices, unfortunately there are some (personally controllable) factors that will lend themselves fiendishly well to dark circles:

Smoking causes vascular problems, constricting the blood vessels, resulting in poor circulation and making the blood vessels appear darker and more prominent.

Sleep deprivation: Lack of sleep can create paler, more translucent skin, illuminating the vessels below.

Caffeine and alcohol consumption:
Too much caffeine and alcohol will lead to dehydration, causing blood vessels to become swollen. It will also lessen one’s ability to sleep.

Dietary deficiencies:
Dark circles (in conjunction with other symptoms) may be a sign of iron-deficiency anaemia, for example. In the majority of cases, eating the right foods or supplements may treat dietary deficiencies.

Other causes
• Allergies or nasal congestion, inflaming and enlarging the under eye vessels.
• Some medical conditions (such as thyroid or liver problems)
• Some medications (such as meds for high blood pressure) We can see just how many influencing factors there are with dark circles

Peels & Creams to treat Dark Circles
Once the cause is diagnosed, however, we have a number of tricks up our non-surgical sleeves.

Chemical peels –
There are specific, superficial to medium depth peels to target pigment on the delicate eye area in the full range of skin types. The latest peels use synergistic properties to lighten the skin as well as make it stronger and more resilient. Read more

Lightening creams –
To tackle melasma or sun damage, for example, we may recommend a series of highly effective prescription lightening creams.

Hyaluronic Acid 
For volume loss and fat descent we would offer hyaluronic acid filler to soften the shadow from the depression and create more cushioning between the skin and deeper structures that further the appearance of dark circles. Strategically, this beings by targeting any mid facial volume loss to support a vertical lift of lower lid.

C02 Laser –
This is another effective treatment for skin laxity, smoothing and tightening the skin of the upper and lower eyelids. The laser energy is absorbed by water in the deep layers of the skin’s dermis, causing the collagen to remodel and contract, which improves texture and tone. In addition, the outer layers of skin will peel following the procedure, which helps to eliminate brown spots and superficial fine lines. It may be used in some cases of under eye bulge also, others needing surgical referral.

Q-Switched Laser –
Pigmentation may be addresses by delivering an intense beam of light to specifically target the melanin that causes pigmentation. The light is then absorbed and converted into heat, which either disperses the group of melanin cells or destroys the cells carrying the pigment molecule. For pigmentation, laser would always be recommended as treatment secondary to peels or creams, as there is greater risk-benefit ratio and multiple treatment sessions are required.

There can be one to multiple treatments for this condition in order to optimize results. There is a laundry list of options to treat this condition. Please give Dr. Gary a opportunity to map out the best possible treatment that will clear your condition by finding the reason why you have Dark Circles under the Eyes.
Exploring Effective Treatments for Dark Circles: Insights from Cosmetic Surgeon and Dermatologist Dr. Gary Rothfeld


Dark circles under the eyes can be a source of frustration and self-consciousness for many individuals. They can make you look tired, older, and less vibrant than you feel. Fortunately, advancements in cosmetic dermatology have led to a wide range of effective treatments to address this common concern. Dr. Gary Rothfeld, a renowned cosmetic surgeon and dermatologist, has been at the forefront of developing and perfecting various treatments for dark circles. In this article, we will delve into some of the treatments Dr. Rothfeld recommends to rejuvenate the delicate under-eye area.

Understanding Dark Circles

Before exploring treatments, it's essential to understand the underlying causes of dark circles. Dr. Rothfeld emphasizes that dark circles can result from a combination of factors, including genetics, lifestyle, and aging. Common causes include:

Thinning Skin: As we age, the skin under the eyes becomes thinner and more prone to showing blood vessels and pigmentation irregularities.

Blood Vessel Visibility: Dilated blood vessels under the eyes can create a bluish tint, contributing to the appearance of dark circles.
Hyperpigmentation: Excessive melanin production can cause darkening of the skin in the under-eye area.

Heredity: Genetic factors can play a significant role in the development of dark circles, making them more challenging to treat in some individuals.

Lifestyle Factors: Lack of sleep, poor diet, smoking, and excessive alcohol consumption can exacerbate the appearance of dark circles.
Treatment Options

Dr. Gary Rothfeld offers a comprehensive range of treatments to address dark circles, tailoring each approach to the unique needs and concerns of his patients. Here are some of the most popular options:

Topical Creams and Serums: Prescription-strength topical treatments containing ingredients like retinoids, hydroquinone, and vitamin C can help reduce pigmentation and improve skin texture when used consistently.

Dermal Fillers: Hyaluronic acid-based dermal fillers can be strategically injected into the under-eye area to plump and smooth the skin, minimizing the appearance of hollows and shadows.

Chemical Peels: Mild chemical peels can help exfoliate the top layer of skin, promoting collagen production and reducing pigmentation.

Platelet-Rich Plasma (PRP) Therapy: PRP, derived from your blood, contains growth factors that stimulate collagen production and improve skin tone and texture.

Laser Therapy: Laser treatments can target blood vessels, reduce pigmentation, and stimulate collagen production, leading to a rejuvenated appearance.

Micro-needling: This minimally invasive procedure involves tiny needles that create controlled micro-injuries to stimulate collagen production and improve skin texture.

Surgical Procedures: In some cases, surgical options such as blepharoplasty (eyelid surgery) may be recommended to address underlying structural issues.

Customized Approach

Dr. Rothfeld emphasizes the importance of a personalized treatment plan. Not all dark circles are the same, and what works for one person may not work for another. A consultation with a board-certified dermatologist or cosmetic surgeon like Dr. Rothfeld is crucial to determine the underlying causes of your dark circles and develop a tailored treatment strategy.


Dark circles under the eyes are a common concern, but they are not insurmountable. With the expertise of professionals like Dr. Gary Rothfeld, a variety of effective treatments are available to address the underlying causes and rejuvenate the under-eye area. Whether it's through topical treatments, injectables, or advanced laser therapy, the key to success lies in a customized approach that considers each individual's unique needs and goals. If you've been struggling with dark circles, don't hesitate to consult with a qualified specialist to explore your options and regain a more refreshed and youthful appearance. 

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