What is a ring?

Unlike under-eye bags, which are similar to edema of the lower eyelids, dark circles (also known as the judo-palpebral fold) refer to variations in the color of the skin under the eyes. Their color varies because the skin is extremely thin in this area, and congestion of the vascular system is more visible.

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

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

Pigmented dark circles are defined as the circular spots that appear around the eyes. This is what gives the eyes a sad or tired look, lacking vivacity and vitality.

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

But there are actually two shades of color, corresponding to different causes and therefore different treatments.

Where do dark circles come from?

Over time, the skin around the eyes becomes thinner, revealing dark circles that detract from the harmonious appearance 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. The latter, which betray a poor lifestyle, adversely affect the quality of the skin around the eyes, which becomes colored in an unattractive way.

Hereditary factors

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

The skin aging process

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

Dark circles appear black, but they are never really black.

What are the different types of dark circles?

The types of dark circles vary according to skin type or specific factors. While some are generally due to fatigue or stress, they can also be linked to poor lymphatic drainage, or poor lifestyle habits. For the best possible treatment, it’s best to know your dark circle type, so you can find the right treatment for you.

Blue circles

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

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

Dark circles

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

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

To mask this dark-ring discoloration, 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 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) in the thickness of this area of the skin: as the epidermis around the eyes is very thin, the red color is even more visible. They should not be confused with hollow circles, caused by a loss of skin volume.

This red color 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 remove red circles, Dr Hayot performs a variant of lipofilling: nano-lipofilling, a technique that extracts fat, recovers stem cells and injects them into the eyelids.

How to combat dark circles?

Treatment of dark circles is aimed at tackling the causes, either medically or surgically.

Surgical management of dark circles

For dark or chili-pink circles, the aim of dark circle surgery is to recreate volume, to treat the hollow of the circle or the pigment 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 risk-free procedure, as it involves the patient’s own fat. This is called autologous fat grafting, and there is no risk of rejection.

In many cases, this surgical treatment is part of an overall face and eye surgery to restore youthfulness and radiance. It’s possible to treat bags under the eyes, correct an upper palpebral crease such as theAsian 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 mistakenly recommend hyaluronic acid injections. In reality, there is a double risk:

• if the hyaluronic acid remains visible through transparency, light will generate 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 disease.
• 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 declining areas, eventually creating unsightly bags.

To treat dark circles, the only safe and effective solution is microfilling/nanofilling.

Dark circles

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

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