Lower eyelid dark circles have many causes and a targeted treatment is dependent upon an accurate analysis of the problem. Some “dark circles” occur due to shadows that are created by skin and soft tissue depressions of the lower eyelid skin. However, some patients may exhibit an increase in pigmentation of the skin due to the deposition of brown (melanin) pigment and/or iron deposits (hemosiderin) derived from red blood cells, deposited in the superficial and deep dermal layer of the lower eyelid skin. Often patients who have dark circles have a combination of “hollowing” and shadowing of the lower eyelid skin along with pigment deposits as described above. Therefore a combination of laser resurfacing,topical medications and injectable fillers are utilized to achieve improvement.
A: Dark circles can occur in all ethnic groups but are most commonly encountered in patients of Middle Eastern, Mediterranean, and Asian ethnicities.
A: If you have deep “hollowing” of the lower eyelid that creates shadows then your dark circles may be treated by adding tissue fillers like Restylane® or Belotero balance®, or Juvederm XC Voluma® beneath the skin to fill and raise the depressed tissue upward. This will decrease the shadowing effect of skin hollowing. If on the other hand, Doctor Kopelman determines that you have dark circles as a result of pigment deposits, then he first recommends topical skin bleaching agents that work synergistically – Elure®, a skin bleaching enzyme derived from mushrooms that breaks down pigment (melanin), Lumixyl® a decapeptide cream, and 4% hydroquinone, a topical cream, inhibits pigment producing cells (melanocytes) from producing pigment (melanin) in the skin combined with retinol (like Retin-A® cream)and a topical steroid cream before sleep. Elure® and Lumixyl® start to work immediately with improvement usually seen within two weeks while Hydroquinone works more slowly. It usually takes several weeks for hydroquinone to have a suppressive effect on pigment generating cells. Therefore, these agents work in a complimentary way. In addition, avoiding sun exposure and wearing polaroid sunglasses are important steps in diminishing dark circles as well as frequent applications of sunblock during the day are necessary to prevent the sun from stimulating the formation of melanin. If these drugs do not adequately diminish the appearance of dark circles then Dr. Kopelman will utilize skin lasers that target pigment. The Q-switched Alexandrite laser which selectively targets pigmented cells and sequential low energy Fraxel® laser treatments over several months are effective ways to reduce the pigment. Dr. Kopelman would be pleased to discuss the optimal therapeutic plan that is right for you.
Interested in learning more about how Dr. Kopelman can help reduce dark lower eyelid circles? Contact Ms. Anne Lembersky our patient care coordinator 201-444-4499 to arrange for an in-depth consultation to discover how topical treatments, dermal fillers, and laser therapy can help to improve lower eyelid dark circles.