Why do I get dark circles under my eyes?

What are dark circles?

Unlike under-eye bags, which are a form of oedema of the lower eyelids, dark circles (also known as the jugo-palpebral fold) refer to variations in the colour of the skin under the eyes. Their colour varies because the skin is extremely thin in this area, and congestion of the vascular network is more visible.

They can be a sign of skin ageing. There are usually two main signs of ageing, which are even more visible around the eyes:

• under the effect of the sun in particular, the skin becomes pigmented, leading to deposits of melanin in the epidermis or dermis: these are the well-known age spots.
• the melting of connective and fatty tissue thins the structures and contributes to the sagging of skin tissue: the skin becomes more transparent, revealing the underlying vessels.

Pigmented dark circles are the circular patches that appear around the eyes. They give the eyes a sad or tired look, lacking vivacity and vitality.

These are generally referred to as dark circles or pigmented circles.

There are in fact two shades of colour, corresponding to different causes and therefore to different treatments.

Where do dark circles come from?

Over time, the skin around the eyes becomes thinner, revealing dark circles that spoil the harmony of the eyes. Dark circles are caused by a combination of factors:

External factors

Mainly lack of sleep, stress, anxiety, smoking and excessive alcohol consumption. These reflect a poor lifestyle and affect the quality of the skin around the eyes, which takes on an unattractive colour.

Hereditary factors

Various scientific studies have shown that heredity is often at the root of the change in the colour of the eye contour that causes dark circles.

Skin ageing

As the amount of collagen and elastin responsible for the density and tone of the skin around the eyes decreases, the subcutaneous blood vessels become more visible, leading to purple, blue and red under-eye circles.

Dark circles look black, but they are never truly black.

What are the different types of dark circles?

The types of dark circles vary according to skin type and to specific factors. While some are generally due to fatigue or stress, they can also be linked to poor lymphatic drainage or to poor lifestyle habits. To treat them as well as possible, it is best to know which type of dark circle you have, so as to find the right treatment.

Blue circles

These dark circles have a blue or purplish colour, corresponding to the underlying veins. They appear as the skin and hypodermis become thinner, creating a transparent effect that also reveals the bony contours. The main aim of treatment is therefore to recreate volume and structure, restoring thickness and opacity between the epidermis and the vascularised subcutaneous tissues.

This treatment can be medical or surgical. However, hyaluronic acid injections are used only for very specific and limited indications.

Brown circles

These dark circles appear as circular patches tending towards brown, brownish-black or reddish-black. This colouration is linked to melanin-type pigment deposits: eumelanin appears black, pheomelanin red.

The aim of treatment is to lighten the skin and restore a clear, radiant look through photorejuvenation.

To mask this discolouration, Dr Hayot uses an innovative technique that has already proved its worth: nano-lipostructure, or nano-lipofilling. Not yet widely used in France, it aims to thicken and regenerate the eyelid skin using a solution of stem cells and growth factors taken from the patient’s own fat. This “fat juice” makes the skin less transparent and regenerates the hypodermis, making dark circles disappear.

Red circles

Red circles appear when small blood vessels dilate excessively (vasodilatation) within this area of the skin: as the epidermis around the eyes is very thin, the red colour is all the more visible. They should not be confused with hollow circles, which are caused by a loss of volume.

This red colour can also be explained by:

• Hereditary factors associated with age
• External factors: poor lifestyle, prolonged exposure to UV rays
• Certain conditions: anemia, allergies, conjunctivitis.

To treat red circles, Dr Hayot performs a variant of lipofilling: nano-lipofilling, a technique that harvests fat, recovers the stem cells and injects them into the eyelids.

How can dark circles be treated?

Treatment of dark circles aims to tackle the causes, either medically or surgically.

Surgical management of dark circles

For dark or pinkish circles, the aim of dark circle surgery is to recreate volume, in order to treat the hollow of the circle or the pigmented layer.

The technique of choice is lipofilling or microlipofilling, in which the surgeon takes a small amount of fat from the abdomen, for example, and reinjects it under the eye to fill the hollow. This is a procedure carried out with limited risks, discussed in consultation, as it uses the patient’s own fat. It is known as autologous fat grafting, and there is a very limited risk of rejection.

In many cases, this surgical treatment forms part of overall facial and eye surgery to restore youthfulness and radiance. It is possible to treat under-eye bags, correct an upper palpebral crease such as the Asian eye, or reshape cheekbones that are too hollow.

Medical management of dark circles

Hollow or blue circles

For the treatment of dark circles, some people wrongly recommend hyaluronic acid injections. In reality, there is a double risk:

• if the hyaluronic acid remains visible through the skin, light generates a blue reflection as it passes through the colloidal structure. This Tyndall effect accentuates the bluish hue of dark circles, making the treatment worse than the condition.
• As the skin is thin and the subcutaneous space reduced, hyaluronic acid swells by hydrophilicity, like a sponge. As it increases in volume, it distends the skin in the lower areas, eventually creating unsightly bags.

Treating dark circles depends on what causes them: the hollow, the pigment and the skin do not call for the same answer, and the choice is made after examination.

Brown circles

Fractional laser photorejuvenation aims to erase the pigment deposited in the epidermis or dermis of dark circles. However, using a laser close to the eyes is always delicate, despite the use of protective eyewear. Nanofilling is more effective: nanolipostructure thickens the skin, erasing the transparency effect. This innovative technique is widely used in the United States, although few practitioners in France use it as yet.

Yet it remains the treatment of choice for all dark circles, purplish circles and brown circles.